Health Board faces tough decisions amid financial struggles

Elgan Hearn, local democracy reporter

As a local Health Board grapples with a mounting financial deficit, board members are preparing to make significant decisions that could reshape healthcare delivery across the county.

Despite widespread public opposition, the Powys Teaching Health Board is set to proceed with proposals to reduce the operating hours of minor injury units and centralise inpatient hospital care.

The changes, initially being labelled as “temporary,” have sparked intense debate within local communities, with many raising concerns about the long-term impacts on healthcare access.

Backlash

The health board’s proposals, particularly the reduction in Minor Injury Units operating hours at hospitals in Brecon and Llandrindod Wells, have met with strong opposition from residents. Over 3,000 people signed petitions calling for the preservation of overnight services at both facilities.

During an extended engagement period, the health board gathered feedback from nearly 800 voices, including residents, staff, and local politicians with public meetings and webinars attracting hundreds more, with the majority expressing concerns about the downgrading of local healthcare services.

A key focus of criticism has been the perceived threat to the county’s Minor Injury Units, which provide critical out-of-hours care. Many feel that the proposed cuts could leave patients vulnerable, particularly in more rural areas where access to larger hospitals may be limited.

Despite these concerns, the health board remains committed to its case for change, citing a need to stabilise the service and reduce uncertainty.

Pressure

The root cause of the proposed changes lies in the health board’s financial crisis. The board is facing a projected deficit of £23 million this year, a figure that could grow to £35 million if action is not taken.

In July, the board agreed to trial the service changes for six months in response to this budgetary pressure, though the proposed cuts, particularly to Minor Injury Unit hours, are seen as an immediate, albeit temporary, measure to address the shortfall.

The executive committee of the health board has acknowledged that the changes will not be easy for the public to accept, but insists that no viable alternatives were identified during the consultation process.

The committee argues that the temporary measures are necessary to pave the way for longer-term solutions that will secure sustainable healthcare services in the county.

Consolidation

In addition to the changes to Minor Injury Unit hours, the board is considering centralising inpatient care by grouping patients in hospitals based on their specific needs.

Under this plan, hospitals like Llanidloes War Memorial Hospital and Bronllys would focus on preparing patients for discharge, while facilities in Brecon and Newtown would specialise in rehabilitation services for conditions such as strokes.

The centralisation strategy has drawn mixed reactions. While some see the potential benefits of more specialised care, others worry about the impact on patient access, particularly for those who live far from these specialised units.

Nonetheless, health board leadership believe that this restructuring is essential to ensuring patient safety and service efficiency.

Future

The next steps in this process will come at a crucial meeting of the health board in October, where members will review the results of the public engagement and decide whether to proceed with the changes.

If approved, the cuts to hours will take effect by December 1, with the inpatient changes following by the end of November, and a review of these temporary measures is scheduled for May 2025, which will determine whether they become permanent.

While the board maintains that these changes are necessary to secure the future of healthcare in Powys, it remains to be seen how the public will respond in the long term, particularly if these “temporary” measures become permanent.

The unfortunate battle between balancing budgets and meeting public healthcare needs in Wales is far from over.