1.208 There was considerable support for the proposal to centralise urology diagnostics and treatment on a single site. Some described the single option pragmatically in terms like it is what it is. Others, though, explicitly welcomed the proposed change, recognising the potential benefits for care quality, speed, and coordination, especially in urgent suspected cancer cases; and noting that improved patient experience should outweigh the inconvenience of increased travel. Questionnaire respondents also felt that concentrating services on one site would make optimal use of specialist equipment and staff, therefore providing a more efficient service; and would help with staff recruitment and retention.
1.209 It was often mentioned that creating a urology centre of excellence at Prince Philip makes sense, not only because there is already an existing urology service there, but also because it aligns with the endoscopy service (which would remain at Prince Philip under all proposed options for endoscopy and may be expanded).
1.210 Despite broad acceptance, concerns were raised, mainly around travel distances and accessibility. Consultees in rural areas - especially in Ceredigion and northwards toward Gwynedd suggested that the model may place disproportionate time and cost burdens on older, frail, and low-income patients; and consolidating in a hospital so far to the East was seen as potentially widening geographic health inequalities and reducing timely access to cancer diagnostics. The one-stop-shop model was also viewed by a minority as potentially overwhelming or impractical for older or multimorbid patients.
1.211 More specifically, the West Wales Renal Service asked how radiology, endoscopy, renal services, and emergency care would align with urology if key components were to be located on different sites. They were concerned that this fragmentation would result in repeated transfers (which would require improvements to ambulance and other patient transfer services) and would likely increase referrals to Morriston, “where all services are in one place.”