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A SPECIALIST nurse has spoken out as critical care services at Prince Philip Hospital in Llanelli are quietly scaled back ahead of a public consultation — with direct implications for Pembrokeshire patients who rely on Glangwili Hospital for intensive care.
Hywel Dda University Health Board is preparing to launch a consultation on its Clinical Services Plan, which includes a proposal to formally downgrade the Intensive Care Unit (ICU) at Prince Philip Hospital and replace it with an Enhanced Care Unit (ECU).
However, the transition has already begun. The Herald understands that ICU staff are being reassigned, and patients requiring high-level intensive care are being routinely transferred to Glangwili Hospital in Carmarthen — nearly 24 miles away — despite no final decision having been made.
One senior nurse at the hospital told The Herald: 'Staff are being moved off the unit. There are people who need ICU beds but have to wait, as there are none now here. Everyone who needs one has to be transferred to Glangwili.'
The ICU at Glangwili is under significant pressure (Image: File)
She continued: 'They could have bleeds, they are not stable. Not only that, but if they need to be transferred between hospitals, that is done by a specialist NHS service based in Cardiff – the Adult Critical Care Transfer Service (ACCTS), part of EMRTS Cymru. We call them ACCTS. When we sign the paperwork, we can see the Health Board is paying around £6,000 per patient for each transfer. The transport is carried out in a specialist ambulance, including an anaesthetist, doctor, and critical care team, to ensure patient stability during transfer. It's not cheap.'
The nurse also claimed that there are enough skilled staff locally to continue providing intensive care, but the team is being broken up. 'We are a specialised team, and we are being dispersed. The people of Llanelli are being put at risk. For what? To save money.'
She said patients from Llanelli were now overwhelming beds in Carmarthen, leaving Glangwili Hospital with little capacity for new cases. 'Everyone now down at Glangwili are people with Llanelli area postcodes. They should be being treated here near their family, loved ones. And now down in Carmarthen they are chocker – no room to accept new patients, which is going to impact on patients further west into Pembrokeshire.'
This concern is echoed in Pembrokeshire, where Withybush General Hospital still technically retains seven ICU beds. However, ongoing staff shortages and the discovery of unsafe RAAC concrete have meant that many patients requiring critical care from Pembrokeshire are already being transferred to Glangwili. Now, with Llanelli patients added to the demand, access to critical care is under further pressure across the region.
Costly specialist ambulances from Cardiff are used to transport ICU patients between Llanelli and Carmarthen hospitals (Image: NHS)
Hywel Dda University Health Board is expected to launch a 12-week public consultation on its Clinical Services Plan this week, with options that could lead to permanent reconfiguration of hospital services across Carmarthenshire, Pembrokeshire, and Ceredigion. However, documents seen by The Herald confirm that changes such as the ICU downgrade may proceed before consultation results are finalised.
Appendix 7.55 of the Clinical Services Plan states: 'We recognise that the need to respond to service fragility may mean some service change and investment decisions are required ahead of any final reconfiguration, and these will be developed with service, operational and executive leadership.'
Another section of the Plan notes: 'Due to the nature of service provision across Mid and West Wales, it is recognised that a wide range of services have some fragilities. This was a key driver behind the development of the Health Board's strategy which seeks to reduce, if not eliminate, the risks to sustainable service provision.'
Hywel Dda University Health Board's Medical Director: Mark Henwood (Image: HDUHB)
Commenting directly, Hywel Dda University Health Board's Medical Director, Mark Henwood, said: 'There has been a temporary change in place for critical care services at Prince Philip Hospital since July 2022. This was approved by the Board because of an inability to safely staff two critical care units with Consultant staff in Carmarthenshire providing care to the most unwell patients. This has meant that the sickest patients have been stabilised and transferred mostly to the Critical Care Unit at Glangwili Hospital.
'The temporary change was needed to improve our ability to safely deliver our critical care services in Carmarthenshire with the staffing available.
'We launched our Clinical Services Plan consultation at our Board Meeting today and Critical Care is one of the services which we will be looking at.
'In the consultation, options A and B propose having fewer intensive care units, and Option C proposes maintaining the current temporary arrangement at Prince Philip Hospital, where the sickest patients are transferred to Glangwili intensive care unit.
'In all options, bringing specialist critical care consultants together onto fewer sites would make the service more sustainable, improve safety, and help meet quality standards for our patients.'
However, critics argue that the Health Board's response amounts to a technocratic justification that fails to meaningfully address community impact, consultation integrity, or patient safety.
Lee Waters MS: 'You can't run a consultation while services are being stripped away'
Lee Waters MS: The people of Llanelli deserve proper, local access to intensive care
Commenting, Llanelli's Member of the Senedd, Lee Waters, told The Herald: 'It looks very much like decisions about critical care at Prince Philip Hospital are being made before the public's had a real say—just like we saw with the overnight closure of the Minor Injuries Unit. That's not how you build trust. The people of Llanelli deserve proper, local access to intensive care, and I'm not convinced the Health Board has a credible plan to deliver that. I've always tried to be reasonable about change, but in this case the case simply hasn't been made. You can't run a meaningful consultation while services are being quietly stripped away.'
Dame Nia Griffith MP: 'This erosion of services by the backdoor has got to stop'
Commenting, Llanelli's MP, Dame Nia Griffith, said: 'I am extremely concerned to hear reports of intensive care services at Prince Philip Hospital being scaled back, because people in Llanelli should be able to access this care here, and not see loved ones taken all the way to Glangwili for services that have hitherto been provided in Llanelli.
'Moreover, the fact that this is happening without there having been any consultation, or even any mention of this, completely undermines trust in the Health Board. I will be seeking an urgent meeting with Hywel Dda health board bosses to seek clarification, and make it absolutely clear to them that they must recognise the need for these services in Llanelli and design their staffing model accordingly, with full teams of appropriately qualified staff based here.
'Everyone knows that they are already struggling for space in Glangwili so it makes no sense to be sending more Llanelli patients up there, and on top of that, there is the cost of transporting patients, the discomfort for the patients and the anxiety and inconvenience for the family. This erosion of services by the backdoor has got to stop.'
Welsh Conservatives: 'Declare a health emergency'
Commenting, a Welsh Conservative spokesperson said: 'The downgrading of ICU services at Prince Philip Hospital before public consultation is unacceptable and undermines trust in the health system.
'The Welsh NHS is in crisis under Labour, with over 10,000 patients waiting more than 12 hours in A&E and two-year waits still unacceptably high, the Welsh Labour Government continues to fail our communities.
'The Welsh Conservatives would declare a health emergency, directing the resources and the entire apparatus of government at the health service, ensuring timely access to care and restoring faith in our Welsh NHS.'
Sam Kurtz, Senedd Member for Carmarthen West and South Pembrokeshire added: 'If any decisions are taken before the consultation has concluded, then both the Health Board and the Welsh Labour Government must be prepared to justify them to a deeply concerned public.
'Recruitment has long been a challenge, one that has only worsened under the shadow cast by ongoing uncertainty over the future of healthcare in West Wales.
'That uncertainty stems from the Welsh Labour Government's continued drive to centralise services, often to the detriment of rural communities.'
Kurtz added: 'Access to critical healthcare should never be a postcode lottery.'
Campaigners: 'Not acceptable – and a shock'
Shocked: Hospital campaigner Cllr Deryk Cundy was not consulted, he said (Image: BBC)
Chair of the SOSPPAN campaign group, Councillor Deryk Cundy, told The Herald that they had raised concerns with Hywel Dda over 'rumours from a separate source' suggesting changes to intensive care were already under way — before any formal decision by the Health Board.
'We have not been directly contacted about these changes,' he said. 'SOSPPAN has been working closely with Hywel Dda trying to find a way forward — recommending a merger of the Minor Injuries Unit and Same Day Emergency Care, operating 16 hours per day, with increased mental health cover available in Llanelli 24/7.'
He said that when combined with the existing 24-hour Acute Medical Assessment Unit, this could improve service delivery in Llanelli and reduce pressure on Glangwili Hospital. However, he described the ICU downgrade as 'a shock' and 'not acceptable'.
'For too long, Hywel Dda management have said departments are unsafe and instead of making them safe, they shut them down — only to reopen them 20 miles away. We will be asking for an early meeting with the Health Board, and if these proposals are confirmed, we will express our determination to prevent any further reductions in service at Prince Philip Hospital.'
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