GP mental health referrals to change across west Wales

Adults seeking routine mental health support in west Wales will be directed to a telephone helpline rather than local specialist teams under a new pathway approved by Hywel Dda University Health Board.

The change, agreed by the board this week, will see patients in Ceredigion assessed by their GP as needing non-urgent support asked to contact NHS 111 Wales “Press 2” instead of being referred directly to community mental health teams.

The model, which has been operating temporarily in Ceredigion since March 2025, will now be made permanent and rolled out in phases across Carmarthenshire and Pembrokeshire.

Health board officials say the move is designed to improve access to care and ensure patients receive support more quickly.

Liz Carroll, Service Director for Mental Health and Learning Disabilities, said the change would help streamline services and prioritise those with the greatest need.

“Our priority is to ensure safe and efficient access to mental health care and ensure that all patients receive the support they need, when they need it,” she said.

“In Ceredigion, the pathway was temporarily changed as an emergency measure because of significant shortages of nursing and medical staff in the community mental health team.

“Making this change permanent will mean more adults needing non-urgent mental health support will access support much quicker through the NHS 111 Wales Press 2 service.”

She added that the shift would also free up capacity for people with more complex or urgent needs to be seen face-to-face.

Previously, patients in Ceredigion could wait up to 28 days or longer for an in-person assessment, despite fewer than 5% requiring that level of intervention.

The health board said an evaluation of the temporary system found no increase in serious incidents, adverse events or complaints, and concluded that care had been delivered safely.

Accessibility

However, the decision follows a nine-week engagement period which highlighted concerns among patients, clinicians and third sector organisations — particularly around accessibility for those who may struggle with telephone-based services.

Andrew Carruthers, Chief Operating Officer at the health board, said feedback had played a key role in shaping the final decision.

“People told us they wanted greater clarity and consistency around how the referral pathway works,” he said.

“We also heard concerns about accessibility… as well as worries about medication and prescribing arrangements.”

He said the board had committed to addressing those concerns as the model is introduced more widely.

“We will work with our colleagues to reduce the areas of concern… and introduce the pathway in phases across Pembrokeshire and Carmarthenshire,” he added.

Specialist teams

GPs will continue to refer patients with urgent or complex mental health needs directly to specialist teams, while a dedicated NHS 111 line will remain available for clinicians concerned about a patient’s ability to access the service.

The NHS 111 Wales Press 2 service offers 24-hour telephone support from wellbeing practitioners, overseen by registered mental health nurses, and is free to call from both landlines and mobiles.