South Wales NHS: Solution urged to end shake-up confusion
Health boards in south Wales have been urged to come up with a solution as plans to centralise key services at five hospitals face uncertainty.
Four boards backed a recommendation for it on Thursday but one rejected the plan and put forward its own idea.
Cwm Taf went against the proposals relating to A&E, specialist care for mothers, newborn babies and children.
It stands to lose services from one of its main hospitals, the Royal Glamorgan in Llantrisant.
Cwm Taf backed most of the proposals, but proposed sharing services between the Royal Glamorgan and the Princess of Wales Hospital in Bridgend - run by Abertawe Bro Morgannwg health board - as a "starting point" to centralising units.
Its watchdog - Cwm Taf Community Health Council (CHC) - said a decision needed to be made on the recommendation.
Dr Paul Worthington, the CHC's chief officer, told BBC Radio Wales: "It was three hours of very intense and very passionate discussion - very frank and very transparent.
"But we got to the end and the health board came up with this decision.
"We were looking for a specific decision and this was a little more confusing than anticipated. It's back to the drawing board in some ways."
He said the CHC feels in "limbo" and it would have preferred a definitive decision either way.
Dr Worthington added: "We want to give the health board some space to see if they can come forward with a solution.
"I've had texts and phone calls from people I know in the Cwm Taf area asking what it means for them. At the moment what I can say is that we don't know as there's still work to be done.
"We want to see a resolution not least because our patients want to be clear on where their services are going to be."
Since the start of 2012, senior managers and medical professionals from the five health boards and the Welsh Ambulance Service have been working together in the South Wales Programme (SWP) to develop proposals for hospitals across the region from Swansea to Newport and Abergavenny.
Standards of care
The proposed changes come amid concerns that services across eight hospitals are currently spread too thinly. However, managers insist no individual A&E department would close.
There are also concerns that professional standards of care are not being met, junior doctors do not get the training they need and senior doctors do not get to see enough patients.
Cardiff's University Hospital of Wales, Morriston Hospital in Swansea, a new hospital near Cwmbran, Prince Charles Hospital in Merthyr and the Princess of Wales Hospital, Bridgend, are the five hospitals where services would be centralised.
The future for the Royal Glamorgan would see it become a "beacon site" for developing a new model of acute medicine for people with chronic illnesses.
But the recommendation needed to be accepted by the five south Wales health boards and the ambulance service who met on Thursday.
However, Cwm Taf has proposed the alternative model which has led to confusion over whether the reorganisation plan will be accepted.
Talks will take place on Tuesday to find a solution but Health Minister Mark Drakeford said Cwm Taf would not hold up changes.
Paul Hollard, programme director for the SWP, said: "We will work together to discuss these and consider the next steps so that the South Wales Programme work can proceed with minimum delay.
"It is vital that we get this right to ensure the best healthcare possible for the people of south Wales and south Powys."
If a solution can be found, a final decision will be scrutinised by the five CHCs at a later date.
Should they not be happy, the matter will be referred to the Welsh government.
Cardiff and Vale CHC has already said it is disappointed that its health board supported the recommendation.
The reorganisation plans would also see three Care alliances set up alongside the five sites and would see clinicians from different hospitals working together across health board boundaries to provide care for patients.
They would share information, skills and expertise and the alliances would decide which work goes where.
That includes being involved with the centralising of services like consultant-led maternity and neonatal care, along with inpatient children's services and A&E.
The alliances would also ensure patients continue to have access to local assessment, care, treatment and follow-ups.
But there may be occasions - as happens now - when some patients with complex conditions need to travel to a specialist centre.
However, if an alliance was to propose any changes, it would have to go out to consultation.