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Public consultation on site for new hospital recommended

Safe Sustainable Accessible and Kind

28 July 2022

Hywel Dda University Health Board will next week decide whether to hold a formal public consultation to assist with selection of the site for a new urgent and planned care hospital somewhere in the zone between and including Narberth and St Clears.

An extraordinary health board meeting is being held at 9.30am on Thursday 4 August 2022 and one of the recommendations in the report being discussed, and supported by the independent watchdog Hywel Dda Community Health Council, is to hold a public consultation process.

A huge amount of work to review five potential sites for the proposed new hospital – one in Narberth, two sites near Whitland and two near St Clears – has already taken place with public and patient representatives, clinical and non-clinical staff, and stakeholders, including other public sector organisations. The process has been awarded best practice by the independent body the Consultation Institute, but the health board considers the next step should be formal consultation, to ensure that the wider public have an opportunity to consider the options.

Ahead of the meeting, Hywel Dda Director of Strategic Development & Operational Planning, Lee Davies said: “We are so grateful for the significant work that has been carried out during the appraisal process and this will be presented to the health board next week. It will be down to the board to determine which sites should be taken forward for further consideration and a recommended public consultation as this is such a fundamental part of our service provision for future generations.”

This would be the next step towards the health board’s long term strategy for a healthier mid and west Wales. It follows submission of a programme business case to the Welsh Government earlier this year, seeking more than a billion pounds of investment in the buildings and capital infrastructure in west Wales.

A fundamental enabler to investing more in community and preventative health and care, and to deal with long standing challenges in the health and care system in the area, is the provision of a new urgent and planned care hospital.

The zone, somewhere between and including Narberth and St Clears, is the most central for the majority of the population in the south and was determined as part of the engagement, option development and public consultation held between 2017 and 2018.

The health board meeting will hear outputs from four separate land appraisal groups, focusing individually on the technical, clinical, workforce, and financial/economic considerations of the possible sites and areas within the zone.

From the reports, there is not a current ‘preferred’ site as there is a range of different evidence, impacts and viewpoints to be considered.

The technical appraisal group, made up of a majority of public from across our localities as well as staff, scored the potential sites considering weighted technical criteria and feedback from public engagement. Four of the five sites had very similar scores, with only one of the sites near St Clears scoring significantly lower than others.

Two distinct clinical groups – one for neonatal services, obstetrics and paediatrics and another for stroke services - considered the implications of siting the new hospital either further east, centrally or further west within the zone.

The neonatal services, obstetrics, and paediatrics expert group found of the three geographical areas within the zone, those furthest east presented the least clinical risk to services. Attendees of the workshop were of the opinion that a site further east outside the zone would be preferable. They were concerned that the zone presents a risk of reduction in critical mass of patients, due to potential for people in the east attending services elsewhere and resulting in a reduction in birth numbers, and neonatal and paediatric admissions. This was outside the scope of the appraisal and the geographical zone was agreed following engagement and consultation in 2018.

The expert group for stroke services reported that any area of the zone would be suitable due to the focus on pathways and how patients are treated beyond their initial admission. It did however state that for access to workforce reasons the sites central or east would be more preferable.

The workforce appraisal focused on the accessibility impact for the Health Board’s workforce. Evidence the group considered, included travel time analysis and potential staffing impact and risk. The group noted that there would be impact on those who traditionally are able to work locally to their homes and those who reasonably expect to travel linked to their professions. Different strategies to reduce this impact would be adopted as work progresses. The group found it inconclusive to say if a site further east would have a greater impact to securing a sustainable workforce overall, including for recruitment.

The financial and economic appraisal focused on appraising the process and outcomes that may be required for capital funding and next steps in land acquisition. It found as a percentage of the overall estimated costs of the development, there was little to distinguish between different sites.

The Health Board will also be presented with information about the overarching and ongoing Equality and Health Impact Assessment and how people with protected characteristics are being involved and considered, as well as how any negative impacts for people will be minimised.

You can watch the meeting on live stream, and a link will be available from the Health Board website (opens in new tab)