The cost of moving to a new model of health provision in Powys could increase in the short term, according to a health board finance chief.

This is because the health board would need to fund the “up-front costs” as well as funding the current provision as it transitions to a leaner, more home-based care model.

At a meeting of Powys Teaching Health Board on 16 September, members received a proposal to start a consultation on five options to radically change health provision in the county.

All options would see the removal of beds from Machynlleth and Llanidloes hospitals and have been greeted with fury by residents, councillors, and politicians.

At the outset of the meeting, PTHB chairman Dr Carl Cooper said that the discussion of a pre-consultation business case was the culmination of two years’ work on the “Better Together” programme.

Dr Cooper stressed that a final decision would be made in the spring next year after the consultation responses had been analysed.

Independent member Steve Elliott asked: “There will be some quite considerable up-front costs, how do we propose to manage that given our current financial position?”

The health board is already projecting a deficit of just under £45m this year.

Acting executive director for finance Hywel Pullen said: “There would be the need to invest in our community services up front, we would require increased costs for a time while we’re double running.”

The “reduction of costs” from using services from health boards and trusts outside of the county, as well as “eventually closing wards” as the health board consolidates to certain sites, would come later, he explained.

Mr Pullen said: “We will need to build those costs into future plans and those would need to be approved by the (Welsh) government as we implement change.”