General emergency surgery axed as part of health board shake up

Bruce Sinclair, Local Democracy Reporter

General emergency surgery is to be removed from a west Wales hospital as part of a wide range of changes agreed by Hywel Dda Health Board.

At a two-day meeting held on February 18 and 19, the health board backed changes which will see no emergency general surgery operations taking place at Pembrokeshire’s Withybush hospital, but a strengthening of the same-day emergency care (SDEC).

Last year, the 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 an option for Withybush patients needing specialist critical care being transferred to Glangwili.

Another option, in Ceredigion, included the loss of Bronglais’s stroke service, becoming a ‘treat and transfer’ hospital, with patients transferred to other hospitals in the board area, including Withybush 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.

No change

For the other three hospitals, there will be no change in emergency general surgery provision, other than a strengthening of SDEC at Glangwili.

Members stressed the changes would not happen overnight, with the board hearing from chief executive Phil Kloer the changes were about “improving the quality of service for the public,” adding a Pembrokeshire public-preferred option of emergency general surgery operations taking place on alternate weeks, with a similar arrangement at Glangwili, had raised concerns from clinicians and managers.

The Board also backed changes to the critical care service, which will see the current intensive care units situation remaining the same at all hospitals other than Prince Philip, which will see the Intensive care unit (with transfer of sickest patients) changed to an enhanced care unit.

Reacting to the change, local Senedd member Paul Davies MS: “I’m appalled that Hywel Dda University Health Board has voted to remove general emergency services from Withybush hospital – but I’m not surprised.

“The Health Board is obsessed with removing services from Pembrokeshire and has spent years downgrading and removing services from Withybush hospital.

“As one constituent has rightly said, the Board should be rebranded the Carmarthenshire Health Board, as it continues to strip assets from other hospitals in west Wales.”

He added: “Removing general emergency services critically undermines the sustainability of Withybush hospital’s A&E department and will result in patients having to be transported for urgent treatment.

“This is not acceptable – I will be taking this to the Welsh Government and urging Ministers to intervene and stop the Health Board from making this catastrophic decision.”

‘Concerning news’

Commenting, Welsh Conservative Shadow Cabinet Secretary for Health and Social Care, Peter Fox MS, said: “This will be concerning news for patients and families in Ceredigion and across mid and West Wales.

“Downgrading emergency general surgery services in the area will mean longer journeys for urgent care, increasing pressure on patients, families and ambulance services.

“The Health Board must focus on investing in local infrastructure and ensuring safe, timely access to care, rather than centralising services and leaving communities facing longer travel times in critical situations.”

Local Welsh Conservative Senedd Member Samuel Kurtz MS added: “Residents in Pembrokeshire and Ceredigion are being treated like second class citizens, as it is always us in the West that has to see our services cut.

“The salami slicing of services is exactly what the Labour government have wanted, and the health board are delivering. This is a sad day, and residents will rightly be angry and concerned.”

‘Deep disappointment’ 

Also commenting, Sandra Jervis, Welsh Liberal Democrat Senedd Candidate for Ceredigion Penfro, said: “It remains a deep disappointment that Ysbyty Bronglais is being pushed towards a Treat and Transfer model, even with the prospect of a rehabilitation unit on site.

“Whilst locating the 24-hour stroke unit at Glangwili Hospital is clearly more sensible than Prince Philip, it still does nothing to address the needs of patients in the north of Ceredigion and the wider rural Mid Wales catchment served by Bronglais.

“The unanswered transport concerns of so many residents remain exactly that, unanswered. Families are rightly worried about long journeys at the most frightening moments of their lives, and the Health Board has yet to provide clear guarantees on how safe and timely transfers will be delivered.

“To suggest there is ‘confusion’ about what Treat and Transfer means is patronising. People understand perfectly well that acute services are being centralised away from Aberystwyth. The real issue is whether rural communities are being short-changed.”