A campaign group set up in the wake of ‘reckless’ plans to remove stroke services from Bronglais Hospital in Aberystwyth has warned of ‘consultation fatigue’ for residents as a second consultation on the plans closes.

Protect Bronglais Services (PBS), established in 2024, has written to the health board as part of a second consultation on stroke services in Ceredigion, Carmarthenshire and Pembrokeshire with preferred plans seeing the unit at Bronglais downgraded despite mass protests.

Hywel Dda University Health Board endorsed the launch of a second phase of public consultation on the future of stroke services across its four main hospitals in late May.

It forms part of the wider Clinical Services Plan that the Health Board engaged upon in summer 2025.

A public consultation on the Clinical Services Plan last year drew more than 4,000 responses and led to a large protest meeting in Aberystwyth’s Great Hall, and more than 17,000 signing one of the biggest petitions in the Senedd’s 26-year history.

Protestors carried placards in support of Bronglais Hospital. Photo: Julie McNicholls Vale
Protestors carried placards in support of Bronglais Hospital. (Julie McNicholls Vale)

Hywel Dda Health board members in February were told the current service being offered was not achieving the standards required, but the board was told the service is safe currently.

No definite decision was made at that meeting on the future of stroke services, but a new plan then emerged - an amalgamation of new options presented to the health board in February.

The preferred option being consulted on includes a 24-hour acute stroke and rehabilitation unit at Glangwili Hospital; a stroke rehabilitation unit at Bronglais Hospital; and treat and transfer services at Bronglais, Prince Philip and Withybush hospitals, with patients transferred to Glangwili Hospital or a specialist thrombectomy centre where appropriate.

PBS said it is a “collective feeling that it is something of a travesty that we should all have to go through this again”, and said during its meetings with residents that they had “encountered much ‘consultation fatigue’ as you might well expect.”

PBS said that while it “supports longer term aims of the Hywel Dda University Health Board which are directed at the prevention of serious health conditions and improving people’s health generally”, “with an increasingly ageing population in our part of Wales, more of us will continue to depend on stroke care in future years, whether first hand as patients, or as the loved ones and carers of someone who has suffered a stroke.”

“We recognise the significant challenges and complexities involved in providing safe and sustainable health care services for this largely rural population, spread as it is across a vast geographical area with inadequate transport links,” PBS said.

“Those relying on Hywel Dda services also include many people living outside the actual Health Board boundaries, in Southern Gwynedd and Powys, for whom Bronglais is the nearest General Hospital by some distance.

“Nevertheless, timely and convenient access to certain health care services, including those for stroke, must be viewed as a constituent part of the provision of safe treatment and not as an afterthought or insignificant detail.”

In its submissions to the second consultation, the campaign group said that it remains “strongly opposed to any proposal which would seek to dismantle or reduce stroke services at Bronglais.”

PBS said that “the latest preferred option is no more acceptable to PBS than either of the options presented in the previous consultation process.”

“It proposes to reduce the number of acute stroke units in Hywel Dda still further, down to just one at Glangwili, with all others becoming ‘treat and transfer’,” the group said.

“The addition of a rehabilitation unit at Bronglais, although a welcome retention of some local services, does not offset the loss of acute treatment here.

“This proposal would still concentrate all acute stroke services in the south of the health board region, and although Glangwili is closer to Bronglais than either Withybush or Prince Philip hospitals, people in North Ceredigion, southern Gwynedd and Powys would still struggle to access those services within a reasonable timeframe.

“Hywel dda has once again failed to recognise the needs of the highly rural population served by Bronglais Hospital, including communities in North Ceredigion, Powys and Southern Gwynedd.

“The proposed centralisation of stroke services is based on models developed for large urban areas and does not reflect the geography, transport challenges and the population density of mid Wales.

“A key rationale for change to stroke services given by the Health Board is fragility of service, but to reduce four currently functioning acute stroke units in Hywel Dda down to just one covering such a huge area would make the service more fragile, not less.

“It would be a reckless act to base acute stroke services for the whole of Hywel Dda at a single hospital.

“Retaining more than one acute stroke unit within Hywel Dda would provide greater resilience and better reflect the needs of our rural communities.

“PBS remains firmly convinced that the downsides of the ‘preferred option’ heavily outweigh the benefits.

“We and many others in Mid Wales continue to struggle to understand why Hywel Dda appears so set against the idea of retaining and investing in the existing excellent acute stroke services at Bronglais hospital.”

The health board said that “stroke services in Hywel Dda do not consistently meet national clinical standards and are spread across four hospital sites with no specialist stroke cover available seven days a week.”

“This can impact outcomes and recovery for stroke patients,” the health board added.

The second phase of the consultation ran for eight weeks from 28 May until 26 July.

It cost £71,809 to undertake, documents show.

The Health Board said it will “carefully consider all feedback from both phases of the consultation, alongside supporting evidence, data, clinical advice and impact assessments before making a final decision later this year.”

The health board said it would “seek to analyse the responses so that they can be brought to Board in November” but this “will be determined by level of responses received and may need to go to the next planned Board in January 2027.”

A final decision on the future of stroke services across the Hywel Dda University Health Board area will then be made.