Uncertainty looks set to continues for staff and patients over the future of Tywyn Community Hospital.

It comes as decisions over its future could be delayed until after the Senedd elections.

Shortlisted options for the hospital could form part of a formal public consultation process after the ballot, but reinstating inpatient beds is not an option that made the shortlist.

The temporary closure of Dyfi Ward in April 2023 due to workforce shortages and reliance on agency staff, triggered a review of hospital services and prompted a local outcry.

New services were later introduced, including expanded inpatient capacity at Dolgellau Hospital, the Tuag Adref community service, a treatment room, a reopened minor Injuries Unit, and Wellbeing facilities, a Betsi Cadwaladr University Health Board report notes.

Presenting the document on 27 November, Paolo Tardivel, Interim Executive Director of Transformation & Strategic Planning, told the board, that despite recruitment efforts “reopening the inpatient ward remained challenging due to workforce resilience and sustainability concerns”.

He described how stakeholder sessions called ‘Balanced Room’ had been held to help design and appraise five short-listed options.

They had been whittled down to three, and do not include re-opening beds.

However it did include ‘maintaining current services without beds’, ‘developing Tywyn as a community health hub; and ‘using Dyfi Ward as a day treatment centre, alongside community-based provision’.

An option to reopen inpatient beds, was “not being prioritised” he said, “due to value being placed on the new services and the sustainability and workforce risk”.

Llais, the Welsh Government body which aims to give people a say in the planning and delivery of health and social care services – had advised the board that the absence of inpatient beds among the options had constituted a “substantial service change and therefore would require a formal consultation”.

Mr Tardivel said: “Llais are concerned there is insufficient time to do the necessary work required to support a consultation of this nature prior to the May Senedd election pre-election period.

“Given the pre-election period, a consultation could not commence until after the May, 2026 elections.”

The committee noted that preparatory work, including public engagement, impact assessments, and development of consultation materials could be undertaken in the interim.

The report stated “it is recognised that staff who were substantively employed in both services prior to the temporary closure have and continue to face uncertainty whilst the service review, options appraisal and, if required formal consultation, are concluded”.

It was important that staff continue to be “effectively engaged and supported throughout the process”.

Geoff Ryall-Harvey of Llais said the proposed changes constituted “a substantial service change” and “Llais recommends a full consultation within the [Welsh Government] guidance. The gold standard for that is 12 weeks”.

He said that the Balanced Room sessions had made “a good start” in engaging with the public but there was a “local concern that reopening the hospital and retaining the new service was not in the options list” and would need to be added.

CEO Carol Shillabeer said that “she felt gathering many voices was important”.