A consultation on the Hywel Dda University Health Board’s Clinical Services Plan, which focuses on nine healthcare services that are “fragile and in need of change,” is coming to an end in days, with final decisions expected to be announced later this yearRobert Harries Senior Reporter, Bruce Sinclair and Local Democracy Reporter
08:36, 29 Aug 2025
Withybush General Hospital Haverfordwest(Image: Local Democracy Reporting Service)
Just three days remain to respond to a public consultation that could result in some west Wales hospitals losing services, including a proposal for patients at Withybush in Pembrokeshire requiring specialist critical care to be moved to Glangwili.
A separate proposal in Ceredigion would see Bronglais lose its stroke service, transforming it into a ‘treat and transfer’ facility, with patients moved to other hospitals within the health board area, including Withybush for inpatient stroke treatment. Just this week there were fresh calls for large investment to be pumped into upgrading Carmarthen’s Glangwili Hospital with a new replacement hospital seemingly further away from reality than ever.
Hywel Dda University Health Board’s ‘Clinical Services Plan’ targets nine healthcare services that are “fragile and in need of change,” according to the organisation. Read the biggest stories in Wales first by signing up to our daily newsletter here.
The services and potential modifications at the four principal hospitals – Haverfordwest’s Withybush, Carmarthen’s Glangwili, Llanelli’s Prince Philip and Aberystwyth’s Bronglais – encompass critical care, emergency general surgery, stroke, endoscopy, radiology, dermatology, ophthalmology, orthopaedics, and urology.
No alterations to emergency care (A&E) or minor injury care access form part of this consultation, with a separate ongoing consultation regarding minor injury care at Prince Philip.
The health board previously stated these nine clinical services were chosen due to concerns about their capacity to maintain safe, high-quality services or deliver care promptly. At the board meeting in May, members agreed to launch a public consultation, running until August 31, into the proposed changes.
These changes present various options for each of the nine services across the area, with some hospitals potentially gaining or losing services, and community site options also being considered in certain cases.
For critical care, three options are on the table.
The first option is to maintain intensive care units at Bronglais and Glangwili, while providing an enhanced care unit at Withybush and Prince Philip. An additional enhanced care unit would be developed at Glangwili, allowing the intensive care unit there to focus on the most critically ill patients.
Patients at Prince Philip or Withybush requiring specialist critical care would be transferred to Glangwili.
The second option proposes keeping intensive care units at Bronglais, Glangwili and Withybush, with Prince Philip housing an enhanced care unit. Patients needing specialist critical care would be stabilised at Prince Philip before being transferred to the Glangwili intensive care unit.
The third option suggests maintaining intensive care units at all sites.
In terms of emergency general surgery, two options have been proposed.
Currently, full emergency general surgery services, including surgical operations for adults, are provided at Glangwili, Bronglais and Withybush. Patients from Prince Philip are transported to Glangwili.
Emergency general surgery consultant surgeons would be stationed at Bronglais and Glangwili, offering full emergency general surgery services including surgical procedures. Patients requiring surgery at Withybush would be transported to Glangwili for their operation, before being returned to Withybush to recover when deemed fit.
Emergency general surgery consultant surgeons would be based at Bronglais, and would alternate weekly between Glangwili or Withybush to perform surgical operations.
This option necessitates additional surgical cover at Glangwili for children and young people (paediatrics) during weeks when the service is operating in Withybush.
Two options have been proposed for stroke services, which are currently operated at all four main hospitals, including Prince Philip and Withybush having stroke units, with specialist cover 12-hours a day. This means stroke patients from ‘treat and transfer’ hospitals at Bronglais and Glangwili would be transferred to Prince Philip or Withybush for their inpatient stroke care.
For endoscopy, operating from Bronglais, Glangwili, Prince Philip and Withybush, there are three options, including Bronglais no longer offering urology, as it does now, and Glangwili no longer offering respiratory and urology.
For radiology, there are four options.
Planned diagnostic radiology and planned day case interventional radiology (both Monday-Friday, daytime) is provided from Bronglais, Prince Philip and Withybush.
One possibility features planned diagnostic radiology delivered from a fresh and dedicated diagnostic centre (location yet to be determined), within a community environment, which does not form part of the alternative proposals.
This proposed centre alongside extended operating hours for scheduled diagnostic radiology would enable Prince Philip and Withybush to offer a focused cancer service.
Regarding dermatology, four possibilities are being considered.
Following the Covid-19 pandemic, dermatology provision including outpatient consultations and minor procedures has predominantly been delivered at Prince Philip.
Concerning ophthalmology, three possibilities exist, including a community location (site yet to be determined) within Pembrokeshire.
Regarding orthopaedics, four possibilities are under consideration; whilst for urology, presently delivered across all four principal hospital locations, there is one possibility, to consolidate overnight patients (inpatients) at Prince Philip Hospital. Outpatient services, day cases and additional diagnostics would continue at Bronglais and Withybush.
Glangwili would exclusively handle emergency cases arriving via the emergency department.
During the May meeting, Medical Director Mr Mark Henwood stated: “No decisions have been made on the options presented, and there are currently no preferred solutions. The changes we are looking to make are to ensure we have safe, high-quality services and affordable healthcare in the future, and have at their heart the best interests of the people of west Wales and their patient experience.
“We ask that you review the consultation documents and share your views on which options you believe are best able to address service fragilities, improve standards, or reduce waiting times.
“We want to listen to your concerns or potential impacts you think options may have and your views on the future role of our hospitals. We also welcome any alternative options or ideas you may have.”
Following the consultation, the proposals will be further discussed at a future health board meeting, expected to be in November of this year.