New plan promises more care closer to home, ‘Digital First’ services, and stronger focus on prevention

HYWEL DDA UNIVERSITY HEALTH BOARD will consider a refreshed version of its long-term health and care strategy at a public board meeting on Thursday (Jan 29).

The proposed strategy, titled A Healthier Mid and West Wales – Healthier lives, well lived, sets out the Health Board’s priorities up to 2040 and updates ambitions first published in 2018.

Health chiefs say the refreshed plan does not change Hywel Dda’s core aim of helping people live healthier lives for longer, with a stronger emphasis on preventing ill-health and supporting people to stay well. Instead, it updates the strategy to reflect changing needs across the region, alongside wider pressures on health and care services including rising demand and the lasting impact of the COVID-19 pandemic.

The strategy sets out how clinical developments, new digital tools and community facilities could provide more opportunities to offer help earlier and closer to home, while outlining how services may need to adapt in the years ahead.

Hywel Dda said the draft refresh has been shaped by engagement with communities, staff and partners across Carmarthenshire, Ceredigion and Pembrokeshire. The engagement took place in two phases between July and November 2025 and involved almost 3,000 people.

Residents were asked what matters most to them in living a healthier life, as well as being invited to share views on priorities for health and care. The Health Board said feedback was used to develop four key themes which underpin the refreshed strategy: thriving teams, healthier communities, great care and positive futures.

During the engagement, people consistently raised concerns about the distance they have to travel to access healthcare. The Health Board said the refreshed strategy aims to deliver more care closer to where people live, with greater support in communities and at home.

The plan also outlines an expanded role for digital services, including easier access to advice, appointment booking and test results. The Health Board said it intends to create a ‘Digital First’ service designed to connect homes, communities and hospitals.

The refreshed strategy also builds on work started in 2018 on a Social Model for Health and Wellbeing, which aims to shift services away from mainly reacting to illness and towards preventing ill-health earlier, with prevention described as a central priority for improving health and reducing long-term demand.

Hywel Dda Chief Executive Professor Phil Kloer said: “Our communities have been clear about what matters most to them. People want fair access to care, strong local services, and support to stay well in their daily lives.

“This proposed strategy refresh is about listening to that feedback and setting a clear direction for how we work together over the next 15 years. Our strategy focuses on health and keeping people well, not just treating illness.

“It is also guided by our values of belonging, growth and working together. These values continue to emphasise the importance of putting people first, improving our services, and supporting each other to deliver the best care possible.

“We will continue to work with our communities and the individuals who play a vital role in shaping our social model for health and wellbeing.”

Lee Davies, Hywel Dda’s Executive Director of Strategy and Planning, said delivering the refreshed plan would require “a more radical approach” to how care is provided.

He said: “The principles of our 2018 strategy remain the same, but the world around us has changed. This refresh ensures our vision, goals and priorities reflect today’s challenges and opportunities.

“We will continue to move towards prevention, wellbeing and primary and community care, supported by digital solutions where appropriate. Most importantly, it shows how what people told us is being reflected in our plans.”

The Health Board said that if the refreshed strategy is approved, it will be finalised and published in multiple accessible formats. Work with communities, staff and partners would continue as delivery plans are developed, and the strategy would be regularly reviewed to reflect changes and developments in health needs across the region.

50% jump from March as Health Board says charges must increase to maintain “high-quality care”

WITHYBUSH HOSPITAL staff with young children have raised concerns over a steep rise in crèche fees which they say could leave some parents questioning whether it is worth staying in work.

Hywel Dda University Health Board has confirmed the hourly rate at the Withybush Crèche will increase from £4.50 per hour to £6.50 per hour from March 2026.

Parents told The Herald the increase will hit families with children under three particularly hard, as they do not qualify for the same level of childcare support available to older children.

One parent of a two-year-old said the change could add around £450 a month for parents using the service five days a week, warning that once childcare is taken into account, their partner — who works in an administrative role at the hospital — would effectively be “working for £20 a day”.

In a statement, Andrew Carruthers, Chief Operating Officer at Hywel Dda University Health Board said: “From March 2026, we will need to increase the hourly rate for our childcare fees at Withybush Crèche from £4.50 per hour to £6.50 per hour, which is broadly in line with other local service providers. Our fees have remained the same for several years, but to continue to provide the high-quality care children attending our crèche deserve, we now need to make this adjustment.

“This decision has not been taken lightly and follows a rigorous review into how we could offer best value for money for parents using the service.

“We have sent letters to parents explaining the changes and are inviting parents who have any questions or would like to talk this through to get in touch with us.”

Health board paper recommends moving 4,350 patients to nearby surgeries from 30 June 2026 as staffing and building pressures continue.

HYWEL DDA HEALTH BOARD is set to consider the future delivery of GP services for patients registered at Meddygfa’r Sarn, Pontyates, at a public Board meeting on Thursday, January 29.

A paper due to be discussed recommends a managed dispersal of the practice list to neighbouring surgeries from June 30, 2026, with patients transferred to another practice closest to their home address.

Meddygfa’r Sarn has been health board managed since 2017, after the former GP partners resigned the practice’s General Medical Services (GMS) contract. Since then, Hywel Dda has been responsible for services for a registered population of around 4,350 patients.

The health board says the practice has faced ongoing staffing difficulties and currently has no permanently employed doctors. It also describes the building as small, with limited facilities.

In October 2025, the board convened a Vacant Practice Panel in line with national guidance to review long-term options for GP provision in the area, considering patient access, workforce sustainability, premises, quality of care and financial issues.

The panel concluded that a managed dispersal offered the most sustainable long-term solution for patients and primary care services in the Amman Gwendraeth area.

If approved, patients would be transferred to nearby practices including Coalbrook Surgery (Pontyberem) and Meddygfa Minafon (Kidwelly), with a smaller number moving to practices in Llanelli.

Andrew Carruthers, Hywel Dda’s Chief Operating Officer, said the health board has a duty to ensure GP services are safe, sustainable and high quality, adding that Meddygfa’r Sarn has struggled to provide the level of continuity of care the board would like.

He said that if the recommendation is approved, the health board would engage with patients, staff, local communities and stakeholders before any changes are implemented.

The Board meeting will take place at 9.30am on Thursday, January 29, at Ceredigion County Council Chambers, Aberaeron, and will be streamed live online.