OUT of hours health services in west Wales are at increasing risk of closures as immense pressure on staff rotas continues, the health board has said.

Hywel Dda University Health Board discussed a report on the risk to continuity of emergency out of hours service provision that highlighted that there was an “increasing likelihood of having to close a service for a period of time.”

It adds that “diverts” would also need to be put in place across the health board region covering Pembrokeshire, Ceredigion and Carmarthenshire.

The board members were told that “operational contingency plans” were being developed with recent problems in Carmarthenshire resulting in the closure of GP out of hours.

Accident and emergency rotas at Glangwili and Withybush Hospitals are also affected along with GP out of hours across the three counties.

There are also threats to the paediatrics rotas at Bronglais, Withybush and Glangwili Hospitals, Prince Philip Hospital’s minor injuries unit as well as mental health out of hours.

The situation could become even worse in August when trainee places ‘change over’ with Hywel Dda “facing significant gaps in allocated trainees at this particular time,” said Keith Jones, general manager, family and child health.

Executive medical director and director of clinical strategy Dr Phil Kloer told members that the transforming clinical services plans are “based on this fragility”.

He added that attempts to recruit had been affected by recent Home Office changes to visas.

New independent member Anna Lewis asked about the risk of “normalising” services under pressure and how sure the team were “services haven’t tipped from fragile to unsafe.”

Dr Kloer agreed that was a risk, adding “we are normalising it in the sense that it’s what we are doing everyday.”

Director of nursing, quality and patient experience Mandy Rayani said she had discussed the possibility of closing an understaffed service: “I will not tolerate services being delivered in a way that is unsafe and patients will experience harm.”