Hospital staff still endure uncertain futures at community hospitals - including Tywyn - that have seen the “temporary” closures of inpatient beds.

Tywyn’s Dyfi Ward saw “temporary” measures imposed more than two years ago due to a shortage of trained nursing staff.

A Betsi Cadwaladr University Health Board (BCUHB) report said the closure was due to concerns over the “sustainability” of the care model, a very limited number of patients suitable for the type of care in the setting, and reliance on temporary staff.

The report recognised staff “have and continue to face uncertainty” amid the ongoing service review, and aimed to set out proposals for developing longer term solutions for Tywyn.

BCUHB said further discussions and consultation would be carried out this year, with final recommendations coming in December.

Kamala Williams, BCUHB’s head of health strategy and planning, told the meeting re-opening beds had not been ruled out, but BCUHB was “duty bound” to consider other ways of delivering safe, sustainable and high-quality services that met the needs of the respective local communities.

An ongoing process to “identify sustainable solutions” was underway, with engagements, regular briefings and follow-up sessions with Llais, an independent body representing patients, and community representatives.

Since Tywyn’s closure, inpatient bed capacity at Dolgellau Hospital had risen from 14-18 beds, staff redeployed to Homeward Bound community service, a new treatment room established, a five-day-a-week Minor Injuries Unit reopened, and a Wellbeing Hub supported health promotion and community engagement.

Recruitment had also been “successful” but the report noted: “Workforce skill mix, retention and resilience still remained with significant issues preventing the reopening of the ward safely, sustainably and without likely detriment to the other clinical and community services provided at the hospital”.

A public forum by Llais highlighted “strong support” for accessible, locally delivered care and locals expressed concern over the loss of inpatient services.

During a wider discussion on “wellbeing objectives” at BCUHB during the meeting, vice chairman Gareth Williams said staff on temporary contracts were being treated “unfairly” and it went against the board’s principle of “fair work”.

He said he felt they should “not just say they were in favour of ‘fair work’ but demonstrate it”.

He said: “Time after time, when I go round this organisation, I find staff being treated unfairly, in terms of those on short term contracts, where it is said, ‘oh, we will extend it for three months, we might make a decision then’.

“That’s really letting people down, people with mortgages and other responsibilities, it’s like leaving them to twist in the wind, while we decide what we are doing.

“It is not acceptable if we say we are committed to fair work. But we are starting to make progress.”

Speaking after the meeting, Geoff Ryall-Harvey, Llais regional director of the north Wales region, said of Tywyn and Penley, Wrexham, in a similar position to Tywyn: “Tywyn and Penley are important local services, local people are very concerned about the loss of these beds and it is vital that BCUHB listen to local concerns.”