POWYS Teaching Health Board  (PTHB) members have unanimously voted to cut the opening hours of minor injury units and centralise some inpatient hospital care.

At a crunch board meeting on Thursday afternoon, October 10, members received detailed feedback from a six-week engagement process on changes to services described by some campaigners as a "downgrade by stealth".

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

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.

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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.

Due to the backlash from residents and discussion with patient forum Llais, PTHB extended the engagement period into September and decided to re-take the decision once analysis of the public comments had been done.

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Deputy director for engagement and communication Adrian Osborne took the board through the results of the engagement process.

Mr Osborne said: “There was a strength of public feeling that truly does reflect the pride and passion that people feel for their local services in this rural county.

“People reflected on their experiences of services that they felt are declining in their communities towns and villages, such as banks, post offices and schools.”

He added that there had been some support for the changes as a “prudent step” to address demand within available resources.

Powys director of patient forum Llais, Katie Blackburn said: “We’ve heard a very strong sense of community feeling and loss.

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“The concern is that temporary will become permanent.”

She told the board that if the agreed the changes Llais had a number of expectations.

These include that the health board continually evaluate the changes and at the end of the six month period the option of “reversing” the decision would be included in any recommendations.

Independent board member Jennifer Owen-Adams said: “The temporary period of six months falls over the winter when we all know there is increasing pressure on health services.

“Can these proposals withstand the winter pressures that we know is going to come on our services.”

Chief executive Hayley Thomas said: “There is no reduction in bed numbers over the sites as a result of these proposals.

“It’s the same capacity that we currently have got going into the winter period.

“This is part of getting ready for winter and the reality is we need to address patient flow and delays across the whole system.

“The whole purpose around this is to improve our productivity and to have better outcomes.”

After a two hour discussion, PTHB chairman Carl Cooper steered the board to a vote on the changes, which proved to be supported unanimously.

The changes are set to come into force by December 1.

Following the vote, Ms Thomas said: “It’s very important that the work on a long term model starts now.”

She believed that learning needed to be taken away from this process.

Ms Tomas said: “This is so that the health board work with the public, staff and partners to make sure they are helping us look at options for the future to keep health and social care sustainable in the county.

“Because this is a shared challenge, and we can’t do this alone.”

The engagement exercise had had 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.

A third petition was signed by 2,300 people against the changes to Llanidloes hospital which was formally lodged with the health board ahead of the meeting.

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