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Decision Made, Glangwili and Withybush Hospitals are to Lose A & E

Well the 12-week consultation period has ended and today some decisions have been made, which includes that Glangwili Hospital in Carmarthen and Withybush Hospital in Haverfordwest both being Downgraded.

Hywel Dda University Health Board covers Carmarthenshire, Ceredigion, Pembrokeshire and borders and are embarking on an ambitious 20-year journey to transform the way people receive health care and support within these areas.

Local Response to Consultation

During April and July this year, one of the largest local NHS consultations in the UK was held to gather everyone’s feedback about options of possibly changes. There was a huge and passionate response from the local population in relation to the Consultation. There were more than 5,400 questionnaires received, 4,000 attendees at events and workshops, hundreds of written submissions, five petitions and extensive social media debate.


The Main Decisions Made Today

At a public board meeting held today Wednesday 26th September, decisions of what changes were to be actioned were made and the result was mostly like what was option B on the consultation documents. The main decisions which were agreed today includes: -

  • Bronglais Hospital in Aberystwyth – Will stay as a District General Hospital, the hospital services to be retained and developed here, in-line with the Mid Wales Joint Health and Social Care Committee recognising importance of hospital in delivery of services to populations of Ceredigion, Powys and South Gwynedd.
  • Prince Philip Hospital, Llanelli – Will stay as a District General Hospital, keeping acute medicine hospital services that need medical input, following recent modernisation of services developed with the local community and serving a densely populated area
  • Glangwili in Carmarthen and Withybush in Haverfordwest – Both these Hospitals will be “re-purposed” Essentially, downgraded from a General Hospital and they will lose their to support community health needs including overnight beds, day case procedures, out-patient and walk-in services such as minor injuries and much more
  • Build a New Hospital – The exact location has not been totally decided however it is preferred to be in the south of Hywel Dda, somewhere between Narberth and St Clears. This New Hospital will provide specialist urgent and emergency care services as well as planned care
  • More Investment – More investment will be made to the integration of social care with health and well-being across the seven localities of north and south Ceredigion, north and south Pembrokeshire, Taf/Tywi, Amman/Gwendraeth and Llanelli.

So even though these key decisions have been made, the health board received really insightful feedback from people during the consultation and wants to investigate further, and demonstrate, some developments, including such things as:

  • Examine the opportunities a new hospital and community model could offer maternity and child health services to ensure doctor and midwifery led care, and care for children (paediatrics) and sick babies (neonatal) are maintained within the boundaries of the Hywel Dda area.
  • Align with the transformation work in mental health services to ensure mental health and learning disability assessment and treatment units are provided at the new urgent and planned care hospital.
  • Work with people living and working in the areas furthest from a new hospital to provide additional support for emergency and urgent care (potential to look at things like placing paramedics within in a community as opposed to within a vehicle)
  • Work closely with Abertawe Bro Morgannwg University Health Boardon services where patients could benefit from a regional approach
  • Respond to public anxiety over the ability to manage emergency conditions that are time sensitive (e.g. ST Elevation Myocardial Infarction STEMI, stroke and sepsis) consider the opportunities a new hospital in the south would provide Bronglais Hospital
  • Work closely with other organisations, including county councils and the third sector, to develop Glangwili and Withybush hospitals
  • Formally state the Health Board’s support for building a case for provision of a 24/7 service to bring medics to the scene of an accident (e.g. the Emergency Medical Retrieval Transport Service, which operates 12 hours a day and CHANTS (Neonatal Retrieval Service)
  • Develop a plan to maximise use of technology in health and care, backed up by secure IT so patient data is safe and joined up between services in the hospital and community
  • Work with education and university partners to train a workforce with the skills and expertise to work in the new service model, and drive research, innovation and evaluation into our service development


Comments from Those Involved in the Decision

Chief Executive Steve Moore said: “Today is a hugely momentous day as we confirm we will take a new direction to providing much more preventative and community-based healthcare to our population. We’ve heard the concern people have with current healthcare provision and our ability to deliver this sea-change in the years to come but our clinicians have led this work and we believe what has been put before us today offers us the best chance to deal with the fragility our NHS faces and to provide the population with safe, effective care that meets their needs.”

Chair Bernardine Rees added: “We are really grateful to everyone who got involved in our consultation as it has given us really rich feedback. Our ambition is to continue that conversation and input so that we can grow services in our seven localities, using schemes we have already delivered, such as the front of house project at Prince Philip Hospital and Tenby walk-in, as the basis of what can be achieved.”

Medical Director and Director of Clinical Strategy Dr Philip Kloer said: “We’re aware that some people, particularly those who live furthest from the new hospital zone between Narberth and St Clears may be anxious about these changes. They will not happen overnight and we are committed to working with those communities and our partners to demonstrate and test what additional provision can be made, particularly for time-sensitive emergency conditions.

 “For example we are working with partners to build the case for the Emergency Medical Retrieval Team (doctors who are brought to the scene to treat and then transfer) and CHANTS (the Neonatal Retrieval Team) to be a 24-hour service, and also investigating the potential to place advanced paramedics in communities so they are available solely to that community.

 “Another important factor in providing life-saving treatment is getting people quickly to the definitive hospital which will provide their care. At the moment, people in our coastal areas of Pembrokeshire have to travel to Glangwili for some treatment, which in the future, we will be able to offer at a more equitable location, for the south of Hywel Dda, in the new hospital zone.”


What Happens Next

The next step will be for clinicians and staff to work with the public and other organisations to bring the additional detail together into a draft Health Strategy to put before public Health Board at the end of November. The position of the New Hospital has not been decided and will be dependent also on a full business case, which will be made to the Welsh Government.





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