New health boards to control NHS

By Hywel Griffith
BBC Wales health correspondent

Individual patients are now going to have more choice about their care

A new way of running the NHS in Wales has come into force, with the 22 local health boards set up six years ago being scrapped.

They have been integrated with NHS trusts to form seven boards, which take control of all hospitals and community services, GP and dentist funding.

The new boards will be responsible for deciding which treatments and services are available.

They will also ensure that hospitals meet targets on waiting times.

Health Minister Edwina Hart set out her plan to abolish the old "internal market" system of commissioning in 2008.

NEW LOCAL HEALTH BOARDS 1 Betsi Cadwaladr LHB - Conwy, Denbighshire, Flintshire and Wrexham, Anglesey and Gwynedd 2 Hywel Dda LHB - Ceredigion, Carmarthenshire, Pembrokeshire 3 Abertawe Bro Morgannwg University LHB - Swansea, Neath Port Talbot, Bridgend 4 Powys Teaching LHB Powys county 5 Cwm Taf LHB - Rhondda Cynon Taf, Merthyr Tydfil 6 Cardiff and Vale LHB - Cardiff and Vale of Glamorgan 7 Aneurin Bevan LHB - Gwent

The only NHS trusts to remain are the Welsh Ambulance Service and Velindre Hospital in Cardiff, which specialises in cancer treatment.

In the short term, the changes should have very little impact on the day-to-day running of the NHS, although for some, there will be new names to learn.

For example, all health services in north Wales will now come under the new Betsi Cadwaladr University Health Board which takes over the reins from six separate local health boards and two NHS trusts.

"For individual patients," said Kate Crosby, who manages the Monnow Vale Health and Social Care Centre in Monmouth, "they are going to have familiar staff looking after them, and they are going to have more choice about where that takes place and who does it."

She added: "I don't think they have anything to fear and they have a lot to gain actually." There are, however, concerns that the seven new health boards will mean local needs are not met in the future, especially in areas where services have previously been under threat.

The new NHS claims it can deliver more care closer to patients' homes

Chronic conditions

"We obviously would like to see the status maintained of our district general hospital in Withybush," said Tony Wales from Pembrokeshire Community Health Council.

"There are fears among members of the public that we might see a re-provision of services and patients having to travel to a district general hospital in Carmarthen."

"We think its very important for Pembrokeshire to access their services as locally as possible," he added.

Where patients receive healthcare care will certainly change over time, with the aim of supporting more people in their own homes, especially those suffering from chronic conditions.

A pilot scheme in Carmarthenshire has seen emergency hospital admissions for emphysema fall by 40%, and admissions for heart failure reduce by 30%.

This has partly been achieved by monitoring patients remotely, using computerised testing kits which feed results back to staff.

The new health boards will all be encouraged to work in these new ways - but it could also create tension if it results in hospital bed numbers being reduced.