Hywel Dda Health board has warned that patients from Ceredigion will have to travel to the south for treatment in the future as it updates its strategy.

The health board met on Thursday to discuss its clinical services plan, which will also see the removal of stroke services at Bronglais Hospital in Aberystwyth.

In a report to the board, Hywel Dda University Health Board said: “Bronglais Hospital (BGH) has a unique role in meeting the needs of a very large and very rural part of Wales, serving populations of Hywel Dda, Powys and Betsi Cadwaladr.

“The Bronglais strategy sets out the approach to strengthening this and through the Mid Wales Collaborative there is opportunity to increase the offer to the Mid Wales population, thereby also adding to Bronglais' resilience.

“The lack of scale at Bronglais inevitably leads to fragilities and a strengthened model in the south of Hywel Dda will be important for the sustainability of services.

“Increasingly, we anticipate services will be provided on a networked basis.

“This may lead to more patients having to travel to sites in the south of Hywel Dda but will offer more resilience to core services, underpinning the long-term sustainability of specialties on the Bronglais site.

“The use of digital and other technologies will support remote working to minimise patient transfers and travel.”

Speaking at the meeting, Lee Davies, Director of Strategy and Planning said the proposed new hospital between Carmarthenshire and Pembrokeshire is at least 10 years away and the investment in the original timeframe is ‘increasingly unlikely’.

Hywel Dda Chair, Neil Wooding repeated on numerous occasions that the board needed to be ‘bold and courageous’ in its future planning for services, adding ‘it’s going to be a painful journey’, with another board member, Anna Lewis saying ‘centralisation is inevitable’.