Health chiefs have decided to push ahead with plans to change stroke services in Bronglais, but with the potential of setting up a rehabilitation unit at the Aberystwyth site.

Following two days of debate, Hywel Dda University Health Board has opted to go with a new option of downgrading Bronglais to a treat and transfer unit with a stroke rehabilitation unit set up.

A 24-hour stroke unit will be established at Glangwili and not Prince Philip with that hospital and Withybush also becoming treat and transfer units.

This decision will however have to go out for further public engagement, which isn’t the same as a consultation, the meeting was told.

Board members were told the current service being offered was not achieving the standards required, but the board was told the service is safe currently.

Executive Medical Director, Mark Henwood, said: “We're not offering the highest level of care to our patients.

“There has been confusion about treat and transfer. All patients will receive immediate treatment and then transferred for acute care.”

He also went on to say that there had been a lot of talk about ‘golden hour’ but said that only applied to trauma care.

Chief Operating Officer Andrew Carruthers added: “The key thing to me operationally is a single specialist unit is probably the only way we can deliver the standard of care required.

“That has to be the direction of travel for us.”

Cllr Rhodri Evans did not back any of the proposals, telling the meeting: “Travel is a big issue. For me there needs to be a north and south provision.

“Tywyn is a long way. The roads are terrible Four hours to Prince Philip or Withybush travel is a big issue.

“After that 72 hours what happens then.

“The nurses work very well but families need to be there. They improve the chances people get better sooner.

“Four hours down the road. that's not acceptable.

“None of those option match what I feel should be our priority.”

Mark Henwood responded: “We cannot provide currently and dont think we will be able to recruit medical staff for that unit in Bronglais unfortunately

We should consider what transport we could provide hotel support to relatively small number of patients to get that acute centre.”

Executive Director for Strategy and Planning, Lee Davies, added: “Option A is the most deliverable option.

“There are challenges with that.

“Critical mass isn’t there in Bronglais - that would be a precarious service - if you have a stroke, you run the risk of not getting appropriate care.

“A rehabilitation unit in bronglais I would support

Vice Chair Eleanor Marks said: “It has been a challenge of head and heart.

“Nobody wants to see a services moved.

“I think I can honestly only come down with clinicians. It has to be one specialist site.

“It’s a hard call for all of us.”

Chair Neil Wooding said: “We need a broader transport and travel service between our sites.

“We need to support this with an underpinning people can travel between sites.”

Ceredigion MS Elin Jones welcomed the fact that both original stroke consultation options were rejected by the health board.

She said: “There is now considerable confusion around what may be proposed for stroke patients at Bronglais.

“Whilst Glangwili now seems likely to be the location of the board’s main Stroke Unit rather than Llanelli, it’s less certain what the Rehabilitation service proposed for Bronglais will entail. People in the Teifi Valley will be much better served by a Glanwgili Unit rather than face transfer to Llanelli.

“However, for Bronglais, the Treat and Transfer Model remains in the new proposal, and no clarity has been proposed on how a safe and dedicated model of transfer for very ill stroke patients will be guaranteed. People will also want to know what a longer-term rehabilitation service at Bronglais will look like.

“At the very least we need now to get a detailed alternative proposal from the Health Board and there needs to be a meaningful formal consultation on the new proposal.

“This time it also needs to have a detailed plan for how ambulance transfer would be achieved.”

Dwyfor Meirionnydd MS, Mabon ap Gwynfor said: “We all agree on one thing - that we want to see the highest level of care for patients – our loved ones.

“But that care must take into account travelling distances for patients and their families, which is why developing rather than cutting services at Bronglais is crucial.

“I welcome the fact that new options are being considered, specifically looking to develop a new rehab unit at Bronglais.

“However, I’m concerned that there is so little detail about the new proposal.

“I, and the people of mid Wales, need to understand what the proposal entails before we can come to a conclusion. I will therefore be seeking further detail from the health board at the earliest possible opportunity, and this will need to go through the rigorous full consultation process as well.

“I remain steadfast in the belief that Bronglais should be developed as a centre of excellence for rural health.”