THE need to reorganise key hospital services across fewer sites in South Wales has been accepted overwhelmingly, an analysis of responses to consultation on the issue has revealed.

But there is concern among some health bodies and people working in hospitals in the region that these services — A&E, inpatient children’s services, and consultant-led maternity and neo-natal care — should be concentrated at fewer hospitals than the five proposed.

Health boards, including Aneurin Bevan, will be asked to decide later this month on a way forward for reorganisation, under what is known as the South Wales Programme, a project driven by a need to make the aforementioned services more sustainable, and safe, and to improve quality of care.

At its heart is the issue of staffing these services, not least longstanding problems about consultant numbers and the availability of sufficient numbers of middle-grade doctors.

The five-hospital solution that was considered the “best fit” to deal with this and other issues — involving the concentration of these services at the University Hospital of Wales in Cardiff, Morriston Hospital in Swansea, the planned Specialist and Critical Care Centre (SCCC) near Cwmbran, Prince Charles Hospital in Merthyr Tydfil, and the Princess of Wales Hospital in Bridgend – was endorsed by the majority of the more than 61,000 individuals and organisations that responded to the public consultation.

But there was concern, including from bodies such as the Academy of Medical Royal Colleges Wales Committee, the National Clinical Forum, and the Royal College of Paediatrics and Child Health, that five sites is too many. A number of doctors and other NHS staff in the region agreed, and there was a fear expressed that a five-hospital proposal is driven as much by political need as clinical need.

One staff member, from Gwent, said: “Workforce numbers will not support more than four emergency units.” You need to spell it out to the public who always get misinformed and protest about closure of local hospitals. The NHS needs to run according to clinical based reasons and not politics.”

Even a four-hospital solution however, would include the proposed SCCC, which will treat Gwent’s sickest patients, though not for several years.

The consultation responses revealed a sizeable concern about whether it would ever be built - though it took place before a recent announcement that the outline business case for the centre has been approved by the Welsh Government - and what happens in the interim, given that the health board that stated that maintaining some of the services at both the Royal Gwent and Nevill Hall Hospitals ahead of the SCCC opening will be difficult.