Community Hospitals in Rural Mid Wales

Rural Health and Care Wales (RHCW) was asked by the RHCW Stakeholder Group to review the Community Hospital provision across Mid Wales in order to ascertain their true value to the Mid Wales population, this value not always accurately reflected in national evaluation markers. The Mid Wales region comprises the most rural areas of Wales and is sparsely populated, with limited provision in terms of major health care sites. It has one district hospital (Bronglais, Aberystwyth) but a number of very important, supportive Community Hospitals. For the purpose of this research, Mid Wales is defined as being the region between the arc that connects Barmouth in the North-West of Wales across to Welshpool in the North-East, and down to an opposite arc to the South, which connects Cardigan in the West, across to Llandovery and then onto Builth Wells in the East. The three county areas that are included in this Mid Wales region are Ceredigion, South Gwynedd (Meirionnydd) and North Powys. The Community Hospitals in this region are managed by three Health Board Trusts - Hywel Dda University Health Board (HDdUHB), Betsi Cadwaladr University Health Board (BCUHB) and Powys Teaching Health Board (PTHB). This review commences with a factual presentation of the Community Hospitals across the Mid Wales region and the services that they offer, including staffing resources, facilities and opening hours. The review will also consider the definitions of a Community Hospital and history behind their establishments. IT seeks to outline the functional roles of a Community Hospital from the perspective of being “a small hospital for the local community” (community-hospital noun - Definition, pictures, pronunciation and usage notes | Oxford Advanced Learner's Dictionary at OxfordLearnersDictionaries.com and / or as a community hub and arbitrator of community belonging and connection: “(Community Assets)….are entities which are beneficial to the local community…” Understanding Welsh Places: Filling the evidence gap for places in Wales – Wales Institute of Social and Economic Research and Data (wiserd.ac.uk) “Community hospitals mean a deep sense of reassurance and of ontological security, …….. This reassurance comes, in part, from the physical presence of a community hospital, which acts as a visible expression of both historic and contemporary collective care and identity, but also from the different forms of interaction with it and the sense of ownership that this inspires”. (PDF) Analysis of the profile, characteristics, patient experience and community value of community hospitals: a multimethod study. Health Serv Deliv Res 2019;7(1) (researchgate.net) Having considered the practical offerings of the Community Hospitals across Mid Wales, the review will then seek to ascertain their “value” to the population of Mid Wales and compare this value with existing measures of evaluation used for Community Hospitals within Wales and across UK. It will conclude with a discourse on the appropriateness of the national evaluation tools to the value measures of the rural Community Hospitals in Mid Wales and provide recommendations on what are the true reflections of value of the Community Hospitals to the people living in rural Wales.