Powys Teaching Health Board has unveiled proposals to restructure inpatient services across the county as part of its Better Together programme, with a 14-week public consultation currently underway. The health board is considering two options for community hospital beds: one would consolidate services in three hospitals in Brecon, Newtown, and Llandrindod Wells, reducing capacity from 146 to approximately 90 beds, while the second would concentrate all beds in just two hospitals in Brecon and Newtown, cutting capacity to around 60 beds. Under both scenarios, inpatient wards would close in Welshpool, Machynlleth, Ystradgynlais, and Llanidloes, with the most extensive option also eliminating beds at Llandrindod Wells.
The health board has argued that the changes are necessary to ensure service sustainability and safety, citing difficulties in staffing and delivering care across Powys’ large geographical area. Current occupancy rates at community hospitals range between 85 and 90 percent. The proposal has generated significant community opposition, with more than 400 residents attending a public meeting in Llanidloes in August to voice concerns. Local officials and GPs have also raised objections, particularly regarding the impact on an aging rural population. Powys has one of Wales’ oldest populations, with more than a quarter of residents aged over 65.
Opponents argue that shifting care to community settings is impractical given the distances involved. Residents living in remote areas are often 20 to 30 miles from towns, and travel becomes especially challenging during winter months. The health board estimates average journey times to inpatient care could increase from approximately 12 minutes to 24 minutes, with some patients potentially facing journeys exceeding 45 minutes each way. Community representatives have also raised concerns about workforce capacity, noting that staff displaced from closed hospitals would require training to transition to community-based roles.
The proposals extend beyond inpatient beds to encompass urgent care restructuring. The health board is proposing either three urgent care sites or two, with services delivered through Urgent Care Centres in major towns and minor injuries units. Mental health services would be consolidated at a single location, either Bronllys hospital or a new facility in the Bronllys or Brecon area. The health board’s statement indicated that rising demand, longer patient lifespans with multiple chronic conditions, and workforce recruitment challenges are driving the need for reorganization. Any service changes would be implemented over several years.
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