Rural health board shake-up opposed as locals fight cuts to hospital beds

Proposals to cut community hospital beds in some of Wales' most rural areas have met with strong resistance.

The plans would see inpatient beds reduced from 146 to either 90 or 60 in Powys, with services concentrated in just two or three of the county's eight community hospitals.

It means inpatient wards could disappear from Welshpool, Machynlleth, Ystradgynlais and Llanidloes, while Llandrindod Wells could also lose its beds under the most extensive option.

Powys Teaching Health Board said the changes were needed to make services safe and sustainable, arguing that its current model was increasingly difficult to staff and deliver across such a large geographical area.

A 14-week public consultation on the future of health services in Powys was now under way, but the plans had already been opposed by GPs, politicians and communities concerned about the impact on an ageing rural population.

In August more than 400 people attended a public meeting in Llanidloes to oppose the closure of community hospital beds in the town.

A drop-in meeting was held in Llanidloes on Tuesday, following a number of public meetings in other parts of Powys to discuss the health board's plans.

Jill O'Connor, from the Llanidloes Hospital Alliance Group said plans to instead deliver more care in the community were not workable, arguing that it would be difficult to provide care for people who live at least 20 or 30 miles out of town in remote rural areas, particularly in the middle of winter.

"It beggars belief that they want to go and work, treat people in homes when actually... you can treat a bigger group collectively in a hospital rather than with individual staff," she said.

"And we don't think that they've actually put the infrastructure in place.

"Yes, they will have excess numbers of nurses... from the hospitals that they're going to close, but those people need training up," she said.

"The community feels very passionately that this is their hospital and it serves the community."

Powys has one of the oldest populations in Wales, with more than a quarter of residents aged over 65.

The health board estimates the average journey time to inpatient care could rise from around 12 minutes to 24 minutes under the proposals. For some people living furthest from hospitals, journeys could take more than 45 minutes each way.

The impact of potentially losing local inpatient facilities is causing concern for many families.

Tuppin Scrase said his wife died five years ago after receiving palliative care in Llanidloes, and that he would not have been able to see her if she had not been cared for further away.

"At that time, it was the time of Covid, and if she'd had to remain in Shrewsbury or Aberystwyth, which are our nearest general hospitals, I could never have seen her," he said.

"In the whole month it took her to die, I would not have been able to see her. It was only because it was local that I could actually get there and be with her."

Under its Better Together programme the health board is proposing changes to services in a range of areas - adult physical health, adult mental health, urgent care and some diagnostic services.

Among the proposed changes, the most controversial could affect inpatient beds in most of Powys' community hospitals where occupancy rates are usually around 85 to 90%.

Powys does not have a general hospital, but it does have beds in eight community hospitals.

According to a report to the health board the current model "provides valued local services, but its dispersed configuration makes it increasingly difficult to meet needs consistently".

It will consult on two possible options:

• The first option would see beds located in three community hospitals in Brecon, Newtown and Llandrindod Wells. This would mean a reduction from 146 to around 90 inpatient beds for the whole of Powys.
• The second option would see beds located in two community hospitals in Brecon and Newtown. This would mean a reduction to around 60 inpatient beds.

Any changes would happen over a number of years.

A health board report said about 40% of its budget is spent on services commissioned from outside of Powys - in the last financial year this was around £198m.

There are also proposed changes to Powys' minor injuries units and the way urgent care is delivered in the county.

At the moment, urgent care is delivered in a variety of ways including by GPs, an out of hours service, pharmacies and health board minor injuries units.

But the health board believes the current service "does not provide consistent or equitable access across the county" and demand for urgent care is increasing.

Its is proposing two options for changes to urgent care and diagnostic services.

The first option would see urgent care available on three sites - Urgent Care Centres (UCCs) would be established in Newtown and Brecon, and a minor injuries unit in Llandrindod Wells, operating from eight in the morning until eight at night, seven days a week.

The minor injury unit would stay in Welshpool until the UCC opens in Newtown, and then the minor injury unit in Welshpool would close.

The second option would see just two UCCs in Newtown and Brecon.

One option for changes to mental health services is proposed - the consolidation of all adult and older adult mental health services at a single site, either at Bronllys hospital or a new site in the Bronllys/Brecon area, as well as expanding community mental health services.

The health board said their proposals responded to major challenges facing health services.

"People are living longer, often with several long-term conditions; demand is rising; and recruiting and retaining the workforce needed to sustain small services across a large rural county is becoming increasingly difficult," Powys Teaching Health Board said in a statement previously.

It said the overhaul was necessary to ensure services could "remain safe, effective and sustainable, while helping more people stay well, remain independent and receive care at home or closer to home".

The consultation closes on 10 January 2027.