PLANS are on track to turn three of Gwent's former general hospitals into centres of excellence for specialist treatment, a health board leader has said.
The opening of the Grange University Hospital in late 2020 meant an exodus of critical care and A&E services - and staff - from sites elsewhere around the region.
The Grange is now the health board's only dedicated A&E provider, while three other hospitals - namely the Royal Gwent in Newport, Nevill Hall in Abergavenny, and Ysbyty Ystrad Fawr in Ystrad Mynach - have all seen their roles change significantly.
Such sweeping changes raised a few eyebrows in 2020, and in the years since the Covid pandemic and wider pressures on waiting times have meant the decision to close many services at those three hospitals has come under fire.
But the vision of the health board, it told the Argus, is to spread services out equally across the region with specialist locations for various treatments, rather than have a more fragmented service dotted around Gwent, as existed before 2020.
In this new model, every hospital would have a unique function for the whole population of Gwent, and not just its local community.
The Royal Gwent, Nevill Hall, and Ystrad Fawr “still play a key role” in healthcare, explained Chris Dawson-Morris, the interim director of planning and performance at Aneurin Bevan University Health Board.
These three “enhanced local general hospitals”, he added, are still busy and are “a massive part of our system”, offering treatments for minor injuries and illnesses, as well as planned or non-urgent procedures.
The health board’s minor injury units see around 1,700 people a week, and – at a time when waiting times at the Grange continue to come under scrutiny – performance at those minor units continue to beat national waiting-time targets.
The aim is to further develop these three hospitals, with each one becoming the major provider of a certain type of care.
At Ystrad Fawr, a new breast unit will be built as part of an £11m capital investment, and construction work is due to begin soon.
Nevill Hall is waiting for final approval to set up a satellite radiotherapy unit, in conjunction with the Velindre Cancer Centre.
And at the Royal Gwent, a special elective care service for planned surgery is already up and running.
Mr Dawson-Morris acknowledged some outside factors meant the three hospitals hadn’t yet hit the heights originally envisaged when the Grange opened.
Workforce pressures on health and social care had meant some services were “consolidated for safety reasons” and could not be offered at all hospitals.
Chris Dawson-Morris, the interim director of planning and performance at Aneurin Bevan University Health Board
“If you’ve not got the workforce, you can’t do that,” he said.
There is also the ongoing problem with patient flow – something the Argus has highlighted repeatedly in Gwent but which is being felt in healthcare around the UK.
Mr Dawson-Morris estimated there were “at any one day between 250 and 350 medically-fit patients” in Gwent’s hospitals, unable to be discharged because of delays in social or domiciliary care, which are in turn facing their own recruitment crises at the moment.
“There isn’t a short-term fix or one we can do on our own,” he said, adding that wider economic issues and public spending cuts were likely to make the situation worse.
But other recent changes are more optimistic. The development of same-day emergency care appointments, by which patients suffering less immediate illnesses are usually referred to a hospital by a GP rather than arriving by ambulance, could provide “a more direct, faster service”.
There also remains some confusion, two years on, over which hospital is most appropriate for patients to attend. If you are unsure, Mr Dawson-Morris recommended calling 111 for advice.
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