Our hospital services were designed more than 50 years ago. Since then, care is more efficient, has shifted towards community-based care and prevention of poor health, and is less reliant on hospital beds. We have four small to medium-sized main (acute) hospitals, each with its own medical and surgical services, and three Emergency Units, plus a busy 24/7 Minor Injury Unit at Prince Philip Hospital. No other part of Wales has a higher number of main sites per population. Typically, an area with a population of under 400,000, would be served by one to two emergency units and medical sites. The result of this is duplication, a stretched workforce, variation in the safety and quality of care and how it is provided, and fragile services. By reducing the duplication, it may be possible to develop and provide some additional specialist services within the Hywel Dda area instead of outside of area.