Hywel Dda University Health Board has decided to close St Davids Surgery, leaving patients, especially the elderly with limited travel options, without access to local medical care. Nearly 3,000 patients in the UK’s smallest city are set to be transferred to other practices ahead of the surgery’s closure. St Davids will now be the only city in the UK without medical facilities.

The health board has resolved to relocate patients from the surgery in St Davids, Pembrokeshire, prior to its shutdown at the end of October. The decision follows the resignation of the practice’s sole GP, Dr Stephen Riley, who stepped down from the General Medical Services contract in April after failing to recruit new partners.

In June, 520 concerned residents attended an open day hosted by the health board to discuss the future of GP services, where a protest was staged. The overwhelming majority of the 2,728 patients, approximately 2,500, will be transferred to the surgery in Solva, which is managed by the health board. An additional 161 patients are expected to transfer to Fishguard, while 28 will go to the St Thomas’s practice in Haverfordwest and 26 to the town’s Winch Lane practice.

Jill Paterson, Director of Primary Care, informed a meeting on Thursday (Jul 25) that establishing a health board-managed surgery in St Davids would cost an extra £267,000 on top of the £586,000 annual cost of providing a GP service. Paterson noted that renaming the Solva practice could provide a sense of “ownership” for St Davids residents, suggesting the name “Peninsula Practice,” though final details remain undecided.

Neil Wooding, Chairman of the Health Board, stressed that the future of GP services in St Davids must be “affordable and sustainable.” The health board agreed to explore the possibility of establishing a branch surgery in St Davids, offering about 20 hours of nurse-led care and services such as phlebotomy and physiotherapy.

St Davids representative on Pembrokeshire County Council, Cllr Bethan Price said: “Obviously there is disappointment that the surgery is going. We will have a nurse led-practice in the city for 20-hours a week, but we do not know yet where this will be. There is concern about elderly and vulnerable people and transport, but at least we still have Solva surgery in the Peninsula.”

Senedd Member Paul Davies has condemned the health board’s decision, warning that relocating GP services could have devastating effects on patients, particularly the elderly and vulnerable who lack transport options. The board decided on 25th July 2024 to manage the dispersal of patients to surgeries in Solva, Fishguard, and Haverfordwest while continuing to develop a local branch surgery for limited services.

Davies stated, “I’m appalled that the Health Board has taken this decision. The Health Board is fully aware of the impact that this closure could have on patients, particularly those that are elderly, vulnerable, and have no means of transport to travel to a surgery further away. Whilst the Health Board has undertaken a consultation exercise, it’s clear that the views of patients haven’t been sufficiently addressed and many will have to travel further for vital treatment.”

He added, “It’s absolutely critical that the Welsh Government intervenes to support the local community. People living in St Davids should have access to GP services in their community, and the Welsh Government must now do everything possible to prevent this closure from happening. I will be raising this matter at the Senedd at the earliest opportunity.”

“For years, health services have been under threat across Pembrokeshire, which is fast becoming a blind spot for the Welsh Government and the Health Board. The people of Pembrokeshire deserve better, and we will keep fighting until this decision is overturned.”

In a detailed statement sent to the press on Thursday afternoon, Jill Paterson, Director of Primary Care said: “We recognise the strength of feeling in the community and the value which the community attach to retaining services as locally as possible.

“While the Board has decided that the best option to secure stable and sustainable services is to transfer the patients to other neighbouring practices, the Board also recognised that a branch surgery should be established in St David’s to address the concerns of those patients transferring to Solva Surgery who are concerned about travelling for appointments.

“The vast majority of patients including all those living in St David’s will be transferred to Solva Surgery at the end of October. 

“This represents an important step on the route to establishing a single Practice for the Peninsula, and reflects the ambition of the Peninsula Stakeholders Group which includes representatives from St David’s City Council and Solva and Llanrhian Community Councils.  

“The Health Board is grateful for the ongoing contributions of local representatives and other stakeholders to the longer-term vision of a single Peninsula Practice for the wider community.

“We would like to thank Dr Stephen Riley and his team and for the care that they have provided over the years. We very much appreciate the continuing support given by the Community to the team at St David’s Surgery throughout this challenging period.”

Ms Paterson explained that a Panel met twice during the process to consider the available options, both before and after the engagement period. 

“After carefully considering all feedback, the Panel supported a recommendation whereby patients of St David’s Surgery would be allocated to another GP practice closest to their home address,” Ms Paterson said.

“For the vast majority of patients this will mean transferring to the neighbouring Solva Surgery, which is a Health Board Managed Practice, with those patients living closer to Fishguard and Haverfordwest being allocated to practices at those locations.

“St David’s staff will be transferring over to Solva Surgery and we will be making internal alterations to the building to ensure it can accommodate the additional patients and staff.

“We feel that this solution will be achievable by the beginning of November when the contract terminates and would allow for a safe, sustainable and secure model to be established for the future.”

Ms Paterson continued: “We understand local people will want to know what the future of their GP services will look like, and we will be writing to all patients and stakeholders to inform them of the outcome and to share details and services for their new practice.”