Proposals by Powys Teaching Health Board to reduce inpatient beds in some of Wales' most rural areas are facing strong opposition from GPs, politicians, and local communities. The plans, part of the health board's "Better Together" program, could see the number of community hospital beds in Powys decrease from 146 to either 90 or 60.
Under the most extensive proposal, inpatient wards could be eliminated from hospitals in Welshpool, Machynlleth, Ystradgynlais, and Llanidloes, with Llandrindod Wells also potentially losing its beds. The health board argues these changes are necessary for safety and sustainability, citing difficulties in staffing and delivering services across the county's large geographical area. A 14-week public consultation on the future of health services in Powys is currently underway.
Proposed Service Changes
The health board is considering two options for inpatient beds. The first option would centralize beds in three community hospitals: Brecon, Newtown, and Llandrindod Wells, resulting in approximately 90 beds. The second option would consolidate beds into two hospitals in Brecon and Newtown, reducing the total to about 60 beds. Any such changes would be implemented over several years.
In addition to inpatient beds, the proposals include changes to urgent care and diagnostic services. One option for urgent care would establish Urgent Care Centres (UCCs) in Newtown and Brecon, and a minor injuries unit in Llandrindod Wells, operating daily from 8 a.m. to 8 p.m. The minor injury unit in Welshpool would remain open until the Newtown UCC is operational, after which it would close. The second option for urgent care would involve only two UCCs, located in Newtown and Brecon.
A proposal for mental health services includes consolidating all adult and older adult mental health services at a single site, potentially at Bronllys hospital or a new location in the Bronllys/Brecon area, alongside expanding community mental health services.
Community Resistance
The proposed cuts have already generated significant public concern. In August, over 400 people attended a public meeting in Llanidloes to protest the potential closure of community hospital beds in the town. The health board reports that community hospital beds in Powys typically operate at 85% to 90% occupancy.
According to a report presented to the health board, the current dispersed model "provides valued local services, but its dispersed configuration makes it increasingly difficult to meet needs consistently." The health board also noted that approximately 40% of its budget, around £198 million in the last financial year, is spent on services commissioned from outside Powys. The current delivery of urgent care across the county is also described as inconsistent and inequitable, with increasing demand.