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Health board confirms major hospital changes across west Wales

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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.

At Bronglais General Hospital in Aberystwyth there will be increasing focus on acute and emergency care

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.

The Health Board promises increased planned care activity while continuing initial emergency access at Withybush Hospital in Haverfordwest

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.

The Health Board said that Glangwili Hospital there will be increasing focus on acute and emergency care

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

Deputy Minister sets out priorities for social care, mental and women’s health

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Plans include same-day mental health support, a National Care Service for Wales and action on women’s health

PLANS to improve access to social care, provide same-day mental health support and strengthen women’s health services have been outlined by the Welsh Government.

Deputy Minister for Social Care, Mental Health and Women’s Health Delyth Jewell said she wanted to give greater prominence to areas which she believes have not received the attention they deserve.

Her priorities include progressing plans for a National Care Service for Wales, with the ambition of delivering social care that is free at the point of need.

The Deputy Minister also said safeguarding arrangements would be strengthened to better protect children and adults at risk.

Mental health services are set to move towards a model of open-access, same-day support, with 21 demonstrator sites already underway and further rollout planned.

The Welsh Government said future action on dementia will also be set out in a new Dementia Strategy for Wales, focusing on brain health, earlier diagnosis and improved support.

A Women’s Health Summit will also be held later this month, bringing together women with lived experience and clinicians.

The summit will focus on tackling the normalisation of pain, with work already underway to improve endometriosis and abortion services, as well as maternity safety and support for families who experience the loss of a baby.

Delyth Jewell said: “I want to help shine a light onto areas that haven’t had the focus they are due.

“On mental health, women’s health, and yes, the social care system that for too long has been undervalued.

“These areas deserve more attention and prominence. They deserve a voice in the heart of government, and I promise I will give that to them.”

 

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Community

Hywel Dda reaffirms commitment to Armed Forces community

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HYWEL DDA UNIVERSITY HEALTH BOARD has reaffirmed its commitment to the Armed Forces community by re-signing the Armed Forces Covenant.

The covenant was signed at the Wales National Armed Forces Day 2026 event, held at Pembrey Country Park on Saturday, June 27.

It was signed on behalf of the health board by Armed Forces Champion and Independent Board Member Michael Imperato, alongside Lisa Gostling, Deputy Chief Executive and Director of Workforce and Organisational Development.

The Armed Forces Covenant is a national promise to ensure that members of the Armed Forces community are treated fairly. It supports serving personnel, veterans, service leavers and their families, with a veteran defined as anyone who has served for at least one day.

By re-signing the covenant, Hywel Dda says it is continuing its role as an Armed Forces friendly employer and healthcare provider across west Wales.

This includes supporting the recruitment and employment of veterans, recognising military skills, providing additional support for reservists, offering flexible working for service families, working with partner organisations, supporting cadet groups and Armed Forces charities, and improving access to healthcare for veterans.

Anyone currently serving, or who has previously served in the Armed Forces, can find out more about the support available through Hywel Dda University Health Board’s Armed Forces Covenant pages.

Staff who are part of the Armed Forces community can also access support through the health board’s Armed Forces Staff Network by contacting [email protected].

 

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Health

Hywel Dda rolls out new tool to help patients stay independent in hospital

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Early warning system aims to prevent hospital-related decline and support faster recovery

HYWEL DDA University Health Board is among the first in Wales to introduce a new approach to spotting and preventing hospital-related decline in patients.

The Deconditioning Early Warning Indicator, known as DEWI, helps staff identify early signs that a patient may be losing strength, mobility or confidence during a hospital stay.

The aim is to make sure patients remain as active and independent as possible while receiving care, helping them return home at the same level of independence they had before admission, or even before they became unwell.

Deconditioning can develop quickly, even during a short stay in hospital, and can affect a patient’s physical, mental and emotional wellbeing.

The DEWI tool uses a structured set of indicators to build a picture of each patient’s abilities and to highlight any changes at an early stage. This allows staff to put timely support in place, including help with movement, nutrition, hydration and confidence.

Developed by NHS Wales Performance and Improvement, the tool has been tested across a number of health boards and was formally launched in November 2025. It is now being rolled out across Hywel Dda hospital sites.

More than 650 patients have already been supported using the DEWI tool during their hospital stay, with early indications showing positive trends in maintaining or improving function during admission.

Sharon Daniel, Executive Director of Nursing, Quality and Patient Experience, said: “We recognise that deconditioning can cause significant harm to our patients, often developing quickly and impacting independence and recovery during a hospital stay.

“It is therefore highly encouraging to see the Health Board leading the way in embedding the DEWI tool, alongside the development of a complementary Action Bundle which helps patients to stay active and independent.”

Across Hywel Dda, ward teams are now building the tool into everyday care. This includes the use of visual information boards and activities designed to encourage patients to remain active, engaged and independent.

Estelle Williams, Sister on the Acute Frailty Unit at Withybush General Hospital, said the tool was already helping staff focus on practical steps.

She said: “From a ward perspective, the DEWI tool has been really useful in helping our staff think about deconditioning as part of everyday care.

“It keeps things simple and focuses on practical actions we can take, like supporting patients to stay mobile, encouraging independence and paying attention to nutrition and hydration.

“It also fits nicely alongside the initiatives we already have in place, including the use of fortified milkshakes, bringing everything together in a more joined-up way.”

James Severs, Executive Director of Allied Health Professions and Health Science, said preventing deconditioning was central to improving outcomes for patients.

He said: “Preventing deconditioning is fundamental to improving patient outcomes and reducing the long-term impact of illness.

“This work highlights the vital role all ward staff have in keeping people active, supporting recovery and maintaining independence throughout their hospital stay.

“By identifying risks early and intervening promptly, we are helping patients recover faster and return home with greater confidence.”

The Health Board said future phases will focus on further developing the DEWI tool and embedding it as part of standard care before, during and after hospital admission.

Caption: The Deconditioning Team at Withybush General Hospital. From left: Annie, Occupational Therapy Technician; Ruth and Rosie, nurses; Lauren, Health Care Assistant; Estelle, Sister; and Violet from Hotel Services.

 

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