A medical director has warned that health services cannot continue as they are as Hywel Dda prepares to make decision on a host of controversial decisions.

Hywel Dda University Health Board will hold an Extraordinary Board meeting on 18 and 19 February 2026 to consider the future model for nine services, including the downgrading of stroke services at Bronglais Hospital in Aberystwyth.

Speaking ahead of the meeting, Mark Henwood, Executive Medical Director said: “We know that these services are fragile and cannot continue as they are. Our clinical teams are spread across multiple sites and recruitment is an issue across the NHS. Our hospitals require ongoing maintenance, with some parts approaching or having reached the end of their intended lifespan. We need to make decisions on the changes needed to address these fragilities, so our services raise standards and meet the needs of our population into the future.”

An independent consultation report prepared by Opinion Research Services (ORS) has been published on the board’s website: https://hduhb.nhs.wales/clinical-services-plan/.

The report summarises feedback from the public consultation, including more than 4,000 questionnaire responses alongside views gathered at public events, staff meetings and stakeholder sessions. Over 4,000 people also attended Health Board events and meetings during the consultation to share their views.

Campaigners against the plans claim the consultation process has cost the health board around £300,000.

The plans to downgrade stroke services at Bronglais to a treat and transfer unit, with patients being sent to Llanelli, have been met with ferocious opposition, with claims the health board isn’t listening to concerns from people in rural areas.

A protest is planned in Aberystwyth on 7 February at 10.30am.

Lisa Francis from Protect Bronglais Services said: "We need to make our voices heard and views clear.

"Mid Wales is a health desert and there is currently no clarity over what they might opt for.

"If the plans to downgrade stroke services at Bronglais are given the go ahead, its makes anything else they plan to do a lot easier.”

Dr Neil Wooding, Chair of Hywel Dda University Health Board, said: “We have a responsibility to weigh public feedback together with clinical evidence, workforce considerations, sustainability challenges and the need for services to meet the highest possible standards. As we move into the next stage, it is vital that the decisions we make are for the benefit of all our communities across Hywel Dda and neighbouring areas.

“We must also ensure that our decisions deliver clear public value and support the best possible patient outcomes. As a Health Board, we have a statutory responsibility to provide the best possible services for our communities, and any decisions we make must support that responsibility without setting an unhelpful precedent for the future.

“These decisions will shape our services for the longer term, so it is essential that we take the time needed to reach well informed, balanced conclusions. Above all, we must ensure that the services we provide meet people’s needs, both now and into the future.”