Calls for full consultation after Health Board backs merged option

FEARS are mounting over the future of stroke services in west Wales after Hywel Dda University Health Board backed a new configuration that could see specialist treatment centralised in Carmarthen, with patients in Ceredigion facing transfer from Aberystwyth.

At a meeting on Thursday (Feb 19), the Health Board rejected both of its original consultation options but voted in favour of a new “merged” proposal — known as Option 106/210 — which would place the main specialist stroke unit at Glangwili Hospital in Carmarthen rather than Prince Philip Hospital in Llanelli.

Under the proposal, Bronglais Hospital in Aberystwyth would operate a Treat and Transfer model alongside a stroke rehabilitation service, meaning many acute stroke patients would initially be treated locally before being transferred for specialist care.

Ceredigion MS Elin Jones has welcomed the decision to move the main unit to Glangwili rather than Llanelli but warned that significant questions remain unanswered about what the new plans would mean in practice.

She said: “There is now considerable confusion around what may be proposed for stroke patients at Bronglais. Whilst Glangwili now seems likely to be the location of the Board’s main Stroke Unit rather than Llanelli, it’s less certain what the rehabilitation service proposed for Bronglais will entail.

“People in the Teifi Valley will be much better served by a Glangwili unit rather than face transfer to Llanelli. However, for Bronglais, the Treat and Transfer model remains in the new proposal, and no clarity has been proposed on how a safe and dedicated model of transfer for very ill stroke patients will be guaranteed.

“People will also want to know what a longer-term rehabilitation service at Bronglais will look like.”

Ms Jones said the Health Board must now produce a detailed alternative proposal followed by a full public consultation, including clear plans for ambulance transfers.

“At the very least we need now to get a detailed alternative proposal from the Health Board and there needs to be a meaningful formal consultation on the new proposal. This time it also needs to have a detailed plan for how ambulance transfer would be achieved,” she added.

Similar concerns have been raised by the Welsh Liberal Democrats, who argue that the new configuration still risks disadvantaging rural communities in mid and north Ceredigion.

Sandra Jervis, the party’s Senedd candidate for Ceredigion Penfro, said it remained “a deep disappointment” that Bronglais was being pushed towards a Treat and Transfer model.

“Whilst locating the 24-hour stroke unit at Glangwili Hospital is clearly more sensible than Prince Philip, it still does nothing to address the needs of patients in the north of Ceredigion and the wider rural Mid Wales catchment served by Bronglais,” she said.

“The unanswered transport concerns of so many residents remain exactly that, unanswered. Families are rightly worried about long journeys at the most frightening moments of their lives, and the Health Board has yet to provide clear guarantees on how safe and timely transfers will be delivered.”

She added that residents understood what Treat and Transfer meant in practice — the centralisation of acute services away from Aberystwyth — and the real issue was whether rural communities were being “short-changed”.

Stroke services have been one of the most contentious healthcare issues in the Hywel Dda area for several years, with campaigners repeatedly warning that longer travel times could affect outcomes for patients in remote areas.

The Health Board is expected to develop the merged proposal further before any formal consultation begins.

Health chiefs say the aim of the changes is to improve clinical outcomes by concentrating specialist expertise, but critics argue that geography and ambulance capacity must be fully addressed before any final decision is made.

THURSDAY’S health board decision to downgrade the emergency general surgery service at Pembrokeshire’s Withybush hospital has been condemned by local politicians.

Last year, Hywel Dda University Health Board consulted with its communities on options for change in critical care, dermatology, emergency general surgery, endoscopy, ophthalmology, orthopaedics, stroke, radiology and urology.

It said its Clinical Services Plan focuses on nine healthcare services that are “fragile and in need of change”.

These nine clinical services were selected because of risks to them being able to continue to offer safe, high-quality services, or care in a timely manner, the board has previously said.

The proposed changes included an option for Withybush patients needing specialist critical care being transferred to Glangwili.

At a two-day meeting into the proposed changes, held on February 18 and 19, the board backed changes into emergency general surgery which will see no emergency general surgery operations taking place at Withybush, but a strengthening of the same-day emergency care (SDEC).

For the other three hospitals, there would be no change in emergency general surgery provision, other than a strengthening of SDEC at Glangwili.

Members stressed the changes would not happen overnight.

Reacting to the decision, local MP Henry Tufnell described it as “another blow for access to healthcare in Pembrokeshire,” adding:  As your MP, I will continue to do everything in my power to fight for improvements to our essential services. I’ll be urging the Health Board to revisit this awful decision on emergency services.”

Plaid Cymru candidate for the forthcoming Senedd elections Kerry Ferguson called on the Health Board to reconsider its decision.

“We are so disappointed with the Health Board’s decision to remove the current emergency general services from Withybush. Whilst the Board has committed to maintaining and strengthening Same Day Emergency Care, residents of west Pembrokeshire will still face at least an hour’s journey to receive emergency operations or significant treatment.

“Residents in Pembrokeshire are rightly worried and anxious about the services Withybush might lose, and losing their emergency general services is a huge blow.

“I call on the Health Board to urgently reconsider their decision, and to take into account the risks and impact that implementing option A will have on residents of Pembrokeshire.”

Local Conservative politicians have also reacted angrily to the Withybush decision, along with changes to the stroke service provision at Ceredigion’s Aberystwyth-based Bronglais hospital.

Local Welsh Conservative Senedd Member, Paul Davies MS said: “I’m appalled that Hywel Dda University Health Board has voted to remove general emergency surgery services from Withybush hospital – but I’m not surprised.

“The Health Board is obsessed with removing services from Pembrokeshire and has spent years downgrading and removing services from Withybush hospital. As one constituent has rightly said, the Board should be rebranded the Carmarthenshire Health Board, as it continues to strip assets from other hospitals in west Wales.

“Removing general emergency surgery services critically undermines the sustainability of Withybush hospital’s A and E department and will result in patients having to be transported for urgent treatment. This is not acceptable – I will be taking this to the Welsh Government and urging Ministers to intervene and stop the Health Board from making this catastrophic decision.”

Fellow Pembrokeshire Conservative Senedd Member Samuel Kurtz MS said: “Residents in Pembrokeshire and Ceredigion are being treated like second class citizens, as it is always us in the West that has to see our services cut.
“The salami slicing of services is exactly what the Labour government have wanted, and the health board are delivering. This is a sad day, and residents will rightly be angry and concerned.”

Withybush to provide initial treatment before specialist care elsewhere

PEMBROKESHIRE patients who suffer a stroke are set to be transferred out of county for specialist treatment under major changes approved this week by Hywel Dda University Health Board.

Under the new model, patients suspected of having a stroke will continue to receive initial assessment and emergency treatment at Withybush Hospital.

However, those requiring specialist stroke care will then be transferred to Glangwili Hospital in Carmarthen, which is expected to become the main specialist stroke centre for the region.

Health leaders say concentrating specialist services in one location will improve outcomes by ensuring patients are treated by dedicated teams with greater expertise and availability.

Concerns about travel times

The changes are likely to raise concerns in Pembrokeshire, where travel distances to Carmarthen can be significant and ambulance journeys lengthy, particularly from rural communities.

Stroke treatment is highly time-critical, with outcomes often depending on how quickly specialist care can be delivered.

Campaigners have previously warned that longer transfer times could increase risks for patients in remote parts of west Wales.

Local care still provided

Health officials stress that Withybush Hospital will continue to play an important role in stroke care.

Patients will still receive emergency assessment, stabilisation and initial treatment locally before transfer if specialist intervention is required.

Where appropriate, patients may later be transferred back closer to home for recovery.

Regional plans still developing

As part of the wider changes across west Wales, proposals to develop enhanced stroke rehabilitation services at Bronglais Hospital in Aberystwyth remain subject to further risk assessment and community consultation.

No final decision has yet been confirmed.

Changing role of Withybush

The stroke changes represent another shift in how services are delivered at Withybush Hospital, with specialist treatment increasingly concentrated at larger centres elsewhere in the region.

The hospital will continue to provide a 24-hour emergency department, diagnostics and other core services, but the way patients access specialist care is evolving.