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.

MILFORD HAVEN’S Torch Theatre has been awarded a £7,500 grant by Milford Haven Town Council, continuing a long tradition of support for community arts at the iconic venue.

Established in 1977 with significant backing from the Town Council, the Torch Theatre remains one of only three building-based professional producing theatres in Wales. It is widely recognised for its in-house productions as well as its extensive youth and community programmes.

The theatre, which operates as a charity, receives public funding through the Arts Council of Wales and Pembrokeshire County Council, alongside support from local businesses and organisations including Milford Haven Port Authority. Leaders at the venue say funding remains essential to maintaining its broad programme of events and activities for the community.

Chelsey Gillard, Interim CEO and Artistic Director at the Torch Theatre, said: “Being awarded grants such as this one from the Town Council helps us to deliver quality arts to the people of Milford Haven, Pembrokeshire and further afield.

“We are very grateful for this continued support and appreciate the work of the Town Council to ensure important provision is supported across Milford.”

The Torch hosts more than 2,000 events and activities each year, attracting over 100,000 visitors. Its community facilities include The Junction, home to the Torch Youth Theatre and a rehearsal space for professional productions. The main auditorium seats 300 people, while the Studio Theatre accommodates 102. The Joanna Field Gallery showcases local exhibitions, and Café Torch serves meals throughout the year.

Ms Gillard added: “We do so much more than what audiences see on stage. Just to name a few of our regular activities, we run a very popular Youth Theatre for ages seven to eighteen, facilitate relaxed environment screenings and shows, host a Welsh learners’ group, Coffi Cymraeg, and hold regular clothes swaps.

“The Torch is also home to Welsh National Opera’s critically acclaimed Cradle Choir for people living with dementia and lots of high-quality classes for adults with disabilities run by Arts Care. All this activity relies on our team of brilliant volunteers and support from grants, trusts and donations.

“This grant will go towards ensuring these activities can continue — thank you.”

Executive Director says emergency surgery transfer is about quality — not loss

THE EXECUTIVE DIRECTOR of Strategy and Planning at Hywel Dda University Health Board has defended the decision to transfer certain emergency surgery operations from Withybush Hospital, saying the changes are designed to strengthen services rather than remove them.

Lee Davies told The Herald the “single biggest change” people in west Wales will notice is increased resilience across hospital services.

“The most significant change will be increased resilience and sustainability across services in West Wales,” he said.

“We are strengthening the way services are delivered so that they are less vulnerable to staffing pressures and more consistently available.”

Why now?

Mr Davies said the decision was driven by concerns that some services had become overly dependent on small numbers of clinicians.

“Wales covers a large geographical area, and currently many services are delivered across multiple sites,” he said.

“That has meant that clinical teams are often spread thinly, with some services heavily dependent on a small number of individuals.

“As a result, those services can become vulnerable if staffing circumstances change.”

He added that in certain areas, performance was not matching standards seen in larger UK centres.

“These changes are necessary to strengthen our services, improve sustainability, and ensure we consistently meet high standards of care.”

Emergency surgery at Withybush

Mr Davies confirmed that patients requiring certain general surgery operations will now be transferred to Glangwili Hospital.

However, he rejected suggestions that this amounted to the removal of all emergency surgical care from Pembrokeshire.

“This does not mean that all emergency surgery activity will cease at Withybush Hospital,” he said.

“A small number of patients who require operative procedures will be transferred to Glangwili. Where appropriate, patients will be transferred back to Withybush at the earliest opportunity.”

He acknowledged that some residents may perceive the change as a loss.

“We recognise that some people may see this as a loss,” he said.

“Rather than reacting to staffing pressures in an unplanned way, we are proactively designing a more sustainable and stable model. We believe this approach will provide safer, higher-quality care for the people of Pembrokeshire.”

Reassurance over local hospitals

Asked whether any hospital would lose services under the wider Clinical Services Plan, Mr Davies said no community would lose access.

“There will be changes to how services are provided across West Wales,” he said.

“However, no community will lose access to services. In some cases, services may be delivered in a different location or in a different way.”

He added that all four main hospital sites would continue to play a “vital and important role”.

Monitoring outcomes

Mr Davies said the board had established baseline quality and safety data ahead of the changes and would closely monitor performance.

“We have defined outcome measures and performance expectations,” he said.

“As we move into the improvement phase, we will evaluate whether the changes are delivering anticipated improvements in quality, safety and patient experience.”