Better Together – When might changes take place?

11 November 2026

Powys Teaching Health Board is inviting people across Powys to help shape the future of local NHS services.

The consultation runs from 5 October 2026 to 10 January 2027 and seeks views on proposals for adult physical health, adult mental health, urgent care and some diagnostic services.

Thirteen locality events and three online events provide opportunities for people to meet the team, ask questions, discuss the proposals and then complete the questionnaire. Full details can be found at http://pthb.nhs.wales/BetterTogether

The latest in our series of regular Better Together articles looks at when any changes to health services in Powys might take place.

You can read the Full Consultation Document on our website or find out more by reading the "When might changes take place?" chapter below.

This chapter explains when changes could happen if, following consultation, decisions are made to implement the options in this consultation document.

No changes would happen straight away.

After the consultation closes, the Health Board will carefully consider all the feedback received before making any decisions. We currently expect decisions to take place in Spring 2027.

If changes are approved, detailed planning would take place before services change. Any changes would be introduced gradually over a number of years. This would help make sure services remain safe and reliable while new ways of working are developed and community services are expanded. The speed of change would depend on factors such as staffing, funding, buildings and facilities, and the availability of the services needed to support people closer to home.

One of the key principles of the proposals is that community services would be strengthened alongside any changes to hospital-based services. This could include investment in services such as Hospital At Home, district nursing, rehabilitation, reablement, mental health support and urgent community services.

If the proposals are approved, people may see changes such as:

More care being provided in people's homes and local communities.
Better access to services that help people recover, regain independence and stay well.
Closer working between physical health and mental health services.
Changes to some inpatient, urgent care and minor injury services.
Improvements to buildings, equipment and technology that support patient care.

Some improvements could happen relatively quickly, particularly where they involve expanding existing community services. Other changes may take longer because they require additional staff, changes to buildings or the development of new services. In some cases, formal organisational change consultation with Health Board staff will need to take place before changes happen. We would work in partnership with any staff affected, and with staff-side representatives from unions and professional associations, and follow the All-Wales Organisational Change policy for the NHS workforce across Wales

Throughout the process, the Health Board would continue to work with patients, staff, local communities and partner organisations.

Our aim is not simply to move services from one location to another. It is to create a health care system that helps more people stay well, maintain their independence and receive support closer to home, while ensuring specialist and inpatient services remain safe, sustainable and available when they are genuinely needed.

It is important that we are open about the possible timetables to help you respond to this consultation. We have some early ideas, but these could only be finalised once decisions are made following the consultation.

Physical Health Option 1 – Enhanced Community Services with Powys Inpatient Services on three sites

If decisions are made in Spring 2027 then there would be an ongoing programme to strengthen skills and urgent community response. In relation to current hospital wards, key milestones could include:

By the end of year 2: Transfer of inpatient services from Bronllys and Llanidloes
By the end of year 4: Transfer of inpatient services from Machynlleth and Ystradgynlais
Year 5 onwards: Transfer of services from Welshpool with final model of 3 sites with 30 inpatient beds each (Brecon, Llandrindod Wells, Newtown) in place

Physical Health Option 2 - Enhanced Community Services with Powys Inpatient Services on two sites

If decisions are made in Spring 2027 then there would be an ongoing programme to strengthen skills and urgent community response. In relation to current hospital wards, key milestones could include:

By the end of year 2: Transfer of inpatient services from Bronllys and Llanidloes
By the end of year 4: Transfer of inpatient services from Machynlleth and Ystradgynlais
Year 5 onwards: Transfer of services from Welshpool and Llandrindod Wells with final model of 2 sites with 30 inpatient beds each (Brecon, Newtown) in place

Urgent Health Care Option 1 – Enhanced Community Services with two Urgent Care Centres and one Minor Injury and Illness Unit

If decisions are made in Spring 2027 then there would be an ongoing programme to strengthen skills and urgent community response. Services would be strengthened in Welshpool on an interim basis until the Urgent Care Centre is established in Newtown. Key milestones could include:

By the end of year 2: Work will have taken place on the alternative local minor injury service offer in Ystradgynlais and the hospital MIU and x-ray would close. The one-day x-ray service in Machynlleth would also close. Recruitment plan in place to achieve seven day x-ray services in Brecon, Llandrindod Wells and Welshpool.
By the end of year 4: Seven day x-ray services fully established in Brecon, Llandrindod Wells and Welshpool. We would also extend the range of point of care testing and same day blood testing available in the county so that Minor Injury Units in Brecon, Llandrindod Wells and Welshpool would become Minor Illness and Injury Units. This means that more services would be provided in the county than now.
Year 5 onwards: A comprehensive county-wide model of urgent care would be fully established in the county. Brecon would be fully established as an Urgent Care Centre. Llandrindod Wells would continue to provide Minor Illness and Injury Services. MIIU and x-ray services from Welshpool would transfer to a new Urgent Care Centre facility in Newtown.

Urgent Health Care Option 2 - Enhanced Community Services with two Urgent Care Centres

By the end of year 2: Work will have taken place on the alternative urgent care offer in Ystradgynlais and the hospital MIU and x-ray would close. The one-day x-ray service in Machynlleth would also close. Recruitment plan in place to achieve seven day x-ray services in Brecon and Welshpool, and maintain five day services in Llandrindod Wells.
By the end of year 4: Seven day x-ray services fully established in Brecon and Welshpool, with five day services continuing in Llandrindod Wells. We would extend the range of point of care testing and same day blood testing available in the county so that Minor Injury Units in Brecon and Welshpool would become Minor Illness and Injury Units. This means that more services would be provided in the county than now. Work will have taken place on the alternative urgent care offer in Llandrindod Wells and the hospital MIU would close.
Year 5 onwards: A comprehensive county-wide model of urgent care would be fully established in the county. Brecon would be fully established as an Urgent Care Centre. MIIU and x-ray services from Welshpool would transfer to a new Urgent Care Centre facility in Newtown.

Mental Health Care Option 1 – Enhanced Community Services with one inpatient site for organic and functional mental health service in Bronllys/Brecon area

If decisions are made in Spring 2027 then there would be an ongoing programme to strengthen skills and urgent community response. Key milestones could include:

By the end of year 2: Identify first site (Llandrindod Wells or Ystradgynlais) to transfer.
By the end of year 4: Capital works to establish Mental Health Centre of Excellence.
Year 5 onwards: Model of care fully implemented, all mental health inpatient care consolidated to the Mental Health Centre of Excellence.

These timelines provide an indication of the possible next steps if the options were agreed following analysis and conscientious consideration of the feedback we hear during this consultation. They do not predetermine the outcome of the consultation. They would adapt and evolve reflecting the decisions made and the feedback we hear.

Alongside these key milestones we could continue to work with you to develop the future vision for each of our sites. We would also continue to work with you on the next phases of Better Together including planned care and women & children’s services.