PATIENTS' watchdogs want health bosses to explore options for keeping a branch surgery serving 475 patients in an isolated Monmouthshire community.

Gwent Community Health Council believes consideration should be given to alternatives to closure of the branch surgery at Llanelly Hill memorial hall by Brynmawr-based Essendene practice, such as setting up a nurse-led clinic.

The memorial hall hosts a two-hour session on Wednesdays, but is deemed inadequate by the practice and Blaenau Gwent Local Health Board through a lack of medical facilities, including resuscitation cover.

Patients oppose closure, because limited public transport into Brynmawr - and none at all to Gilwern, where Essendene also runs a branch surgery - would make it difficult for many to visit their GP.

Public consultation has failed to quell opposition, despite offers of additional appointment slots at Brynmawr, funding of taxis based on need, and a medication home delivery service.

The CHC admits the hall's facilities are poor and it is unlikely GPs can be held to existing arrangements.

But it believes the option of upgrading the hall should be addressed and costed, and a nurse practitioner clinic, able to refer patients when necessary to the main surgery, should be considered, the model being successfully used elsewhere in Gwent.

It also concludes that responsibility for pursuing such an option should rest with Monmouthshire Local Health Board as Llanelly Hill is in Monmouthshire.

As the Essendene practice is in Blaenau Gwent, that area's LHB is currently involved.

"We recognise that keeping a service in Llanelly Hill requires a capital and revenue commitment at a time when NHS resources are very tight," said CHC chief officer, Cathy O'Sullivan.

"But crucially, Llanelly Hill is an isolated community with poor access, and this is a long standing arrangement people understandably wish to maintain.

"Their wishes deserve to be properly addressed and answers provided."

Monmouthshire county councillor Simon Howarth, who represents Llanelly Hill, believes closure is about money, not patient care, and patients would be disadvantaged.

"They are feeble excuses for closure. It would not take much to do up the building and mobile resusictation equipment is available in the likes of supermarkets these days, and they don't cost the earth," he said, adding that a nurse-led service should be seriously considered.