Powys Teaching Health Board (PTHB) members are being advised to plough ahead and cut the opening hours of minor injury units and centralise some inpatient hospital care despite petitions signed by thousands of people against the downgrading of health services in the county.

An in-depth report about the “engagement” exercise, which took place from July 29 and was extended to September 8, will be received by members at a health board meeting on Thursday, October 10.

When the board met in July, members agreed to a “temporary” change out of hours treatment at the Minor Injury Units at hospitals in Brecon and Llandrindod Wells.

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They also agreed that patients should be grouped together in hospitals according to specific need.

This would see two hospital wards in Llanidloes (War Memorial Hospital) and Bronllys specialise in getting patients fit and ready to go home.

Patients that need rehabilitation following illnesses or conditions such as strokes would be looked after at Brecon’s Breconshire War Memorial Hospital and Newtown’s Montgomeryshire County Infirmary.

The “temporary” service changes were supposed to be implemented in September for a trial period of six months and were agreed as a consequence of the health board’s dire financial position.

The health board is now predicting a deficit budget of £23 million this financial year which could balloon to £35 million.

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Due to the backlash from residents and discussion with patient forum Llais, PTHB extended the engagement period and has decided to re-take the decision.

This would allow for analysis of the engagement process findings to be placed before members.

The report said: “During the engagement period we heard from a range of voices including residents, patients, politicians, staff, partner organisations and GPs and Llais.

“We directly heard from nearly 800 voices through survey responses and correspondence, 735 online survey responses in addition to 32 written submissions direct to the health board and 17 via Llais.”

A petition to keep Brecon MIU open overnight was signed by 2,412 people.

A further 673 people signed a petition to keep Llandrindod Wells MIU open overnight.

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The reports estimate that 500 people attended four public meeting and a further 80 people attended online webinars.

The report said: “A greater proportion of responses expressed concern or opposition to the MIU and inpatient proposals than support.”

On the MIU’s the report said: “The executive committee continues to endorse and commend the case for change.

“Making these temporary changes will help us to stabilise the service now and reduce uncertainty and associated risk, so that we can focus on making permanent plans for a safe and sustainable future.”

They believe that people are under a “misconception” and don’t fully understand the role of MIUs and the services they provide.

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On the hospital ward changes the report said: “The executive committee continues to endorse and commend the case for change.

“No feasible alternatives have been identified during the engagement.

“Alternative suggestions have been put forward for consideration as part of the longer term work to develop and agree the future permanent shape of safe and sustainable health services in the county.”

If agreed the changes to the MIUs are expected to come into force “no later” than December 1.

And the hospital wards changes would be implemented by November 30.

A review of the changes would take place by the end of May 2025.