EMERGENCY general emergency surgery is to be removed from Pembrokeshire’s Withybush hospital as part of a wide range of changes backed following by Hywel Dda University Health Board.

Last year, the 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”.

At the launch of the consultation it said the services, and potential changes at the four main hospitals of Haverfordwest’s Withybush, Carmarthen’s Glangwili, Llanelli’s Prince Philip and Aberystwyth’s Bronglais, would see no changes to how people access emergency care (A&E) or minor injury care as part of the consultation.

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.

Another option, in Ceredigion, included the loss of Bronglais’s stroke service, becoming a ‘treat and transfer’ hospital, with patients transferred to other hospitals in the board area, including Withybush for their inpatient stroke care.

During the consultation, communities shared an additional 190 alternative ideas for the services, which have been narrowed down to 22 alternatives to the multiple options outlined in the consultation.

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, with the board hearing from chief executive Phil Kloer the changes were about “improving the quality of service for the public,” adding a Pembrokeshire public-preferred option of emergency general surgery operations taking place on alternate weeks, with a similar arrangement at Glangwili, had raised concerns from clinicians and managers.

The Board also backed changes to the critical care service, which will see the current intensive care units situation remaining the same at all hospitals other than Prince Philip, which will see the Intensive care unit (with transfer of sickest patients) changed to an enhanced care unit.

Reacting to the change, local Senedd member Paul Davies MS: “I’m appalled that Hywel Dda University Health Board has voted to remove general emergency 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.”

He added: “Removing general emergency services critically undermines the sustainability of Withybush hospital’s A&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.”

Politicians clash over NHS performance as latest figures show pressures remain

AMBULANCE response times for the most life-threatening emergencies in Wales have increased, according to the latest NHS performance statistics, prompting fresh political criticism and renewed concerns about pressure on frontline services.

Figures show that for “red” calls — incidents where patients are at high risk of cardiac or respiratory arrest — the median response time rose to nine minutes and 33 seconds. The 90th percentile response time also increased to 22 minutes and 48 seconds compared with the previous month.

Statisticians say these are the longest recorded times since the current ambulance performance system was introduced in July 2025 and remain above the Welsh Government target range of six to eight minutes.

The data comes alongside wider NHS performance figures which show continuing challenges across the health service, including long waiting lists and emergency department pressures.

Waiting list pressures

Across Wales, 5,252 patient pathways were still waiting two years or more for treatment in December. By comparison, England recorded 223 such waits, despite having a population around 18 times larger.

Overall, there were approximately 740,954 patient pathways waiting to start treatment in Wales in December — equivalent to nearly one in four of the population — with around 580,300 individual patients affected.

The median waiting time for treatment in Wales was 19 weeks, compared with 13.4 weeks in England.

Emergency departments also remained under strain. In January, only 63.4% of patients spent less than four hours in emergency departments, far below the 95% target, while 11,392 patients waited more than 12 hours — up 10% on the previous month.

Cancer performance below target

Cancer treatment performance also fell short of national targets, with 60.7% of patients starting treatment within 62 days of first suspicion of cancer, compared with the 75% target.

Political reaction

Reform UK Senedd Member for Brecon and Radnorshire, James Evans MS, criticised the Welsh Government’s handling of the NHS.

He said: “NHS mismanagement, by Labour Ministers and their supporters in Plaid, is posing a serious risk to life.

“Ambulance waiting times are getting worse as Plaid and Labour’s budget deal sees cash splashed on making ambulances greener.

“Reform UK would cut waste and bureaucracy to ensure that taxpayers’ money reaches the front line of our NHS.”

The Welsh Government has previously said NHS performance remains affected by high demand, workforce pressures, and the legacy of the pandemic, while pointing to gradual improvements in some waiting time measures over recent months.

Ongoing challenges

Health experts say ambulance response times are heavily influenced by pressures elsewhere in the system, particularly delays in hospital handovers and shortages in social care, which can prevent patients being discharged quickly.

For patients and families across Wales, the figures highlight continuing challenges despite efforts to improve performance.

The coming months are expected to remain difficult for NHS services as demand continues to rise, with health leaders warning that long-term solutions will require investment, workforce planning, and better integration between health and social care.

Health leaders welcome progress but warn NHS remains under severe pressure

THE NUMBER of people waiting for NHS treatment in Wales has fallen for the seventh consecutive month, according to the latest performance data — but health leaders have warned that services remain under significant strain and many patients are still waiting too long for care.

Figures for December show there were just under 741,000 referral-to-treatment patient pathways waiting to start treatment across Wales, a reduction of around 16,900 compared with November. The figure is the lowest recorded since March 2023.

Management information suggests there were approximately 580,300 individual patients waiting for treatment in December, down from 591,700 the previous month and 616,500 in December 2024.

The number of patients waiting more than two years has also fallen sharply. Just under 5,300 pathways were waiting longer than two years in December — a drop of 92.5% from the pandemic-era peak, and around 1,600 fewer than in November.

Average waiting times have also improved slightly, with patients waiting around 19 weeks on average — 0.2 weeks shorter than the previous month and 4.6 weeks shorter than the same period last year.

Meanwhile, the number of people waiting more than a year for a first outpatient appointment fell to just over 32,700, the lowest level since September 2020 and more than two-thirds lower than the peak recorded in 2022.

Pressure still high

Despite the improvements, NHS leaders say services remain under intense pressure, particularly during the winter period.

Darren Hughes, director of the Welsh NHS Confederation, said the progress showed the “relentless focus” on reducing waiting times was beginning to deliver results.

He said: “It is reassuring to see the continued focus on driving down waiting lists is paying off, especially for those waiting the longest for treatment.

“The overall waiting list fell for the seventh month in a row in December, which is not something we would usually see given the heightened pressures on the NHS in the winter months and an early flu season hitting the UK.”

However, he warned that the health service was still far from where it needed to be.

“NHS leaders are fully aware that we are still not where we need to be — too many people are still waiting a long time for treatment — but we must capitalise on this momentum and make sure best practice is shared across Wales,” he added.

Emergency demand rising

The figures also come against a backdrop of rising demand for urgent and emergency care.

Some health boards declared critical incidents in January as services struggled to cope with pressure, while emergency department attendances were roughly 1,000 per day higher on average compared with January 2025.

However, performance against the newer ambulance measure for the most serious “purple” emergency calls met targets in January despite the increased demand.

Calls for long-term strategy

Health leaders say sustained improvement will require action beyond the NHS itself, including better prevention, stronger social care services, and investment in infrastructure.

Mr Hughes said: “To continue to tackle high demand and drive down waits for the people of Wales, the next Welsh Government must implement a cross-government strategy for prevention, stabilise social care and enable the NHS to invest in its estates and infrastructure.”

Political context

Waiting times remain one of the most politically sensitive issues in Welsh public services, with opposition parties regularly criticising the Welsh Government over performance compared with England.

Ministers have previously argued that the Welsh system treats patients based on clinical need rather than targets alone, and that recovery from the pandemic backlog is progressing.

For patients across West Wales — including those served by Hywel Dda University Health Board — the figures offer cautious optimism, but also underline the scale of the challenge still facing the health service.

Health experts say sustained reductions over coming months will be critical in determining whether the NHS in Wales is genuinely turning a corner or simply experiencing temporary improvement.