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.Under its Better Together programme, external 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, external, 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.