1.164 The importance of minimising patient travel where possible was stressed by many consultees. Specifically, clinical partners emphasised the need for robust patient transport (inter-hospital transfer systems in particular) and clear escalation pathways for patients who become unwell if inpatient interventional radiology is centralised.
1.165 Staff members emphasised the central importance of radiology to other clinical services (emergency general surgery, critical care, and stroke for example) and the need to maintain safe, continuous diagnostic support. In this respect, they expressed concern about workforce shortages and a reliance on agency cover, the feasibility of seven-day services (echoed by some public and patient drop-in event/meeting attendees), and the consultation document’s characterisation of radiographer preferences for 12-hour shifts. Most staff members also noted that the on-call model was also described as essential to recruitment and retention as it provides valuable flexibility and significant financial benefits to staff and remains an important part of workforce stability in Hywel Dda.
1.166 Staff from Cardigan ICC and Tenby Hospital noted capacity concerns at these community sites. At Cardigan, radiology was said to be extremely pressured, with one radiographer often covering high patient volumes and managing complex tasks without consistent support; and at Tenby Hospital, staff reported having to redirect patients to Withybush due to limited X-ray cover. The need for sufficient administration support to enable radiographers to focus on delivery was also stressed.
1.167 Across the consultation methods - including the drop-in event, which was attended by over 400 people - there was strong opposition to the proposed removal of X-ray services from Llandovery Hospital. This, it was felt, would have a major negative impact on local access to care in and around Llandovery, especially for elderly, low-income, and rural patients who already face significant transport challenges and would find travel to alternative sites difficult.
1.168 Consultees described a sense of ‘managed decline’ at the hospital and highlighted the investment of the community, particularly the League of Friends, in purchasing an X-ray machine. Staff and members of the public across the consultation methods argued that underuse reflects referral practices rather than lack of demand (i.e., patients are being sent to Carmarthen for X-ray when they could feasibly be being sent to Llandovery) and that if this were to be addressed, the viability of the service would drastically improve.
1.169 The ease of parking at Llandovery Hospital relative to Glangwili was also highlighted, and it was suggested that if the X-ray service was to be maintained and the Minor Injuries Unit reinstated at Llandovery Hospital, there might be scope to relieve pressure on other hospitals in the area.
1.170 As noted above, the Llandovery drop-in event was very well attended, which may in part have been driven by a misconception that the Health Board is proposing to close the facility in its entirety. However, regardless of these misconceptions, attendees supported the retention of services at Llandovery Hospital and maintaining the facility at its current location.