1.182 Views on Option A were somewhat mixed but tended to be more negative than positive overall.
1.183 Most of the support for Option A came from questionnaire respondents, though some members of the public and a minority of staff members across the other consultation methods also favoured this option. Key reasons for this support were that Option A has the potential to address staff shortages, raise standards, and provide longer specialist cover than under current arrangements. Pembrokeshire-based consultees (including Withybush staff and a sizeable number of questionnaire respondents) were also pleased to see the provision of 12-hour specialist cover at Withybush (which would also be the case under Option B).
1.184 A few staff members responding via the questionnaire queried whether 24/7 specialist care (as proposed under Option B) is strictly necessary, feeling that Option A may be the more ‘balanced’ proposal in offering reduced travel and fewer transfers.
1.185 Overall though, some viewed Option A as unaligned with modern stroke standards and unlikely to deliver consistent acute stroke care, particularly with respect to:
1.186 Outside of the questionnaire, during the residents’ workshops where people explicitly compared the options, Option B tended to be better supported than Option A. The 24-hour specialist stroke service was widely regarded as essential and aligned with national best practice; and some consultees saw value in establishing a single high-volume centre of excellence with stronger recruitment potential and the potential for improved clinical outcomes.
1.187 However, many consultees in Ceredigion and Pembrokeshire opposed Option B. While they were not opposed to the prospect of a 24-hour stroke unit in principle, they viewed the proposed site selection as problematic, questioning the suitability of focusing it in Prince Philip both geographically (with Llanelli being in the extreme south east of the Health Board area, and very close to Morriston Hospital) and because it lacks an emergency department, has limited ICU capability, and has no dialysis service for stroke patients with renal needs. Some questionnaire staff queried whether complex stroke patients might therefore need to be treated at Glangwili rather than Prince Philip; and expressed concern this might negatively impact continuity of care and delay the start of the rehabilitation process.
1.188 On the other hand, the Prince Philip Multidisciplinary team supported the siting of a stroke unit at their hospital, citing strong staffing, infrastructure, and performance locally. Support for this model was also offered by Carmarthenshire Councillors and other Prince Philip staff, though the latter acknowledged a need for additional staffing uplift and resources, especially within therapies, if they are to take on greater responsibilities.