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Health

Board approves new community healthcare model for West Wales hospital

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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.

Health

UK fertility rates falling: Welsh counties among worst-hit, new data shows

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Two-thirds predict family sizes will shrink even further by 2040

NEW figures released by Fertility Family reveal that parts of Wales have seen some of the steepest declines in fertility rates across the UK, with the Isle of Anglesey recording a drop of more than 44% over the past 15 years.

The Beyond the Birth Rate report combines official birth statistics with survey data to explore why fewer people are choosing to have children – and why they’re waiting longer when they do.

Wales’ top ten fertility declines

The study identified the ten Welsh areas most affected by declining birth rates. The Isle of Anglesey tops the list with a fall of 44.21%, followed by Wrexham, Caerphilly and Merthyr Tydfil – all of which have seen declines of more than 27%.

RankAreaFertility rate decline
1Isle of Anglesey-44.21%
2Wrexham-31.01%
3Caerphilly-27.74%
4Merthyr Tydfil-27.53%
5Powys-26.17%
6Conwy-25.45%
7Pembrokeshire-24.46%
8Denbighshire-24.35%
9Cardiff-23.54%
10Blaenau Gwent-23.18%

Newport recorded the smallest decline in Wales, with a drop of just 8.6%.

How does the rest of the UK compare?

London has mirrored Wales’ dramatic decline, with boroughs such as Southwark also showing a 44.21% drop in fertility rates. However, some parts of England have been less affected.

Colchester has seen the smallest national drop, at just -3.95%, while other areas such as Runnymede (-5.19%), Lancaster (-6.04%), and Gravesham (-7.07%) have remained relatively stable.

Financial pressure tops list of reasons

The report suggests that the primary driver behind shrinking family sizes is economic hardship.

  • 40% of people said financial stability was the key reason for delaying children.
  • 23% described starting a family as simply unaffordable.
  • 60% of respondents believe this financial strain is a major factor behind the rising age of first-time mothers.

Why are people waiting longer?

In addition to economic challenges, lifestyle and societal shifts are also playing a major role:

  • 47% cited career ambitions and workplace pressures.
  • 44% blamed difficulties in finding the right partner.
  • 34% pointed to the housing crisis and lack of affordable homes.

These factors are leading to more people having children later in life – a decision which often reduces fertility and the total number of children they may have.

Smaller families likely the future

Over the past 15 years, the UK’s overall fertility rate has declined by 26.9%. That means for every two women of childbearing age, one fewer child is being born.

Looking ahead, 67% of people surveyed expect family sizes to shrink even further in the next 10 to 20 years.

The study also revealed:

  • 40.7% believe more single parents will have children independently.
  • 20.5% expect an increase in adoption and surrogacy.
  • 14.9% foresee co-parenting arrangements becoming more common.
  • A striking 47% said they believe more people will choose not to have children at all.

With both economic and social factors contributing to the trend, the report paints a clear picture: the traditional family model in the UK is evolving – and quickly.

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Health

NHS performance in Wales ‘a mixed bag’ as latest figures released

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THE NUMBER of Welsh NHS patients waiting more than two years for treatment has fallen by 26%, according to data released by the Welsh Government on Thursday, April 17.

However, waiting times for ambulances have increased, while A&E performance continues to be under severe pressure.

The latest NHS statistics for Wales revealed that the NHS treatment waiting list remains at 793,946 pathways. 

 Two-year waits are 15,005 in Wales, compared with only 161 in England. The Labour Health Minister, now First Minister, Eluned Morgan, promised to eliminate these waits by March 2023 and again by March 2024 but failed to meet these targets. The target remains a long way off from being met.

The Welsh Government’s Cabinet Secretary for Health and Social Care, Jeremy Miles, said: “I am very happy to see a significant fall in the longest waits and the overall size of the waiting list falling for the third month in a row.

“This shows what can be achieved when health boards focus on delivering services, including faster treatment and increased NHS capacity, by embracing new ways of working.

“Those efforts have been supported by our £50m additional investment.

“We still have more work to do to reach our ambitious targets, but it is encouraging to see waiting times consistently falling.

“Two-year waits have fallen to their lowest levels since June 2021 and were more than 26% lower compared to the previous month.”

However, the NHS in England has already eliminated two-year waits. At the same time, a significant number of specialisms in Wales, including orthopaedic care, are excluded from the waiting time data.

Jeremy Miles continued: “The number of pathways waiting more than a year for their first outpatient appointment has fallen for a third consecutive month and is nearly 28% lower than the peak in August 2022.

“The number of patient pathways waiting 36 weeks and the average time waiting for treatment were both lower than the previous month.

“Performance improved against the 62-day cancer target in February, increasing to more than 60%, whilst 1,800 people started cancer treatment and 13,000 people were told the good news they did not have cancer.

“A significant improvement was achieved in March in reducing the total number of delayed hospital discharges, with a drop of 114 delays over the previous month. This was the lowest delay figure over the past year and the overall second lowest since reporting began two years ago.”

However, despite the Welsh Government blowing its own trumpet, performance still lags far behind the already poor performance of the Welsh NHS against targets preceding the Covid pandemic.

James Evans MS, Welsh Conservative Shadow Cabinet Secretary for Health and Social Care, said: “Labour Ministers will try to claim success today, but these statistics are worse than a mixed bag.

“The reduction in two-year waits is welcome, but the fact that they still exist at all, when they haven’t for so many months in England, coupled with worsening ambulance response times, is a testament to Labour’s failure to meet their targets.

“The Welsh Conservatives want to see improvements across the board and we can only achieve that by removing restrictions to cross-border, cross-community and cross-sector capacity sharing and by, flnally, enacting a long-term workforce plan.”

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Education

Calls for all Pembrokeshire schools to have EpiPens on site

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A CALL to develop a group to look at a Pembrokeshire-wide policy on schools stocking potentially life-saving EpiPens has been deferred, awaiting the outcome of a Welsh Government scoping exercise.

The current Welsh Government position on emergency adrenaline auto-injectors, commonly known as EpiPens, is different from England, where it was mandatory for schools to hold a stock.

EpiPens are commonly used in the emergency treatment of Anaphylaxis, a severe allergic reaction that can be life-threatening.

Welsh Government guidance allows schools to obtain adrenaline auto-injectors (AAIs) without prescription for emergency use, with Pembrokeshire favouring a school-led decision rather than an authority-led one, replicating Welsh Government guidance.

A call to review the county policy was heard at the April meeting of Pembrokeshire County Council’s Schools and Learning Overview committee following a request from Independent Group leader Cllr Huw Murphy.

Cllr Murphy had said: “Ysgol Bro Ingli H&S Committee met on April 1 to review existing policies, one of which was the First Aid policy. The document provided is the Ysgol Bro Ingli First Aid Policy, which appears to be an adaptation of a generic PCC First Aid document sent to all PCC schools to adapt/implement as appropriate.

“It was highlighted at this meeting that the subject of ‘EpiPens’ was absent, and it appears that PCC may not have developed a county-wide policy on this subject to date, which I think needs scrutiny. At present the stocking of EpiPens is a matter for the Head of a School & Governing Body.

“As was the case when we as an O&S Committee moved to support the introduction of a mobile phone ban in schools, I think we as councillors should provide political leadership to also move to develop a county-wide policy on schools stocking EpiPens (possibly inhalers for asthmatics) and that PCC should fund this cost. It cannot be assumed every child with an allergy will always bring their EpiPen to school and furthermore this does not cover other potential severe allergic reactions eg bee stings.

“I was going to submit an NoM to council but with hindsight feel that the Schools O&S would be the appropriate forum for the matter to be given a thorough airing from where we can hopefully move a recommendation to council.”

Cllr Murphy’s call was backed by Cllr Micheal John, saying: “If there’s a chance of one person dying due to a lack of policy it’s something we have to consider,” moving for a working group to be established to obtain more data ahead of any formal decision.

Another supporter was Cllr Anji Tinley, herself an EpiPen user, compared the provision in schools with defibrillators, saying: “You don’t know you’re going to have a heart attack,” later adding: “£70 to save a life, I don’t think that’s a lot of money.”

Members heard a scoping exercise was currently taking place in Wales, with members agreeing to write to Welsh Government to for an update on its position ahead of any formal group being created.

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