Obstetric agreement at Prince Philip Hospital is due to end in December, with families being asked for their views
PREGNANT women and families choosing to have their babies at Singleton Hospital could face additional journeys to Swansea under a major proposed shake-up of maternity services in west Wales.
A long-standing agreement allowing some consultant-led antenatal appointments to be provided at Prince Philip Hospital in Llanelli is due to end on December 9.
Under the existing arrangement, patients living within the Hywel Dda University Health Board area who choose to give birth at Singleton receive different parts of their pregnancy care from Hywel Dda and Swansea Bay health boards.
The hybrid system has allowed families to access specialist, consultant-led maternity services in Swansea while attending some appointments closer to home in Llanelli.
However, Swansea Bay University Health Board formally notified Hywel Dda on June 6 that it intended to end the Service Level Agreement.
Under the proposed replacement arrangements, patients choosing to give birth at Singleton who require consultant supervision would receive their consultant-led antenatal care in Swansea.
Community midwifery care would continue to be provided locally by Hywel Dda.
Patients whose pregnancies do not require consultant oversight would also continue to receive community midwifery care through Hywel Dda.
Prince Philip clinic will not disappear entirely
The announcement does not mean that all obstetric clinics will be removed from Prince Philip Hospital.
The existing satellite clinic would instead be replaced by an obstetric clinic run directly by Hywel Dda.
That clinic would provide local care for patients choosing to give birth within Carmarthenshire, rather than those planning to deliver at Singleton Hospital.
The practical dividing line would therefore be where the patient intends to give birth.
Those choosing a Carmarthenshire maternity unit would continue to have access to a Hywel Dda-run clinic in Llanelli. Those choosing Singleton and requiring consultant care would attend Swansea for those specialist appointments.
Both health boards say the existing arrangement has created difficulties because they operate under different clinical guidelines, policies and governance systems.
They argue that placing consultant-led care under the responsibility of the health board running the chosen maternity unit would create a safer and more consistent service, with clearer accountability.
Questions over travel and patient choice
The announcement does not state how many patients currently use the Prince Philip satellite service, how frequently they attend appointments there or how many additional journeys to Swansea would result from the change.
It also does not explain whether transport assistance would be available, how patients already receiving care would be transferred between services or what support would be offered to families facing difficulties travelling to Swansea.
These questions are likely to be central to a six-week public engagement exercise beginning on August 17.
Sharon Daniel, Hywel Dda’s Director of Nursing, Quality and Patient Experience, said the safety and quality of care provided to pregnant women, families and babies had to remain the health board’s primary consideration.
She said: “The current arrangement has enabled people from our area to access consultant-led maternity services in Swansea while attending some appointments closer to home.
“However, reviews undertaken by both health boards have highlighted that operating across two organisations with different clinical and governance frameworks can create challenges.
“The engagement process will help us better understand any impact of the changes and ensure that feedback from service users, staff and stakeholders is considered as we plan the implementation of the new ways of working.
“Providing the highest quality service to our families continues to be our priority.”
Agreement due to end in December
The contract is currently expected to end on December 9, subject to the completion of the public engagement process.
The engagement will run for six weeks from August 17 and will seek the views of patients, staff and other interested organisations.
Full details explaining how people can participate are expected to be published before the engagement begins.
Patients can also register with Hywel Dda’s Talking Health scheme to receive information about opportunities to comment on health services across Carmarthenshire, Ceredigion and Pembrokeshire.
