Introduction

It is proposed that the community will become the focus of the provision of health care and treatment. This means that more services will be provided in the community and you, the patient, will no longer need to go to hospital as often.

Services and staff will be developed to deliver more care in the home and in new facilities in community health settings such as GP surgeries, health and social care centres and community clinics.

Acute hospital care will only be provided on the three main hospital sites:

• Ysbyty Gwynedd,
• Ysbyty Glan Clwyd
• Wrexham Maelor Hospital
  - all supported by the English hospitals on the border

Highly specialised healthcare services, called tertiary services, will continue to be provided in specified centres - such as those in Merseyside; Alder Hey, Christies, Walton - for the foreseeable future, but with the development of new technology, that may change and those services may then be able to be provided in North Wales.

The St Asaph, Abergele and Llandudno hospitals all currently provide some acute services but are not supported by around the clock anaesthetic, surgical and intensive care facilities.

HM Stanley Hospital

HM Stanley Hospital currently provides ophthalmology day case surgery, a 20 bedded stroke rehabilitation unit and a range of outpatient and therapy services. The site needs maintenance work amounting to £2.5million to bring it up to the required standard, including work on the electrical systems, heating, structural repairs and theatre replacement. It is proposed that the services currently provided at HM Stanley will be re-provided in Glan Clwyd, or other alternative suitable accommodation.

Abergele Hospital

Abergele Hospital currently provides inpatient and day case beds for orthopaedic surgery. It needs maintenance work amounting to £4.4 million, including replacing the electrical and heating distribution systems. The use of the site is also limited by the weight restrictions on the single bridge access to the site. Under the proposals the orthopaedic services will transfer to the Glan Clwyd Hospital site where they can be delivered in better accommodation, providing a centre of excellence in purpose built accommodation with the full round the clock back up facilities of a major hospital.

Llandudno Hospital

Llandudno Hospital currently has three coronary care beds. It is proposed that acute medical and coronary care services currently provided on the Llandudno hospital site will transfer to Ysbyty Gwynedd and/or Ysbyty Glan Clwyd.

A breast surgery service is also currently offered at Llandudno for North West and central North Wales. It is proposed that the in-patient breast surgery services provided at Llandudno will also transfer to one of the three major sites.

Accident and Emergency Services

Emergency access to hospital care will continue to be provided by the three North Wales accident and emergency departments based, as currently, on the three acute sites in North Wales, plus the Countess of Chester.

When will these changes take place?

The buildings on the three major sites will have to be improved to make them fit for purpose. Transport and parking issues will also have to be taken into consideration. The improvements will begin as soon as possible after the end of the consultation period and should be completed over the next eight to 10 years. A detailed timetable for the work will be drawn up and it could begin within two years of approval and substantially completed within eight to 10 years, depending on available funding.

Temporary changes will be necessary while major building works take place on the three sites. It is likely that some of the smaller hospital sites could be temporarily used whilst improvements to the three major sites are made. As a consequence, it may be several years before acute services are moved from the three satellite sites.

What about Community Hospitals?

Each of the Local Health Boards has developed a Primary Care Estates Strategy in which it outlines the healthcare services to be provided in the community.

In Denbighshire there are five community hospitals:

• Denbigh
• Llangollen - Future in doubt
• Prestatyn - Under review
• Royal Alexandra, Rhyl
• Ruthin

In Flintshire there are currently four community hospitals:

• Deeside
• Flint - Shake-up planned and causing concern among locals.
• Holywell - New hospital to be built
• Mold

In Wrexham there is only one Community Hospital:

• Chirk

The hospitals where their future is in doubt will be the subject of a public consultation to decide the future and the provision of healthcare services.

Further information

The CHC has a document available on its website called What is happening to our hospitals? answering some of the more common questions about the changes being discussed.