South Wales NHS: Health bosses agree shake-up recommendation

Health bosses in south Wales have agreed to centralise vital consultant-led services at five hospitals.

It means the Royal Glamorgan Hospital in Llantrisant will lose consultant-led A&E services and specialist care for mothers, newborn babies and children.

Cwm Taf University Health Board, which is responsible for the Royal Glamorgan, had initially rejected the proposals.

But the group responsible for the plan - the South Wales Programme - say all five health boards are in agreement.

"These agreements are a major step forward in the programme after a long and complicated journey," said South Wales Programme director Paul Hollard.

"There is still much to be done to develop the detailed implementation of the future models of care.

"Our priority continues to be ensuring that the people of south Wales and south Powys have access to high quality, sustainable services in the future."

Since the start of 2012, senior managers and medical professionals from the Cardiff and Vale, Abertawe Bro Morgannwg, Aneurin Bevan, Powys and Cwm Taf health boards and the Welsh Ambulance Service have been working together in the South Wales Programme to develop proposals for hospitals from Swansea to Newport.

No A&E closures

The proposed changes come amid concerns that services across eight hospitals are currently spread too thinly. However, managers insist no individual A&E department would close, but like the Royal Glamorgan some may not be consultant-led.

There are also concerns that professional standards of care are not being met, junior doctors do not get the training they need and senior doctors do not get to see enough patients.

Cardiff's University Hospital of Wales, Morriston Hospital in Swansea, a new hospital near Cwmbran, Prince Charles Hospital in Merthyr and the Princess of Wales Hospital, Bridgend, are the five hospitals where services would be centralised.

The future for the Royal Glamorgan would see it become a "beacon site" for developing a new model of acute medicine for people with chronic illnesses.

Last month all agreed to back the plans except for Cwm Taf which proposed an alternative model which led to confusion over whether the reorganisation plan will be accepted.

It backed the most of the proposals, but instead of moving services from the Royal Glamorgan, it proposed an alternative which would see the Royal Glamorgan and Princess of Wales (which comes under ABM health board) sharing services as a "starting point" to centralising units.

Now, the original plans look set to move forward.

Across boundaries

Care alliances would be also set up alongside the five sites and would see clinicians from different hospitals working together across health board boundaries to provide care for patients.

They would share information, skills and expertise and the alliances would decide which work goes where.

That includes being involved with the centralising of services like consultant-led maternity and neonatal care, along with inpatient children's services and A&E.

The alliances would also ensure patients continue to have access to local assessment, care, treatment and follow-ups.

But there may be occasions - as happens now - when some patients with complex conditions need to travel to a specialist centre.

However, if an alliance was to propose any changes, it would have to go out to consultation.

A final decision will be scrutinised by five Community Health Councils (CHCs) - watchdogs - at a later date and should they not be happy, the matter will be referred to the Welsh government.

The early indication is that it could be referred as Cardiff and Vale CHC is unhappy about the recommendation being supported by its health board while Cwm Taf CHC said it was "disappointed" by the latest development.

Leighton Andrews AM for the Rhondda said: "This is disappointing news, though it is scarcely a surprise. We have campaigned long and hard to keep consultant-led accident and emergency and maternity services at the Royal Glamorgan Hospital.

'I am however relieved that the statement from the South Wales Programme Board at least commits to a long-term future for the Royal Glamorgan Hospital.

"Clearly the statement raises many questions and constituents and staff unions at the hospital will want more answers."