Downgrading of stroke services at Bronglais hospital confirmed

Bruce Sinclair, local democracy reporter

Stroke provision at Ceredigion’s Bronglais hospital is to downgrade to a ‘treat and transfer’ to other hospitals model, but with the addition of a rehabilitation service on-site, following a decision by the health board.

Last year, Hywel Dda University Health Board consulted with its communities on options for change in critical care, dermatology, emergency general surgery, endoscopy, ophthalmology, orthopaedics, stroke, radiology and urology.

It said its Clinical Services Plan focuses on nine healthcare services that are “fragile and in need of change”.

At the launch of the consultation it said the services, and potential changes at the four main hospitals of Haverfordwest’s Withybush, Carmarthen’s Glangwili, Llanelli’s Prince Philip and Aberystwyth’s Bronglais, would see no changes to how people access emergency care (A&E) or minor injury care as part of the consultation.

These nine clinical services were selected because of risks to them being able to continue to offer safe, high-quality services, or care in a timely manner, the board has previously said.

The proposed changes included the loss of Bronglais’s stroke service, becoming a ‘treat and transfer’ hospital, with patients transferred to other hospitals in the board area for their inpatient stroke care.

During the consultation, communities shared an additional 190 alternative ideas for the services, which have been narrowed down to 22 alternatives to the multiple options outlined in the consultation.

At a two-day meeting into the proposed changes, held on February 18 and 19, the board considered four options for the stroke service at Bronglais, rejecting its original two consultation options in favour of a combination of merging the other two options proposed, which would still see a treat and transfer and stroke rehabilitation service at Bronglais, with a specialised unit in Carmarthenshire.

Members heard there would be further engagement around the ‘merged’ proposals for Bronglais before it was finalised.

‘Lack of clarity’

Local Senedd Member Elin Jones welcomed the original consultation options being rejected in favour of a Treat and Transfer and Stroke rehabilitation unit at Bronglais, with the specialist stroke unit in Glangwili in Carmarthen, rather than Prince Phillip Hospital in Llanelli, but said there was a lack of clarity in what was now being proposed.

“There is now considerable confusion around what may be proposed for stroke patients at Bronglais. Whilst Glangwili now seems likely to be the location of the Board’s main Stroke Unit rather than Llanelli, it’s less certain what the Rehabilitation service proposed for Bronglais will entail. People in the Teifi Valley will be much better served by a Glanwgili Unit rather than face transfer to Llanelli.

“However, for Bronglais, the Treat and Transfer Model remains in the new proposal, and no clarity has been proposed on how a safe and dedicated model of transfer for very ill stroke patients will be guaranteed. People will also want to know what a longer-term rehabilitation service at Bronglais will look like.”