HYWEL DDA University Health Board is set to meet on 26 September 2024 to discuss a controversial proposal to reduce the operating hours of the Minor Injury Unit (MIU) at Prince Philip Hospital, Llanelli. The move, which has sparked significant local opposition, would see the 24-hour service cut back to a 12-hour service running from 8am to 8pm daily, starting November 1, 2024.
If approved, the reduction in hours would be a temporary measure, lasting six months, and has been proposed due to growing operational pressures and difficulties in recruiting staff, particularly for night-time shifts. The health board emphasised that the changes are necessary to ensure patient safety, following an inspection by Healthcare Inspectorate Wales (HIW) and growing concerns from staff at the hospital.
Despite these assurances, the proposal has already drawn criticism from local leaders and residents who fear the impact on healthcare provision in Llanelli, and the potential knock-on effects for already overstretched Accident and Emergency departments in nearby Carmarthen and Swansea.
Concerns over patient safety
The proposal to reduce the MIU’s hours follows a damning report from HIW in June 2023, which raised serious concerns about staffing shortages, particularly overnight. Due to these shortages, the unit has been largely staffed by Emergency Nurse Practitioners, who are trained to treat minor injuries but cannot provide the GP-led care required for more complex cases.
Andrew Carruthers, Director of Operations at Hywel Dda University Health Board, acknowledged the difficulties: “Our priority is ensuring the safety of patients. The staffing shortages we are facing, particularly in the evening and overnight, have led us to explore solutions to ensure we can continue to provide safe and effective care. This temporary reduction in hours is necessary to address these concerns while we work to find long-term solutions.”
The board has made clear that the Acute Medical Assessment Unit at Prince Philip Hospital, which treats severely ill patients, will continue to operate 24 hours a day. Patients requiring emergency care will still be assessed and treated at the hospital, as they are now. However, critics argue that any reduction in services at the MIU will have a detrimental effect on the local community.
Opposition from local leaders
The proposal has sparked fierce opposition from Llanelli Town Council and other local politicians. When the idea was first mooted last year, Town council leader David Darkin expressed deep concerns about the impact of the proposed changes: “Llanelli people deserve to have access to vital medical aid on a 24-hour basis, seven days a week. Anything less would be disastrous. We need more services in what is Carmarthenshire’s industrial heartland, not less.”
Darkin’s sentiments were echoed at the time by Llanelli MP Dame Nia Griffith, who previously raised concerns about the future of the MIU in November 2023. At the time, Dame Griffith wrote a post on social media revealing that the health board was already considering reducing the unit’s hours. Speaking in November, and based on her discussions with Steve Moore, the health board’s chief executive, she said she had urged the board to maintain the current round-the-clock service.
“I told him that we in Llanelli are very concerned indeed at any reduction in opening times, and I stressed how important it is to have an easily accessible service available locally,” Griffith said.
Local councillors are also worried that reducing MIU hours will lead to increased strain on other hospitals in the region. Carmarthenshire County Councillor John Prosser warned that reducing services at Prince Philip Hospital would push more patients towards already overburdened Accident and Emergency departments at Glangwili Hospital in Carmarthen and Morriston Hospital in Swansea. “These hospitals are struggling to cope as it is,” Prosser said. “If Prince Philip’s MIU reduces its hours, where are people supposed to go in an emergency overnight?”
Community response
The wider Llanelli community has been vocal in its opposition to the proposed changes, with fears that reduced MIU hours will compromise local access to essential medical services. The reduction of hours is seen as part of a broader concern about cuts to local healthcare in West Wales, which has seen services concentrated in larger hospitals in recent years.
Llanelli’s MIU has been a critical healthcare resource for local residents, treating a range of injuries from sprains and fractures to minor burns and wounds. Local residents argue that the 24-hour nature of the service has been essential for a town of Llanelli’s size and industrial nature, where accidents and injuries can happen at any time of day or night.
As we reported last year, councillor Sue Lewis stressed the importance of keeping the MIU’s hours intact: “This is about more than convenience. People in Llanelli depend on having accessible, immediate medical treatment at all hours. Reducing MIU hours would force more people to travel long distances to A&E departments that are already struggling.”
Concerns about the pressure on other units are widespread. Recent reports show that Accident and Emergency departments at Glangwili and Morriston hospitals are already facing high patient numbers and long waiting times. With the potential influx of patients from Llanelli, there are fears these services could become overwhelmed.
In response to the criticism, Hywel Dda University Health Board stressed that the proposal is still under review and no final decisions have been made. The health board has promised to consult with the community and run an information campaign to explain the reasons for the proposed changes, and what services will remain available.
The board’s Director of Operations, Andrew Carruthers, reiterated the importance of maintaining patient safety: “The recent Healthcare Inspectorate Wales report highlighted a range of concerns that we must address. These challenges are made worse when our clinical teams are regularly called upon to treat conditions and medical emergencies that should be seen elsewhere. The staffing shortages we are facing, particularly in the evening and overnight, are making the current situation unsafe.”
Carruthers added that while reducing hours may seem like a step backwards, the aim is to ensure a safer, more sustainable service: “This is not a decision we take lightly. We recognise the importance of the MIU to the community and will continue to engage with local stakeholders to ensure we fully understand the impact.”
What’s Next?
The health board’s decision is expected to be announced on September 26, following the meeting. In the meantime, the local community, councillors, and politicians are being urged to voice their concerns during the consultation period.
If the proposal is approved, the health board will launch a public information campaign to ensure the community is fully informed about the changes. This will include detailed guidance on when and how to access the MIU, what injuries can still be treated, and alternative services for night-time emergencies.
The future of the MIU at Prince Philip Hospital remains uncertain, but the debate has underscored the ongoing pressures facing healthcare services in West Wales. With concerns about patient safety and service availability on the rise, the health board’s upcoming decision is likely to have far-reaching implications for healthcare provision in Llanelli and beyond.
For more information about the health board’s proposals, residents can visit the Hywel Dda University Health Board website.
