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Mark Drakeford, Minister for Health and Social Services

First published:
23 October 2014
Last updated:



Today, the Welsh Institute for Health and Social Care (WIHSC) is publishing the findings from its independent study of healthcare in Mid Wales. The report can be found here: 

The study was commissioned in January 2014 following representations from local Assembly Members, clinicians and community representatives. As set out in written statements on January 24 and March 17, WIHSC was asked to consider the issues and opportunities for providing accessible, high-quality, safe and sustainable healthcare, which is best suited to the specific needs of people living in Mid Wales.

The terms of reference asked WIHSC to specifically consider patient outcomes and experiences and, by engaging a wide range of contributions, to address how to best develop service delivery models across primary and community care and at Bronglais Hospital, in Aberystwyth. WIHSC was also asked to look at opportunities to deliver more integrated care at, or close to, people’s homes through the use of telemedicine and telehealth technology and to examine new workforce roles and models, including opportunities for partnership arrangements with specialists and the development of more generalist roles.

I welcome WIHSC’s comprehensive response to the terms of reference.  The study team has spoken to more than 900 individuals or groups, including members of the public, patients, clinical staff, managers and administrators; to the Older People’s Commissioner for Wales; the Royal Colleges; the General Medical Council and the Wales Deanery. I would like to thank everyone who responded to the call for evidence.

The findings provide a clear account of the challenges associated with delivering accessible and high-quality healthcare in Mid Wales - longer travelling times to access key services; the difficulties retaining skilled staff and developing resilient services.

However, the report also suggests a number of possible solutions to those challenges. It highlights the willingness among all those who are responsible for designing, managing and delivering the service, as well as the hundreds of thousands of people who depend on health services in Mid Wales, to work together to make the necessary improvements to ensure everyone has access to high-quality, safe and sustainable healthcare.  

Much of the report’s content falls to a wide range of organisations to consider and time will be needed to allow that to take place. However, I would like to make immediately clear – as I did when commissioning the study – that I expect Hywel Dda, Betsi Cadwaladr and Powys health boards and the Welsh Ambulance Services NHS Trust to respond to the findings in a thorough and meaningful way through their planning arrangements, including the development of their 2015-16 medium term plans.

I welcome Hywel Dda University Health Board’s submission to the study team, which provides an optimistic basis for the development of future plans for Bronglais Hospital and the wider the region.

I have written today to each of the boards, setting out my expectations and requesting board-level discussions of the findings and a response before Christmas. I expect the response to build on the involvement of staff and patients’ views.

I will consider the full detail of the Welsh Government’s response to the report but have asked officials to start work immediately in order to advise me about the options for securing improved joint planning between the four organisations – the three health boards and the Welsh Ambulance Services NHS Trust – in the interests of people receiving healthcare in Mid Wales.  

To ensure the necessary thinking and energy in addressing the issues set out in the study is sustained, I will support a high-profile conference in Mid Wales, which will bring together leading thinkers and some of the most successful examples of solutions to rural healthcare problems from around the UK and elsewhere.

The terms of reference made it clear it was not the remit of the Mid Wales Healthcare Study to prepare an action plan or to make decisions about the future – these are statutory responsibilities of the three health boards and the other NHS organisations which cover this part of Wales. However, the findings of this study offer a firm foundation on which to develop a strengthened approach to the joint planning of health services in Mid Wales.