DECISIONS on the future of nine frontline hospital services across west Wales will be made later this month when Hywel Dda University Health Board holds a special two-day Board meeting.

The Extraordinary Board will meet on Wednesday (Feb 18) and Thursday (Feb 19) to determine the next steps for critical care, dermatology, emergency general surgery, endoscopy, ophthalmology, orthopaedics, stroke, radiology and urology services.

Health chiefs say the proposed changes are aimed at tackling staffing shortages, improving clinical standards and cutting waiting times for diagnosis and treatment.

More than 4,000 people responded to a public consultation on the plans. Feedback was gathered through questionnaires, public meetings, staff sessions and discussions with stakeholder groups.

An independent consultation report compiled by Opinion Research Services will form part of the evidence considered by Board members. It will sit alongside updated data on workforce pressures, estate condition, clinical standards and how services link together across hospitals.

All documents to be considered by the Board have now been published online ahead of the meeting.

Alternative ideas assessed

During the consultation, communities also submitted 190 alternative proposals.

Each idea was tested against “hurdle criteria” to check whether it was safe, practical and capable of delivery before being taken forward.

Of those, 22 met the criteria and have been developed into full options. These will be considered alongside the Health Board’s original proposals.

Board members will assess whether each option is clinically sustainable, deliverable, accessible to patients, aligned with the Health Board’s long-term strategy and financially viable. They will also decide whether further engagement or evidence is needed before any final changes are introduced.

Some changes, if approved, could be phased in over time.

Dr Neil Wooding, Chair of the Health Board, said: “At our meeting next week, the Board will carefully consider the consultation feedback alongside the latest clinical evidence, workforce insights, updated impact assessments and the alternative options that were put forward during the consultation.

“Our responsibility is to consider the full range of evidence and ensure we make decisions that ensure that our services are sustainable for the future. No decisions have been made ahead of the Board. We are committed to a thorough and transparent process, ensuring each option and alternative options are considered in the round, and focused on improving services for the people who rely on them.”

KIDNEY RESEARCH UK has launched a new dedicated online forum specially created to give people living with kidney disease and the families and carers who support them a safe and supportive space to talk, learn from each other and share experiences. 

Shaped with help from Welsh patients, the forum offers a dedicated community space for the more than 377,000 people in Wales thought to be living with kidney disease. 

Free to use, the new forum, called Kidney Community, creates a single, safe space where people can connect with others who understand their experiences, ask questions, share practical advice and find support, no matter what stage of the kidney disease journey they are at. 

Kidney Community is open to kidney patients at all stages of the disease, people with a higher risk of developing it, and anyone affected by a diagnosis in their family or friendship groups. 

The forum will be continually supported by Kidney Research UK’s team, helping to ensure discussions are informed, respectful and grounded in trusted information. It has been co-developed with kidney patients and carers to ensure it reflects real needs, concerns and priorities. 

Darren Daniel from Ammanford in southwest Wales helped with the forum’s development. Diagnosed with kidney disease in 2017, Darren has used social media, including TikTok, to raise awareness of kidney health and the realities of living with long-term illness. His experience of connecting with others helped inform the development of the forum. 

Darren said: “When I started sharing my kidney journey online, I saw just how many people were desperate for somewhere to talk honestly about what they were going through. Helping shape this forum felt like a natural next step – making sure it’s real, accessible and driven by the questions people actually ask, not medical jargon.” 

“This forum takes that sense of community and gives it a safe home, backed by Kidney Research UK. It means people don’t have to scroll endlessly or rely on misinformation. Whether you’re newly diagnosed or years into treatment, there’s power in knowing others understand your day-to-day reality, and that support is only a conversation away.” 

Sandra Currie, chief executive of Kidney Research UK, said: “Many people affected by kidney disease tell us they feel unsure where to turn for support. This forum brings patients and carers together in one place, so they can feel heard as part of a community, with access to information and shared experience at every stage of kidney disease. We are providing a safe, welcoming space where every question and every story matters.” 

The launch builds on Kidney Research UK’s long-standing commitment to ensuring the voices of patients and families help shape research, services and support. Existing supporters, volunteers and members of the charity’s Kidney Voices for Research network were among the first invited to join. 

The forum is now live and free to access at kidneycommunity.kidneyresearchuk.org  

A TUTOR who struggled with depression and anxiety found “life-changing” online support through a free NHS Wales service.

Former maths teacher Iain Messenger had experienced anxiety for decades but said looming retirement and the collapse of his marriage were the final straw.

He called the NHS 111 press 2 mental health service after experiencing crippling panic attacks, low self-esteem and ‘dark thoughts’.

He was signposted to SilverCloud Wales, an online platform offering guided self-help programmes for mental health and wellbeing.

Speaking out to coincide with Time to Talk Day – the nation’s biggest mental health conversation – 58-year-old Iain said: “The sense of hopelessness dissipated almost immediately.

“I realised I wasn’t the only one – other people were dealing with the exact same problems and feelings. I no longer felt alone.”

The former teacher, who lives near Welshpool, decided in 2024 to quit the classroom and focus on private tutoring.

But handing in his notice coincided with a marital breakdown, and he began each day of his final months in work battling panic attacks.

“I was struggling with my close relationships, and basic decision-making always turned into a drama,” Iain explained.

“I felt useless, wandering about not able to focus on anything. I couldn’t even read a book or watch the TV.

“I had some pretty dark thoughts – that I was a disaster, and no use to my family. I was in a real mess.”

Iain said seeking help through 111 press 2 in June last year was a ‘huge’ and ‘humbling’ step.

“It’s a bloke thing – you put on a front and pretend you’re OK,” he explained. “And I was typical in that regard, I wouldn’t really speak to anybody.

“You feel like the only person in the world who can’t do life, but then when you phone 111 press 2 and they go through the list of questions, it’s instantly relatable. You realise you’re not the first person to be there.”

Iain was referred for counselling but was advised to try SilverCloud while he waited for an appointment.

The platform features online courses based on cognitive behavioural therapy for issues including depression, anxiety, poor sleep and stress.

Access is free to anyone in Wales aged 16 or over, without seeing a GP.

“I was sceptical at first,” Iain admitted. “I just couldn’t see how an online platform was going to work, I thought I needed someone to press the right buttons and fix me.

“But going through the programme, there were scenarios that described exactly how I was feeling. I identified with so much of what was being said.

“And I was now actively doing something to get well. Just having a plan in place meant I went almost immediately from hopeless to hopeful.”

SilverCloud Wales is managed by NHS Wales’ Online CBT Service, based at Powys Teaching Health Board.

Over 41,000 people have accessed the Wales-wide service since it piloted in Powys in 2018.

As well as programmes for adults, the platform has courses for students and young people, and for parents supporting children and teens with anxiety.

SilverCloud’s three most popular programmes – addressing anxiety and depression – are also available in Welsh.

Online CBT Service project manager Fionnuala Clayton said: “Time to Talk Day reminds us how important it is to speak up when you’re struggling – it’s often the first step to feeling better.

“But we know that isn’t always easy, and that’s where SilverCloud can help. It offers flexible, confidential support you can access straight away, without waiting for a GP appointment. We’re delighted to see the difference it’s made to Iain’s life.”

Iain added: “I’m still using the lessons I picked up through SilverCloud, and they’re becoming more embedded in my thinking.

“I’m grateful – on a daily basis – for the things I learned. It’s been lifechanging.”

Sign up to SilverCloud at: nhswales.silvercloudhealth.com/signup

Cover image:

Former maths teacher: Iain Messenger