SENEDD Member Paul Davies has criticised Hywel Dda University Health Board’s decision to
proceed with the transfer of patients from St David’s surgery to surgeries elsewhere in
Pembrokeshire. In a board meeting held on the 26 th September 2024, the Health Board also
confirmed that it is in discussions with Shalom House in St David’s about the establishment
of a branch surgery to deliver some services.
 
Mr Davies said, “It’s shameful that Hywel Dda University Health Board is pushing ahead with
these plans, despite the vocal opposition shown by the local community.
 
“The city of St David’s will soon be the only city in the United Kingdom without a GP surgery,
and I’m appalled that the Health Board has allowed this to take place. For many people the
travel to other surgeries from St David’s is just too far and too stressful and a weak
commitment to coordinate surgeries with bus times is just not going to cut it.”
 
“Residents have been trying to engage with the Health Board and urging the management to
look at a range of other options and it appears as though the Health Board is unwilling to
consider the views of the people of St David’s. The people of St David’s deserve better, and
I hope all political representatives in Pembrokeshire can work together to stand up for the
local community.”

But Hywel Dda University Health Board says it is continuing the work to prepare for the transfer of patients from St David’s Surgery in Pembrokeshire to nearby surgeries ahead of the end of October when the current contract will come to an end.

The Health Board agreed that the care of patients at St David’s Surgery in Pembrokeshire would be transferred to local practices as close as possible to where they live, in a meeting of the Board at the end of July.

The Health Board also committed to work on establishing a Branch Surgery in St David’s providing services for part of the week for those patients transferring to nearby Solva Surgery.

Jill Paterson, Director of Primary Care, Community and Long-Term Care, at Hywel Dda announced at a Board Meeting today (Thursday, 26 September) that the Health Board is in discussions with Shalom House in St David’s about the establishment of a Branch Surgery

“The location on Nun Street is convenient for patients and is a well-established organisation which is well-supported by the local community and we are delighted to be working with the Shalom Trustees to take forward this development,” said Ms Paterson.

“We are in the process of planning services to be delivered by a multi-disciplinary team and are planning community services there and some cluster-based services too.”

The decision to transfer patients from St David’s Surgery was made following an extensive period of engagement with patients at the practice and Llais, the patient’s voice organisation for Wales. This followed the decision by the one GP who runs the surgery to resign his General Medical Services Contract.

From 1 November 2024 the Solva GP Surgery will be known as the Peninsula Practice/ Meddygfa Penrhyn to reflect the broader reach of the Practice. The name was proposed by the Peninsula Working Group, which includes representatives from St David’s City Council and Solva and Llanrhian community councils. 

The employed staff at St David’s Surgery will transfer to Peninsula Practice to join the growing team there, including administration and nursing staff and the salaried GP.

All patients at St David’s Surgery will have been sent a letter informing them which Practice they will be transferred to, and everyone will be contacted soon with a welcome letter with further information.

Ms Paterson said: “The planning for the transition is well under way. Patients don’t need to do anything – we will be transferring all records and registrations.

“Meanwhile, work to adapt the surgery building in Solva to accommodate the additional staff and patients will be taking place in the coming weeks.  This involves internal alterations to the surgery building which will be taking place over the coming weeks to convert underused rooms into consulting and treatment rooms, and to move some office space to the first floor.”

Ms Paterson said that she was aware that some of the St David’s Surgery patients were concerned about travelling to Solva for appointments.

“In terms of travel, we recognise that this is a challenge. Some individuals are going to have to travel three miles to the Solva Surgery, but we hope that that need will not be significant because we are working to provide as many services in the local community that we can.

“We have also been working with PACTO – the Pembrokeshire Association of Community Transport Organisations. They have helped us develop a leaflet and they are looking for volunteer drivers to assist with this process, so that they can respond to need where buses are not available for individuals.

“We have also had a commitment from the surgery that, as far as possible, when people do need to go to the surgery, they will try to co-ordinate appointment times with bus times.”

For those who need to travel to the Peninsula Surgery in Solva, there will be information regarding public transport options for patients on the surgery website.

Patients who require help or further information should contact the Health Board by telephone us at 0300 303 8322 (option 5), or email [email protected].

GLANGWILI HOSPITAL in Carmarthen is set to face a surge in demand as it becomes the main provider of children’s healthcare services for the entire Dyfed region, following significant changes in paediatric care at Withybush Hospital in Pembrokeshire and Bronglais Hospital in Ceredigion. This centralisation has raised concerns about how Glangwili will manage the influx of young patients from all three counties: Carmarthenshire, Pembrokeshire, and Ceredigion.

The closure of the Paediatric Ambulatory Care Unit (PACU) at Withybush Hospital in Haverfordwest was recently made permanent, leaving families in Pembrokeshire without local access to hospital-based care for children. This decision came after the unit’s hours were reduced in 2016 and its services were “temporarily” transferred to Glangwili during the pandemic, only to never return. Hywel Dda University Health Board cited financial and staffing constraints as the main reasons for this closure, leaving Glangwili as the sole 24-hour inpatient paediatric facility in the region.

Adding to the strain, Hywel Dda University Health Board has announced that children requiring more than 24 hours of care at Bronglais Hospital in Aberystwyth will also be transferred to Glangwili, starting 1 November 2024. This temporary measure, expected to last six months, is a response to a shortage of paediatric nurses at Bronglais. However, families fear that the increased burden on Glangwili could have long-term consequences for children’s healthcare in Dyfed.

The announcement has been met with concern from local politicians and community members. Ceredigion MS Elin Jones described the decision as a “real shock,” warning of its impact on families in the region. “This will cause real concern to ripple through the community,” she remarked, emphasising the need to ensure the change remains temporary. Many residents also fear the decision sets a worrying precedent for the future of paediatric care in Ceredigion.

Dr. Gwen Rees criticised the decision, stating it could lead to “poorer health and wellbeing outcomes” due to limited access to inpatient care. Highlighting the challenges faced by families in rural areas, Dr. Rees noted that the transfer to Glangwili poses logistical and emotional difficulties, particularly for those living over an hour away.

With the upcoming changes, Glangwili Hospital now faces the task of providing paediatric care to the entirety of the former county of Dyfed. Encompassing Carmarthenshire, Pembrokeshire, and Ceredigion, this is a vast and largely rural area, making travel to the hospital difficult for many families. In some cases, parents may now face journeys of over an hour to access hospital care for their children, a situation that is particularly concerning for emergencies and those requiring ongoing treatment.

Parents and local campaigners have expressed their dismay, arguing that the centralisation of services at Glangwili could compromise the quality and timeliness of care for children across the region. Residents of Pembrokeshire and Ceredigion have already voiced their frustrations over the closure of Withybush’s PACU, pointing out that previous “temporary” reductions in services often become permanent. The prospect of Glangwili now having to handle patients from all three counties has only heightened their concerns about the sustainability of paediatric healthcare in west Wales.

In response, Hywel Dda University Health Board has assured the public that the changes are necessary to address staffing shortages and financial challenges while ensuring safe care delivery. Dr. Prem Kumar Pitchaikani, Clinical Director for Women & Children’s Services, emphasised that the adjustments at Bronglais are a “short-term operational change” meant to prioritise the safety of patients and staff. However, many families remain sceptical, especially given the history of gradual service reductions at Withybush.

The health board has also promised to support families affected by these changes, including providing designated ambulance vehicles and exploring other transport solutions. Despite these efforts, the reality of centralising care at Glangwili raises questions about how effectively the hospital can manage the increased patient load without compromising the level of care.

As the changes take effect, communities across Carmarthenshire, Pembrokeshire, and Ceredigion will be watching closely to see how Glangwili Hospital adapts to its new role as the main paediatric care provider for the entire Dyfed region.

HYWEL DDA University Health Board has approved a proposal to replace inpatient beds at Tregaron Community Hospital with enhanced community-based healthcare services. This decision comes after a public engagement exercise and is part of the Cylch Caron project aimed at transforming healthcare delivery in north Ceredigion.

The approved model will see the removal of nine inpatient beds at Tregaron Hospital, shifting focus to providing care in or close to patients’ homes. According to the health board, this move is designed to create a more sustainable, safer service across Ceredigion, improving patient care and allowing people to avoid hospital stays unless necessary. The model will allow staff to work in different ways, offering more support in the community and strengthening community-based nursing services.

A vision for integrated care

The Cylch Caron project, a collaborative effort between Ceredigion County Council, the health board, and the Welsh Government, plans to establish an integrated resource centre in Tregaron. This centre will bring together healthcare, social care, and housing services in a central hub for the town and its surrounding rural areas. The health board believes this model is already successful in south Ceredigion and will provide high-quality patient care by enhancing collaboration across healthcare and support services.

Peter Skitt, County Director for Ceredigion, acknowledged the emotional attachment the local community has to Tregaron Hospital. “We want to do the right thing for our patients and our staff who care for them, and this isn’t always by the traditional model of providing care in a hospital bed,” Skitt said. The health board aims to use the new model to support up to 40 people in their homes, compared to the nine patients who would be accommodated in hospital beds.

Despite the health board’s assurances, the plan to remove inpatient beds has sparked significant concern within the community and among local politicians. During the public engagement period, fears were raised about the future of healthcare services in Tregaron.

Elin Jones, Member of the Senedd for Ceredigion, and Ben Lake, the local MP, have been vocal in their concerns. They argue that the inpatient beds at Tregaron Hospital should remain until the new Cylch Caron centre is operational. “It was always expected that beds would remain in use at Tregaron Hospital until the Cylch Caron project was up and running,” said Elin Jones. The delay in the project’s completion, now expected to take another three to five years, has led to worries about a potential gap in healthcare provision.

Similarly, Tregaron Town Council has expressed “disappointment and anger” over the health board’s decision, stating that decommissioning the beds before the Cylch Caron project opens could dilute local healthcare resources. Tregaron County Councillor Ifan Davies described the hospital as a “special resource for the area,” emphasising its long-standing role in providing care to the community.

The Health Board’s justification

The health board, however, remains firm on the benefits of the new model. It argues that the change will help avoid the risks of hospital stays for patients who are medically fit to be in their home environments. The board has also noted that the staffing situation at Tregaron Hospital has become fragile, with recruitment efforts failing to address the shortages. “Despite efforts to recruit to positions, our current level of staffing is insufficient, and our staffing rotas are fragile,” said Skitt.

This proposal, according to the health board, is an opportunity to strengthen its resilience ahead of the winter months when healthcare services face significant pressures. By adopting the community care model now, they aim to avoid a situation where they might be forced to close beds without notice.

The transition to the new model of care will be phased. Current inpatients at Tregaron Hospital will follow normal discharge procedures, and further admissions will cease immediately. The hospital building will continue to serve as a hub for community staff and as a facility for outpatient services until the integrated resource centre is operational.

Dr Sion James, Deputy Medical Director of Primary Care and a local GP, supports the Cylch Caron vision. He describes the project as a unique opportunity to offer a range of services in a central hub for Tregaron and surrounding rural areas, aiming to create an innovative, sustainable model of community-based care.

While the new community healthcare model promises to provide enhanced nursing support in patients’ homes, local politicians and residents remain concerned about the potential loss of a valued healthcare facility. The health board’s assurances of a safer, more sustainable service will be tested in the coming months as Tregaron’s community adjusts to these changes. For many, the focus now shifts to how well the new model will meet the area’s healthcare needs in practice, especially as the Cylch Caron centre remains years away from completion.