Health Board approves permanent GP referral pathway change for routine adult mental health support

26 March 2026

Hywel Dda University Health Board has today approved a permanent change to the GP referral pathway for routine adult mental health support in Ceredigion.

This means adults in Ceredigion assessed by their GP as needing routine or less urgent support for their mental health will be asked to phone the NHS 111 Wales Press 2 service (opens in new tab) instead of being referred to the Ceredigion community mental health team.

The Board decision follows evidence demonstrating that the temporary introduction of this pathway in Ceredigion has been implemented safely since March 2025 and patients are receiving more timely and appropriate care.

Additionally, following a comprehensive nine-week engagement period with service users, clinicians, GPs and third sector partners, the Board also agreed for the revised pathway to be introduced in a phased way across Carmarthenshire and Pembrokeshire.

“Our priority is to ensure safe and efficient access to mental health care and ensure that all patients receive the support they need, when they need it" said Liz Carroll, Service Director for Mental Health and Learning Disabilities at Hywel Dda University Health Board.

"In Ceredigion, the pathway was temporarily changed as an emergency measure (opens in new tab) because of significant shortages of nursing and medical staff in the community mental health team.

“Making this change permanent will mean more adults needing non-urgent mental health support will access support much quicker through the NHS 111 Wales Press 2 service. This will also benefit people with more complex or urgent mental health needs by creating capacity in our community mental health teams.

“We encourage anyone in need of mental health support to contact NHS 111 Wales Press 2 for assistance."

Previously, patients in Ceredigion waited up to 28 days or longer to be seen in person by the community mental health team, and data showed that less than 5% of these patients needed this level of assessment and support.

Evaluation of this model over the past year has demonstrated that the temporary change has been implemented safely. There has been no reported increase in serious or untoward incidents, adverse events, or complaints linked to the temporary pathway change, providing assurance that patients are receiving timely and appropriate care while maintaining safety.

It has also improved the capacity of the county’s community mental health team to provide face-to-face assessment for those with more complex or urgent needs.

Andrew Carruthers, Chief Operating Officer at Hywel Dda University Health Board, said: “We are grateful to everyone who shared their experiences during the engagement process.

“We have listened carefully and it has played an important part in shaping the Board’s decision today. People told us they wanted greater clarity and consistency around how the referral pathway works, and highlighted gaps in understanding about 111 Press 2, including what the service offers, who delivers it and the limits of its role.

“We also heard concerns about accessibility for people who may find telephone-based services challenging, as well as worries about medication and prescribing arrangements.

“We will work with our colleagues to reduce the areas of concern. We will seek to increase staffing to support a Health Board wide approach and introduce the pathway in phases across Pembrokeshire and Carmarthenshire. As part of this decision today, the Board committed to review the roll-out and what is put in place to build more understanding of the service and greater trust with patients and service users.

“Adoption of this pathway across our Health Board aligns the service we provide with the Mental Health and Wellbeing Strategy and helps us to progress the development of an open access model.

“Today’s decision recognises the positive benefits demonstrated in Ceredigion and will ensure a consistent, equitable approach across west Wales that enables patients to get access to the services they need in a timely way.”

GPs will continue to refer individuals with urgent or complex mental health needs directly to community mental health teams when needed. A dedicated professional NHS 111 support line also remains available for clinicians who have concerns about a patient’s ability to contact the service independently.

One in four of us will experience a mental health condition at some point in our lives. The NHS 111 Wales Press 2 service provides timely telephone assessments delivered by wellbeing practitioners, overseen by registered mental health nurses in Hywel Dda.

The service is available for people of all ages, 24 hours a day, 7 days a week. The number is free to call from a landline or mobile, even if you have no credit left, and calls are welcomed in Welsh.

For more information and for further useful resources you can access from home and organisations who can support your mental health, please visit https://hduhb.nhs.wales/patient-information/mental-health-and-wellbeing (opens in new tab).