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Board approves new community healthcare model for West Wales hospital

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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.

 

Health

Decision pending on adult mental health referral pathway

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HYWEL DDA University Health Board will decide next week whether to make changes to the GP referral pathway for routine adult mental health services permanent.

The decision will be taken at a public Board meeting on Thursday (Mar 26).

Board members will consider a proposal to formalise changes already introduced in Ceredigion and, if approved, roll out the revised pathway across Pembrokeshire and Carmarthenshire.

Since March 2025, adults in Ceredigion seeking routine mental health support have been advised by their GP to contact the NHS 111 Wales ‘Press 2’ service, rather than being referred directly to the county’s Community Mental Health Team.

The temporary change was introduced in response to ongoing staffing shortages. Health Board officials say the approach has helped maintain timely access to face-to-face assessments for those who need them, while directing initial contact through a single access point.

The 111 ‘Press 2’ service provides telephone assessments by local wellbeing practitioners, supervised by registered mental health nurses, offering advice, support and onward referrals where required.

At its November 2025 meeting, the Board agreed to extend the temporary pathway until the end of March 2026. A nine-week engagement exercise followed, running from December 8 to February 9, to gather feedback from patients, professionals and stakeholders on the potential long-term impact.

Andrew Carruthers, Chief Operating Officer at Hywel Dda University Health Board, said: “I would like to thank everyone who took the time to share their views and experiences.

“I would also like to thank West Wales Action for Mental Health for supporting engagement with patients, including those with lived experience, alongside GPs, primary care teams, mental health staff and third sector partners.

“Our priority is to ensure mental health services remain accessible, fair and sustainable. The temporary changes in Ceredigion have shown some positive benefits, and the feedback we have received from across the three counties will play an important role in shaping the Board’s decision.”

The Board will review all evidence and feedback before making a final decision on the future of the adult mental health referral pathway.

GPs will continue to refer patients with urgent or complex needs directly to community mental health teams where appropriate, and have access to a dedicated NHS 111 professional line for additional clinical advice.

Further details, including the full Board papers, are available here:
https://biphdd.gig.cymru/amdanom-ni/eich-bwrdd-iechyd/cyfarfodydd-y-bwrdd-2026/agenda-a-phapuraur-bwrdd-26-mawrth-2026/

The meeting will be streamed live from 9:30am on Thursday (Mar 26) via:
www.youtube.com/hywelddahealthboard1

 

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Health

Parents urged to check children’s vaccinations after meningitis cases

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Local pharmacy reports MenB vaccine shortage amid rising concern

PARENTS and carers across west Wales are being urged to check their children’s vaccination status following recent meningitis cases in the UK.

The warning comes as a local pharmacy has confirmed a shortage of the Meningitis B (MenB) vaccine, highlighting growing pressure on supplies.

Mendus Pharmacy said it currently has no availability of the vaccine due to what it described as a nationwide supply issue.

Mendus Pharmacy: No availability of the vaccine

In a statement, the pharmacy said: “We would like to inform our patients that, due to ongoing supply issues, we currently have no availability of the Meningitis B vaccine.

“Unfortunately, this is a nationwide shortage and all stock is currently unavailable.

“We understand this may be particularly concerning given the recent outbreak reported in Kent, and we completely appreciate the importance of timely vaccination.”

The pharmacy confirmed it is operating a waiting list and will contact patients once supplies return.

Health officials say keeping vaccinations up to date remains one of the most effective ways to prevent serious illness and reduce pressure on NHS services.

Dr Ardiana Gjini, Executive Director of Public Health at Hywel Dda University Health Board, urged parents to act.

She said: “Vaccination is one of the most effective ways we can protect children and young people from serious illness.

“Ensuring your child is fully vaccinated not only safeguards their health but also helps prevent the spread of infections within our communities.

“I strongly encourage all parents and carers to check their child’s vaccination status. If you are concerned that your child may have missed routine vaccinations, please speak to your GP.”

Meningococcal disease is a serious and potentially life-threatening infection that can lead to meningitis or septicaemia. While many people recover, some are left with long-term physical, neurological or psychological complications. Around one in ten cases can be fatal.

Although the disease can affect anyone, babies, young children, teenagers and young adults are at greatest risk.

In Wales, vaccines protecting against meningococcal strains A, B, C, W and Y are offered as part of the NHS immunisation programme. Infants receive the MenB vaccine, while teenagers are offered the MenACWY vaccine.

Latest figures from the Health Board show that uptake among 16-year-olds for the MenACWY vaccine stands at 76.4%, meaning a significant number of young people remain unprotected as they approach adulthood.

For younger children, uptake of the MenB vaccine is higher but still below the recommended 95% target. Around 92.8% of infants are vaccinated by their first birthday, rising slightly to 91.8% by their second.

Health officials say these figures reflect strong engagement from families and primary care teams but stress that continued vigilance is needed.

Families are being advised to check their child’s vaccination record with their GP or by contacting the Health Board directly. Parents should also ensure babies receive their scheduled MenB doses and that teenagers receive their MenACWY and 3-in-1 booster vaccines, which are currently being delivered in schools.

Parents are also urged to remain alert to the symptoms of meningitis and septicaemia and to seek urgent medical advice if they have concerns.

Further information on symptoms is available via NHS 111 Wales.

 

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Health

NHS ‘on brink of collapse’ during Covid as inquiry exposes failures

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Wales warned to act fast as damning report reveals staff trauma, delayed care and deadly gaps

THE UK’s healthcare system came perilously close to collapse during the Covid-19 pandemic, a major public inquiry has found, with Wales now facing pressure to act on urgent recommendations.

A landmark report published on Thursday (Mar 19) lays bare the scale of the crisis, concluding that hospitals across the UK – including in Wales – were pushed to “intolerable strain”, with some patients receiving lower levels of care and others left untreated altogether.

The findings come as First Minister Eluned Morgan welcomed the report and confirmed the Welsh Government will respond within six months.

Flawed response: Investigators identified serious failings in how the pandemic was handled

System “ill-prepared” for pandemic

The inquiry found the UK entered the pandemic in a weakened state, with staff shortages, too few hospital beds, and ageing infrastructure already placing pressure on services.

Healthcare systems “coped, but only just,” the report states, warning that collapse was only avoided due to the “almost superhuman efforts” of NHS staff.

Many workers suffered severe mental health impacts, with burnout and post-traumatic stress widespread across the workforce.

Patients died alone

Among the most distressing findings was the impact of strict hospital visiting rules.

Thousands of patients died without family by their side, while relatives were often forced to say goodbye over the phone or by text.

The report highlights how restrictions, though intended to save lives, caused lasting trauma for families across Wales and the UK.

Covid-19: Healthcare systems “coped, but only just,” the report states

Missed treatment and cancer delays

The inquiry also exposes the devastating knock-on effect on non-Covid care.

Planned operations were cancelled, screening programmes paused, and patients avoided hospitals out of fear – leading to delayed diagnoses and, in some cases, avoidable deaths.

Cancer treatment performance worsened, with late diagnoses contributing to increased mortality.

“Fundamental flaws” in response

Investigators identified serious failings in how the pandemic was handled, including:

  • Early guidance that underestimated airborne transmission
  • Shortages of PPE, leaving staff exposed
  • Poor communication with vulnerable patients
  • Inadequate planning for emergency and critical care capacity

These issues, the report says, put both patients and staff at greater risk.

Ambulances overwhelmed: The report warns future pandemics could see similar failures unless urgent reforms are made

NHS 111 and ambulances overwhelmed

Emergency systems also struggled to cope.

Demand for NHS 111 surged beyond capacity, while ambulance delays increased – even for life-threatening calls.

The report warns future pandemics could see similar failures unless urgent reforms are made.

Long Covid and hidden impact

The long-term effects of Covid are still being felt, with inconsistent care for Long Covid patients and ongoing uncertainty around treatment.

Meanwhile, millions of people who needed routine care remain affected by the backlog created during the pandemic.

Eluned Morgan: Acknowledged the significant impact on patients, staff and families

Welsh Government response

First Minister Eluned Morgan said the Welsh Government would respond “openly and constructively” to the findings.

She acknowledged the significant impact on patients, staff and families and confirmed Wales will address the inquiry’s recommendations within the required six-month timeframe.

Urgent warnings for the future

The inquiry makes ten key recommendations, including:

  • Expanding hospital and emergency capacity
  • Improving infection control guidance
  • Strengthening support for healthcare workers
  • Better data systems to identify vulnerable patients

It warns that without action, the NHS may not withstand the next pandemic.

“We may not be so lucky next time”

In one of the report’s starkest conclusions, Baroness Hallett warned that healthcare systems came dangerously close to failure.

If the crisis had lasted longer – or hit harder – the NHS could have collapsed entirely.

The message is clear: Wales and the UK must prepare now, or risk repeating the same mistakes.

 

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