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.

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.

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.

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.

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.