1.96 There was considerable support for bringing respiratory and urology endoscopy procedures together (Options A and C). Although, as with other services, travel distance and times emerged as concerns in relation to deterring attendance or placing unfair burdens on patients, particularly those who are older or less mobile.
1.97 Those who supported Option A (an additional procedure room at Prince Philip) suggested that increasing clinical sessions during the day is preferable to extended hours, because of the lack of evening transport availability. However, others viewed the addition of a single procedure room as providing insufficient capacity to address current pressures and demand.
1.98 Views on extended hours and weekend provision at Prince Philip (Option C) were mixed. Some consultees saw benefits in increased flexibility, valuing appointments outside standard working hours; while others raised concerns about additional pressure on current staff and the challenges of recruiting to an expanded rota.
1.99 Supporters of Options A and C often stated the importance of maintaining gastro-intestinal/bowel screening at all hospital sites, to minimise travelling and maximise take-up of this important service.
1.100 Those who supported Option B saw a dedicated bowel screening hub as a way to improve capacity, release space in hospitals for other types of screening, enhance consistency, and support the recruitment of specialist staff. Some consultees also favoured this option because it would retain respiratory endoscopy at Glangwili.
1.101 On the other hand, concerns were also expressed around the location, feasibility, cost, and scale of the proposed community bowel screening centre. If it is established, consultees said it should be centrally located, with consideration for areas in which older residents are concentrated, and those with manageable transport links.
1.102 Staff, members of the public, and partner organisations highlighted that longer journeys - particularly for bowel screening, where significant preparation is required and there are potential issues around patient dignity - could reduce uptake and exacerbate inequalities. Use of mobile screening units was thus widely proposed as a means to protect access for remote communities.