KEY hospital services in Gwent are set to be centralised during the next year to tackle staffing, safety and standards issues.

Stroke, emergency general surgery, breast, clinical haematology, and family and therapy services - the latter including neonatal, paediatric, obstetric and maternity provision - are all under the spotlight as part of Aneurin Bevan Health Board's plans for the next three years.

The board has approved in principle to reorganise stroke services so as to introduce a single point of admission for acute stroke patients.

Such a plan would have been implemented upon the opening of the still proposed Specialist and Critical Care Centre (SCCC) in six years time, but has been brought forward so quality standards can be maintained. The details of changes to acute stroke care are not yet available.

It is also proposed that stroke rehabilitation services, currently provided across seven inpatient sites, will be reviewed and reorganised.

Big changes are also in the pipeline for emergency general surgery. This service too was proposed for centralisation when the SCCC opens, but difficulties in maintaining consultant and surgical trainee staffing rotas at Nevill Hall Hospital have prompted the health board to bring forward that plan.

The aim now is to centralise emergency general surgery by next August, with a key part of the plan being to increase routine general surgery across hospitals, to create single site capacity for emergencies.

Difficulties in maintaining medical staffing rotas across two sites - the Royal Gwent and Nevill Hall - are also behind the drawing up of contingency plans to house family and therapy services on one site.

One of the options for easing these difficulties could also save £1.4 million a year in running costs, but this would need considerable capital investment, of around £1.3m.

The feasibility of a single site for family and therapy services is being discussed with health board staff, patients' watchdogs and the Welsh Ambulance Services NHS Trust, and firm plans should be ready by the beginning of 2014.

Clinical haematology - which focuses on investigation and treatment of blood disorders - is another service being considered for centralisation, and this could also be expanded by bringing back to Gwent work currently carried out in Cardiff.

There are also plans to centralise outpatient and diagnostic breast services, with the aim of improving standards and outcomes for patients.