Health board plans could see community hospital beds cut from 146 to as few as 60

Mark Mansfield

A health board could reduce the number of community hospital beds from 146 to as few as 60 under options for a major shake-up of health services.

New Powys Teaching Health Board papers reveal physical health inpatient beds could be concentrated at either three hospitals – Brecon, Llandrindod Wells and Newtown – or just two, at Brecon and Newtown.

Under both options, physical health inpatient beds would be removed from Ystradgynlais, Welshpool, Llanidloes, Machynlleth and Bronllys.

The health board will decide on September 16 whether to launch a formal public consultation on its Better Together proposals, following months of controversy over the future of services in the county.

The current 146 physical health beds are spread across eight community hospitals.

Under the three-site option, beds would remain at Brecon, Llandrindod Wells and Newtown, while the alternative would concentrate all physical health inpatient provision at Brecon and Newtown and could reduce the total number of beds to 60.

All community hospital sites would remain open under the proposals, but the services available at them would change.

The plans also include concentrating urgent care services at Brecon and Newtown.

Llandrindod Wells would retain a Minor Illness and Injury Unit under one of the two options, while existing units at Ystradgynlais and Welshpool would close.

X-ray services would also be removed from Ystradgynlais, Welshpool and Machynlleth.

Adult and older adult inpatient mental health services would meanwhile be consolidated at a single site in the Bronllys or Brecon area, ending existing inpatient provision at Llandrindod Wells and Ystradgynlais.

‘Hoodwinked’

Welsh Liberal Democrat MP David Chadwick and Senedd Member Jane Dodds have accused the health board of “hoodwinking” residents, arguing that the options amount to a choice between different levels of centralisation rather than whether services should be centralised at all.

Brecon, Radnor and Cwm Tawe MP Mr Chadwick said: “People across Powys were promised that they would have a genuine say over the future of their hospitals. Instead, they are being presented with a choice between two different versions of sweeping cuts.

“Before a single resident has responded to the formal consultation, most options have already been taken off the table. Keeping our existing network of community hospital beds isn’t even being offered as a choice. How can anyone reasonably describe that as a genuinely open consultation?

“People will understandably feel they have been hoodwinked.

“For places like Ystradgynlais, the scale of what is being proposed is staggering. The hospital stands to lose its inpatient beds, its Minor Injury Unit, its X-ray service and its mental-health inpatient beds.

“We will not stand for the hollowing out of our community hospitals. We are gearing up our campaign across Powys and will fight tooth and nail to protect the local services our communities depend on.”

Brycheiniog Tawe Nedd MS Ms Dodds called on the Welsh Government to intervene.

She said: “This is a shocking betrayal of the trust of communities across Powys.

“The Plaid Cymru Welsh Government cannot wash its hands of this. These proposals are being brought forward in a Welsh NHS that the Welsh Government is responsible for funding and overseeing, and the Health Minister needs to intervene now.

“I have repeatedly warned Ministers that rural healthcare cannot simply be treated as though Powys were an urban area where another hospital is ten minutes down the road. Removing beds and centralising services inevitably means much longer journeys for some of the oldest and most vulnerable people in Wales.

“If the Welsh Government genuinely believes in protecting rural healthcare, it needs to prove it. That means giving Powys the funding it needs and telling the Health Board to go back to the drawing board with options that actually protect community hospital provision.

“The people of Powys deserve a real choice over the future of their NHS, not a sham consultation where some of the most important options have been discarded before they are even asked.”

Occupancy

The details emerge days after figures obtained through a Freedom of Information request showed six of eight Powys hospitals had average bed occupancy rates above 90% during 2025.

Llandrindod Wells and Machynlleth had the highest rates at 98%, followed by Welshpool and Newtown at 96%, Brecon at 94% and Llanidloes at 91%.

The health board subsequently defended its Better Together programme, arguing that high occupancy did not necessarily demonstrate a need for more beds because many patients were waiting for support that would allow them to return home.

It says the proposals would increase the amount of healthcare provided in people’s homes and communities, reducing the need for bed-based care.

Under the plans, Urgent Care Centres would operate from 8am to 8pm, seven days a week, offering a wider range of assessment, treatment and diagnostic services than existing Minor Injury Units.

Community mental health and crisis response services would also be strengthened alongside NHS 111 Wales Press 2 and sanctuary services.

Health board chair Dr Carl Cooper stressed that members are not being asked to approve the service changes when they meet on September 16.

He said: “The Board is being asked to consider whether these proposals are ready to be examined through formal public consultation.

“Our responsibility is to consider whether the evidence, options and supporting information are sufficiently developed to progress to this important next step. If consultation is approved, we want people to test the evidence, challenge our thinking, and help inform what happens next.

“The recommendations being considered by the Board on 16 September have been informed by feedback from thousands of patients, residents, NHS staff and partner organisations over that last two years.

“This is not currently a decision on the future configuration of services. Such decisions could only be made following full and meaningful consultation.”

Better care

Executive Medical Director Kate Wright said: “Harm from prolonged hospital stays have become well evidenced. It is clear that a health system that can provide more care in community settings would deliver better care and outcomes for patients.

“These proposals explore how we can provide safe, high-quality care for future generations, support more people to stay well and independent, and retain inpatient care for those whose needs cannot safely be met at home.

“They are focused on strengthening community services for patients with physical and mental health needs.”

The health board has previously ruled out maintaining services in their current form, as well as building a district general hospital in Powys or transferring community inpatient care to neighbouring health boards.

It has said recruiting and retaining staff for small services spread across a large rural county is becoming increasingly difficult, while demand is increasing as the population ages and more people live with multiple long-term conditions.

If approved, the consultation would run from October 5 until January 10.

Responses, alternative proposals and new evidence would then be considered before recommendations are brought back to the health board, currently expected in spring 2027.

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