Health
Health board confirms major hospital changes across west Wales
Emergency surgery centralised as Withybush role shifts toward planned care
MAJOR changes to hospital services across west Wales have been approved following an extraordinary meeting of Hywel Dda University Health Board on Thursday (Feb 19).
Board members agreed the next steps in the organisation’s Clinical Services Plan, covering nine services identified as under pressure or “fragile”, including emergency general surgery, critical care, stroke and orthopaedics.
The decisions will see some specialist services concentrated on fewer hospital sites, alongside plans to expand planned care at Prince Philip Hospital in Llanelli and Withybush Hospital in Haverfordwest.
Health chiefs stressed that no immediate changes would take place, with implementation expected to happen gradually over several years.

Consultation and decision process
During summer 2025, the Health Board carried out a major public consultation involving more than 4,000 questionnaire responses and engagement events attended by over 4,000 people.
An independent report produced by Opinion Research Services summarised the feedback, while board members also considered workforce pressures, clinical standards, estate issues and financial factors.
Twenty-two alternative proposals submitted by the public were formally assessed against criteria including sustainability, accessibility and deliverability.
Emergency surgery changes
Under the plans, emergency general surgery operations will be concentrated at Glangwili Hospital in Carmarthen and Bronglais Hospital in Aberystwyth.
Patients from Pembrokeshire requiring surgery will be transferred to Glangwili when operative treatment is needed.
However, emergency departments will continue operating as normal at all four hospitals.

Other service changes
Across the region, the approved direction includes:
• Intensive care units remaining at Bronglais, Glangwili and Withybush, with Prince Philip Hospital providing enhanced care for less critically ill patients.
• Dermatology services primarily based at Prince Philip Hospital, supported by community clinics and telemedicine.
• Endoscopy procedures brought together at Prince Philip while retaining bowel screening across sites.
• Ophthalmology services concentrated mainly at Glangwili with community provision elsewhere.
• Orthopaedic surgery expanding at Withybush for less complex procedures.
• Radiology retaining emergency imaging at all hospitals with new diagnostic hubs planned.
• Urology inpatient care centralised at Prince Philip Hospital.
Stroke services remain under review, with further public engagement planned before final decisions.

Future role of hospitals
The Board confirmed the intended future roles of the four main hospitals:
• Bronglais Hospital — broad range of services.
• Glangwili Hospital — increasing focus on acute and emergency care.
• Prince Philip Hospital — expanding planned care role.
• Withybush Hospital — increased planned care activity while continuing initial emergency access.
Health leaders emphasised there would be no change to how patients access emergency departments or minor injury units.
Board leaders respond
Health Board Chair Dr Neil Wooding said the changes were necessary to secure services for the future.
“Our ambition is for people to live healthier lives for longer by supporting people to keep well and preventing ill health,” he said.
“These decisions are not easy, but as a Board we have a duty to ensure that our services provide the best outcomes for our patients and meet the highest standards.”
Lee Davies, Executive Director of Strategy and Planning, said most services now had a clear direction.
“Our priority is always to deliver the highest standards of care for our patients across Hywel Dda and neighbouring communities,” he said.
Next steps
Detailed implementation plans will now be developed, with further engagement expected in areas where decisions are not yet finalised, particularly stroke services.
Patients are being advised to continue attending appointments as normal while the changes are planned.
More information, including board papers and meeting recordings, is available via the Health Board website.
Health
Have your say on new West Wales learning disability strategy
RESIDENTS across Ceredigion, Pembrokeshire and Carmarthenshire are being invited to help shape a new regional Learning Disability Strategy.
Views sought on five-year plan
The strategy, covering 2026 to 2031, will set out the future direction of services and support for neurodivergent people and people with a learning disability across west Wales.
Over the past two years, Ceredigion County Council, Pembrokeshire County Council, Carmarthenshire County Council and Hywel Dda University Health Board have been working with people with lived experience to help shape the proposals.
At present, each county has its own Learning Disability Strategy. The new plan would bring these together into one regional approach, aimed at making services more consistent and joined-up across the three counties.
The draft recommendations have been developed and reviewed by the Regional Improving Lives Partnership, which includes the three county councils, Hywel Dda University Health Board, The Dream Team, Carmarthenshire People First, Pembrokeshire People First, the West Wales Regional Partnership, and projects funded through the Regional Integration Fund.
Cllr Alun Williams, Ceredigion County Council Cabinet Member for Through Age Wellbeing, said: “We’re committed to ensuring that people with a learning disability and neurodivergent people are at the heart of shaping services that affect them.
“We encourage everyone to take part and share their views to help us develop a strategy that truly meets the needs of communities across West Wales.”
The consultation is open until Sunday, July 5.
Residents can complete the West Wales Learning Disability Strategy Survey online, or request a paper copy from a Ceredigion library or leisure centre. Paper copies can also be requested by calling 01437 764551 or emailing [email protected].
Completed questionnaires should be returned to Norman Industries, Units 1-2, Snowdrop Lane, Haverfordwest, Pembrokeshire, SA61 1JB.

Health
Withybush Emergency Department wins national award for green improvements
WITHYBUSH HOSPITAL’S Emergency Department has won national recognition for work to cut waste, reduce emissions and save money.
The department, based at Hywel Dda University Health Board’s Withybush Hospital in Haverfordwest, has been awarded Bronze accreditation by the Royal College of Emergency Medicine as part of its Green ED programme.
The scheme recognises emergency departments which introduce practical changes to reduce their environmental impact while maintaining safe patient care.
At Withybush, the work was led by a small team made up of consultant Dr Vicki Hughes, resident doctor Dr Lizzie Caisley, ED secretary Janet Bird, and ED clinical fellow Dr Oyewale Osundeyi.
Their changes included replacing plastic medicine pots with paper alternatives, reducing unnecessary cannulas, improving waste segregation, and reviewing computer screen brightness and older equipment to identify where energy savings could be made.
Dr Osundeyi led a project to increase recycling and reduce waste sent for incineration.
He said: “Trying to reduce waste comes with a lot of challenges, because you are trying to change people’s habits and trying to make sure people understand the importance, but we were lucky to get a lot of people involved from the estates team to the nursing departments who helped us achieve this.”
The department also targeted unnecessary coagulation testing in admission bloods, a project led by Dr Caisley.
The change is expected to save around £30,000 a year, as well as cutting carbon emissions.
Dr Caisley said: “By reviewing our routine practices, I was able to identify simple changes that benefit both patients and the environment. It shows how quality improvement work can deliver meaningful financial and environmental savings.”
ED secretary Janet Bird supported the work by gathering information, co-ordinating meetings and helping to put sustainability plans into action.
She said she also created a Green ED information board and presented the programme at resident doctor induction sessions to raise awareness of the changes already introduced.
Dr Hughes said: “A group of individuals, cutting across resident doctors, nurses, administrative staff, and myself as a senior consultant, all got involved in this work.
“There were many different elements to achieving this bronze award. The next step is making sure the team is supported to build on it.”
Withybush was one of eleven emergency departments across England and Wales recognised through the programme.
Together, those departments are estimated to have achieved £216,000 in cost savings and 131,502kg of CO2e savings through more sustainable working practices.
Dr Ian Higginson, President of the Royal College of Emergency Medicine, said: “On behalf of the College – a massive congratulations to the team at Withybush General Hospital who have been awarded a Bronze accreditation through our GreenED programme.
“This accomplishment has been driven by a dedicated, innovative team, who have reduced emissions, as well as waste and saved costs – all to tackle the climate crisis.
“A healthier planet means healthier patients, and we have a duty to act to protect both.
“As a College, we are proud to support Emergency Departments across the UK, and beyond, in playing their part to become more environmentally friendly.”
Health
NHS waiting lists falling — but west Wales faces fresh healthcare uncertainty
Improving treatment figures welcomed, but local concerns grow over pharmacy changes, service reorganisation and access to care
WAITING times across NHS Wales are continuing to improve, according to the latest national figures — but patients in west Wales may question whether those improvements are being felt on the ground as concerns continue over changing local services, pharmacy provision and healthcare access.

New figures released by the Welsh Government show there were just under 666,700 referral-to-treatment patient pathways waiting to start treatment in March — down by around 21,300 compared with February and the lowest level recorded since August 2021.
It marks the tenth consecutive month that waiting lists have fallen, while the proportion of pathways waiting less than 26 weeks rose to 65.9 per cent — the highest figure since May 2020.
The average waiting time for treatment also dropped to 15.5 weeks, the lowest level since April 2020.
However, despite the improving national picture, NHS leaders have warned that Wales remains under significant pressure and that progress must not mask wider challenges facing the health service.
Responding to the figures, the Welsh NHS Confederation said scheduled care was “going in the right direction” but cautioned that emergency pressures, social care pressures and financial constraints remain major concerns.
The organisation’s director, Darren Hughes, said NHS leaders were ready to work with the new Welsh Government as part of its first 100 days in office, but stressed that reforms would require difficult decisions and honest conversations with the public.
He said: “While it’s not a perfect picture across the board, with high demand on urgent and emergency care, scheduled care waits continue to go in the right direction.
“Now is the time to build on this progress and make further inroads into the backlog of care that has built up in recent years.”
But for many people in Pembrokeshire, Carmarthenshire and Ceredigion, improving national statistics may feel at odds with the reality of healthcare closer to home.
Recent changes affecting community pharmacy provision, alongside continuing concerns over access to services, travel distances and healthcare reorganisation within the Hywel Dda University Health Board area, have left some residents questioning whether NHS recovery is being experienced equally across Wales.
Community pharmacy provision has become an increasing concern locally following recent changes affecting some chemist services, raising fears over access to medication and frontline healthcare support — particularly in rural areas where alternatives may involve lengthy travel.
At the same time, debates around the future location of services, staffing shortages and the long-term sustainability of care in west Wales continue to generate concern among patients and campaigners.
For many residents, the NHS debate is no longer only about waiting times — but whether services remain accessible in the first place.
The figures also require some caution. NHS waiting-list totals are measured in “patient pathways” rather than individual patients, meaning one person can appear on the list more than once if waiting for multiple treatments or appointments.
The Welsh NHS Confederation warned that any future improvements would need a “whole-system approach”, involving primary care, community healthcare and social care, alongside action to reduce demand before patients require hospital treatment.
Mr Hughes added that NHS organisations also face tightening budgets and renewed inflationary pressures linked to global events.
He warned: “NHS leaders will need clarity from political leaders on a focused set of priorities and the backing to make the difficult decisions required to reform services, being honest with the public around timelines and expectations.”
Professor Jon Barry, Director in Wales at the Royal College of Surgeons of England (RCS England), said: “The new Welsh Government inherits a significant challenge, and these figures reflect the reality across Wales – long waits, repeated delays, and too many people left in pain.
“There were commitments during the election campaign to develop a clear plan for expanding elective capacity, including early work to establish new surgical hubs across Wales. The priority now is to start delivering on those plans without delay.
“More surgical hubs will help bring down long waits and ensure fewer patients are left dealing with uncertainty and disruption to their daily lives while they wait for treatment.”
The Herald has approached Hywel Dda University Health Board for comment on how improving national waiting-time figures compare with the experience of patients in west Wales, including concerns around pharmacy provision, service changes and access to local care.
The Welsh Government has also been asked what the new administration’s healthcare priorities will mean for communities in rural Wales over the coming months.
Welsh Government response
The Welsh Government said it had pledged to “pick up the pace” to ensure people across Wales are seen faster for NHS treatment.
Health and Care Minister Mabon ap Gwynfor said: “Too many people are waiting too long for NHS treatment. That is the reality and it is an issue we are determined to fix.
“It is people’s lives we are talking about – and my job is to make sure the Welsh Government works closely with the NHS to ensure people who need treatment get it much quicker.”
The new minister said improvements were needed not only in waiting lists, but also in ambulance response times and emergency department access.
The Welsh Government said it would commission an independent review of NHS performance in Wales within its first 100 days, with a particular focus on the impact of waiting lists on population health.
It also plans to set up an expert task group to develop plans for up to ten new elective care hubs across Wales, with a delivery plan due by the end of 2026.
Mr ap Gwynfor added: “Today’s figures are a starting point. We will be honest with the people of Wales about the progress we make, and we will rightly be judged on results. We intend to meet the scale of the challenge ahead.”
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