Politicians calls for major NHS consultation to be paused

Mark Mansfield

Plaid Cymru politicians have called for a major consultation on the future of NHS services to be paused, warning that communities are being offered “different models of centralisation” rather than meaningful choices.

Eight of the party’s elected representatives in Powys have written to Powys Teaching Health Board ahead of a meeting on Wednesday, September 16, when members will decide whether its Better Together proposals should go out to formal public consultation.

The proposals could eventually see community hospital inpatient beds concentrated on either two or three sites, while urgent care would be reorganised around two Urgent Care Centres operating from 8am until 8pm seven days a week.

In their letter, the Plaid MSs and councillors say they recognise the workforce, financial and other pressures facing rural health services and support providing more care at or closer to people’s homes.

But they argue the options being put forward do not give many communities a genuine choice over retaining local hospital services.

They say all the options would remove community inpatient beds, the Minor Injury Unit and local X-ray provision from Ystradgynlais, with hospital-based activity transferred to Brecon.

In Machynlleth, they say all options would remove community inpatient beds and existing limited X-ray provision, while Welshpool would lose its Minor Injury Unit and X-ray provision to Newtown under either urgent-care option.

Residents requiring community inpatient care and enhanced urgent care in Llanidloes would also be directed to Newtown, while physical-health inpatient services at Bronllys would transfer to community provision or Brecon. Panpwnton Ward at Knighton would not reopen under the proposals.

The letter, signed by MSs Elwyn Vaughan, Beca Brown and Becca Phillips and five Plaid councillors, states: “This gives rise to a serious concern that communities are being asked to choose between different models of centralisation, rather than being consulted on a full and balanced range of credible alternatives.”

It adds: “A consultation can only be meaningful if consultees receive sufficient information about realistic alternatives and can influence the fundamental choices—not simply comment on the consequences of a predetermined direction of travel.

“A revised process is urgently needed to ensure that the future of health services in Powys is shaped with communities rather than imposed upon them.”

Plaid is asking the health board to pause the process while it develops a wider range of options, publishes detailed plans for replacement services and produces locality-level assessments covering issues including travel, equality, the Welsh language and socio-economic impacts.

The intervention comes as the health board prepares to consider whether to launch what it describes as one of the most significant public conversations about local NHS services for a generation.

Its Better Together programme is examining adult physical health, adult mental health, urgent care and some diagnostic services over the next decade.

Rising demand

The health board says rising demand, an ageing population and difficulties recruiting and retaining staff to sustain small services across a large rural county mean the current model needs to change.

All of its options would retain some services at every community hospital site, while expanding care delivered in people’s homes and communities.

However, both physical-health options envisage fewer community inpatient sites. One would reduce inpatient provision to three sites and the other to two. The urgent-care proposals would establish two Urgent Care Centres, with one option also retaining a Minor Injury and Illness Unit at a third site.

Mental health proposals include strengthened community and crisis services and concentrating organic and functional mental health inpatient beds at a single site in the Bronllys/Brecon area.

Health board chair Dr Carl Cooper stressed that members are not being asked next week to make a final decision on the configuration of services.

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.”

He said the proposals had been informed by feedback from thousands of patients, residents, NHS staff and partner organisations over the last two years.

Better outcomes

Executive Medical Director Kate Wright said there was increasing evidence of the harm caused by prolonged hospital stays and that providing more care in community settings could deliver better outcomes.

“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,” she said.

The health board’s papers say the options have undergone workforce, financial, estates, travel-time, quality and impact assessments, and insist they are not predetermined solutions but proposals to be tested through consultation.

If approved on Wednesday, a 14-week consultation is due to begin on October 5 and run into January, with no final decision taken until responses and further evidence have been considered.

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