Health board considers concentrating services at fewer sites under major shake-up

Mark Mansfield

Hospital beds and other health services could be concentrated at fewer locations under options being considered as part of a major shake-up of healthcare.

Powys Teaching Health Board has stressed there are no proposals to close any of its community hospital sites, but says changes to the services provided at individual locations are among the options being developed.

The health board is expected to decide in September whether to launch a formal public consultation under its Better Together programme, with final decisions not expected before spring 2027.

The programme is looking at the future of adult physical and mental health community services, some all-age diagnostic services and Minor Injury Units for people aged one and over.

Among the scenarios still under consideration is providing more services through “centres of excellence”, including Rural Regional Centres. The health board acknowledges this could mean services such as hospital beds being provided at fewer locations.

Another option would expand the range of care available in people’s homes by strengthening primary and community healthcare teams.

The health board says more than half of patients currently occupying community hospital beds could be better cared for at home if appropriate community services were available.

However, it has ruled out an option that would see inpatient care, including community hospital beds, provided outside Powys by neighbouring health boards.

It has also ruled out building a district general hospital in the county, saying there are no safe or feasible options for doing so.

‘No change’ ruled out

An option to leave services as they are has also been rejected.

Health board chair Dr Carl Cooper and acting chief executive Pete Hopgood said in an update to politicians: “It has become increasingly clear that ‘no change’ is not an option.

“We know that older people can experience harm and deconditioning from hospital admission.

“We also know that over half of patients currently in a community hospital bed could be better cared for at home, if the right community health care services [were] available.”

They said community hospital beds would remain an “essential and valuable” part of the health service but their role needed to be considered alongside other forms of care.

The remaining scenarios are expected to form the basis of detailed options presented for consultation.

Dr Cooper and Mr Hopgood acknowledged that some could change which services are available at individual community hospitals.

They said: “There are no plans to close any hospital sites in Powys.

“But it is right that we take the time to carefully consider a wide range of options – looking at how we strengthen primary and community services, and how we provide bed-based care in the best possible way for the future.”

The health board says its proposals are being developed in response to changing health needs, staffing pressures and increasing demand, alongside financial pressures facing public services.

Consultation plans

At its July 29 meeting, the board approved plans for how a future consultation would be carried out but did not approve specific options for changing services.

If the consultation goes ahead, public drop-in events would be held in all 13 Powys localities alongside meetings with community groups, independently run focus groups and other opportunities to respond.

The health board said the programme was “not primarily driven by financial considerations” but was intended to develop a healthcare system capable of meeting the future needs of a large rural county.

The board will consider a pre-consultation business case in September before deciding whether the proposals are ready to go out for public consultation.

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