PEMBROKSEHIRE photographer Gillian Mackay has shot her way to victory after being shortlisted for the highly acclaimed British Photography Awards, 2024.

Her stunning photograph, entitled ‘Ice Cream Please’ displays a wild pony harassing a lady who’s standing in a queue for an ice cream. And it certainly wowed this year’s selectors with the result that it has now been included in the awards’ Street Category section.

“I’m delighted and thrilled to be shortlisted for this, because it was certainly a surreal moment when I saw a wild pony harassing a lady in a queue for ice cream,” said Gillian.

Gillian’s focus has always been to try and catch things from an unusual perspective, which makes street photography her ideal genre. Her photographs sometimes include people in high contrast silhouette and sometimes she exposes the image for the person, and other times for the background. Her photographs often catch people in action, or when they are unaware of her presence, such as when they’re sitting alone on a public bench or, in this instance, queuing for an ice cream.

Street photography was first established by Henri Cartier-Bresson, when his aim was to catch random incidents in public places, rather than posed images. And it goes without saying that street photography can be taken anywhere in a public area, not just on the street.

Gillian, who is a member of the Tenby Camera Club, will be travelling to London for the awards ceremony which takes place in November.

The final winner will be chosen by a panel of judges, however there will also be a people’s award which can be visited on the British Photography Awards website.

GLANGWILI HOSPITAL in Carmarthen is set to face a surge in demand as it becomes the main provider of children’s healthcare services for the entire Dyfed region, following significant changes in paediatric care at Withybush Hospital in Pembrokeshire and Bronglais Hospital in Ceredigion. This centralisation has raised concerns about how Glangwili will manage the influx of young patients from all three counties: Carmarthenshire, Pembrokeshire, and Ceredigion.

The closure of the Paediatric Ambulatory Care Unit (PACU) at Withybush Hospital in Haverfordwest was recently made permanent, leaving families in Pembrokeshire without local access to hospital-based care for children. This decision came after the unit’s hours were reduced in 2016 and its services were “temporarily” transferred to Glangwili during the pandemic, only to never return. Hywel Dda University Health Board cited financial and staffing constraints as the main reasons for this closure, leaving Glangwili as the sole 24-hour inpatient paediatric facility in the region.

Adding to the strain, Hywel Dda University Health Board has announced that children requiring more than 24 hours of care at Bronglais Hospital in Aberystwyth will also be transferred to Glangwili, starting 1 November 2024. This temporary measure, expected to last six months, is a response to a shortage of paediatric nurses at Bronglais. However, families fear that the increased burden on Glangwili could have long-term consequences for children’s healthcare in Dyfed.

The announcement has been met with concern from local politicians and community members. Ceredigion MS Elin Jones described the decision as a “real shock,” warning of its impact on families in the region. “This will cause real concern to ripple through the community,” she remarked, emphasising the need to ensure the change remains temporary. Many residents also fear the decision sets a worrying precedent for the future of paediatric care in Ceredigion.

Dr. Gwen Rees criticised the decision, stating it could lead to “poorer health and wellbeing outcomes” due to limited access to inpatient care. Highlighting the challenges faced by families in rural areas, Dr. Rees noted that the transfer to Glangwili poses logistical and emotional difficulties, particularly for those living over an hour away.

With the upcoming changes, Glangwili Hospital now faces the task of providing paediatric care to the entirety of the former county of Dyfed. Encompassing Carmarthenshire, Pembrokeshire, and Ceredigion, this is a vast and largely rural area, making travel to the hospital difficult for many families. In some cases, parents may now face journeys of over an hour to access hospital care for their children, a situation that is particularly concerning for emergencies and those requiring ongoing treatment.

Parents and local campaigners have expressed their dismay, arguing that the centralisation of services at Glangwili could compromise the quality and timeliness of care for children across the region. Residents of Pembrokeshire and Ceredigion have already voiced their frustrations over the closure of Withybush’s PACU, pointing out that previous “temporary” reductions in services often become permanent. The prospect of Glangwili now having to handle patients from all three counties has only heightened their concerns about the sustainability of paediatric healthcare in west Wales.

In response, Hywel Dda University Health Board has assured the public that the changes are necessary to address staffing shortages and financial challenges while ensuring safe care delivery. Dr. Prem Kumar Pitchaikani, Clinical Director for Women & Children’s Services, emphasised that the adjustments at Bronglais are a “short-term operational change” meant to prioritise the safety of patients and staff. However, many families remain sceptical, especially given the history of gradual service reductions at Withybush.

The health board has also promised to support families affected by these changes, including providing designated ambulance vehicles and exploring other transport solutions. Despite these efforts, the reality of centralising care at Glangwili raises questions about how effectively the hospital can manage the increased patient load without compromising the level of care.

As the changes take effect, communities across Carmarthenshire, Pembrokeshire, and Ceredigion will be watching closely to see how Glangwili Hospital adapts to its new role as the main paediatric care provider for the entire Dyfed region.

HYWEL DDA University Health Board has approved a proposal to replace inpatient beds at Tregaron Community Hospital with enhanced community-based healthcare services. This decision comes after a public engagement exercise and is part of the Cylch Caron project aimed at transforming healthcare delivery in north Ceredigion.

The approved model will see the removal of nine inpatient beds at Tregaron Hospital, shifting focus to providing care in or close to patients’ homes. According to the health board, this move is designed to create a more sustainable, safer service across Ceredigion, improving patient care and allowing people to avoid hospital stays unless necessary. The model will allow staff to work in different ways, offering more support in the community and strengthening community-based nursing services.

A vision for integrated care

The Cylch Caron project, a collaborative effort between Ceredigion County Council, the health board, and the Welsh Government, plans to establish an integrated resource centre in Tregaron. This centre will bring together healthcare, social care, and housing services in a central hub for the town and its surrounding rural areas. The health board believes this model is already successful in south Ceredigion and will provide high-quality patient care by enhancing collaboration across healthcare and support services.

Peter Skitt, County Director for Ceredigion, acknowledged the emotional attachment the local community has to Tregaron Hospital. “We want to do the right thing for our patients and our staff who care for them, and this isn’t always by the traditional model of providing care in a hospital bed,” Skitt said. The health board aims to use the new model to support up to 40 people in their homes, compared to the nine patients who would be accommodated in hospital beds.

Despite the health board’s assurances, the plan to remove inpatient beds has sparked significant concern within the community and among local politicians. During the public engagement period, fears were raised about the future of healthcare services in Tregaron.

Elin Jones, Member of the Senedd for Ceredigion, and Ben Lake, the local MP, have been vocal in their concerns. They argue that the inpatient beds at Tregaron Hospital should remain until the new Cylch Caron centre is operational. “It was always expected that beds would remain in use at Tregaron Hospital until the Cylch Caron project was up and running,” said Elin Jones. The delay in the project’s completion, now expected to take another three to five years, has led to worries about a potential gap in healthcare provision.

Similarly, Tregaron Town Council has expressed “disappointment and anger” over the health board’s decision, stating that decommissioning the beds before the Cylch Caron project opens could dilute local healthcare resources. Tregaron County Councillor Ifan Davies described the hospital as a “special resource for the area,” emphasising its long-standing role in providing care to the community.

The Health Board’s justification

The health board, however, remains firm on the benefits of the new model. It argues that the change will help avoid the risks of hospital stays for patients who are medically fit to be in their home environments. The board has also noted that the staffing situation at Tregaron Hospital has become fragile, with recruitment efforts failing to address the shortages. “Despite efforts to recruit to positions, our current level of staffing is insufficient, and our staffing rotas are fragile,” said Skitt.

This proposal, according to the health board, is an opportunity to strengthen its resilience ahead of the winter months when healthcare services face significant pressures. By adopting the community care model now, they aim to avoid a situation where they might be forced to close beds without notice.

The transition to the new model of care will be phased. Current inpatients at Tregaron Hospital will follow normal discharge procedures, and further admissions will cease immediately. The hospital building will continue to serve as a hub for community staff and as a facility for outpatient services until the integrated resource centre is operational.

Dr Sion James, Deputy Medical Director of Primary Care and a local GP, supports the Cylch Caron vision. He describes the project as a unique opportunity to offer a range of services in a central hub for Tregaron and surrounding rural areas, aiming to create an innovative, sustainable model of community-based care.

While the new community healthcare model promises to provide enhanced nursing support in patients’ homes, local politicians and residents remain concerned about the potential loss of a valued healthcare facility. The health board’s assurances of a safer, more sustainable service will be tested in the coming months as Tregaron’s community adjusts to these changes. For many, the focus now shifts to how well the new model will meet the area’s healthcare needs in practice, especially as the Cylch Caron centre remains years away from completion.