Major changes are being planned in the way people in Cardiff and the Vale of Glamorgan access vital health services.

More details have been revealed about the future services in the region's main hospitals and health centres.

There are plans to replace University Hospital of Wales in Cardiff with a new hospital, which will focus on emergency and complex surgery.

But there are also plans to change the way University Hospital Llandough operates with more specialist surgeries.

The health board is set to decide next month whether to move ear, nose and throat surgery to Llandough.

It's part of plans – outlined in the health board's Strategic Clinical Services Plan – to move as many services as possible from hospitals into people's homes or communities.

This is what could lie ahead in a big shake up of health services across Cardiff and the Vale.

New University Hospital of Wales:

The new hospital would be a 24/7, 365-day a year facility for emergency and complex or specialist surgery.

The health board says "there will be immediate access to all essential diagnostic, critical care and specialist clinical services on a 24/7 basis for acutely unwell patients requiring an emergency admission or a complex, specialist or high risk elective procedure".

Services at the new hospital, which the health board hopes will open by 2030, would include:

• The major trauma centre for south Wales – providing specialist care for the most life-threatening injuries.
• Emergency department for Cardiff and the Vale of Glamorgan.
• Full 24/7 diagnostics – including imaging, interventional radiology, pathology laboratory services, radio-pharmacy, endoscopy and cardiac catheter laboratory services.
• All levels of critical care.
• 24/7 emergency operating theatre.
• Complex planned surgery including cancers, spinal, facial, vascular, and robotic surgery.
• A consultant and midwifery-led birthing centre.
• Specialist services including cardiac and neurosurgery, blood and marrow transplant, renal surgery, nephrology and transplant, thrombectomy, advanced gene and cell therapies and All-Wales Genomics service.
• Noah's Ark Children's Hospital for Wales and all paediatric emergency, intensive care and inpatient services.
• All levels of neonatal intensive care.

University Hospital Llandough:

The health board says Llandough hospital would be for "ill but stable patients".

Its services would include:

• Assessment/short-term intervention
• Daytime imaging services – such as X-ray, ultrasound, CT, MRI.
• Pathology/diagnostic daytime services.
• Routine endoscopy – screening, planned and follow up.
• Emergency outpatient service for patients who become unwell and unstable and need a clinical assessment, diagnostic investigation, or short-term clinical intervention service which is not provided by community services.

Medicine/ mental health:

Inpatient and hospital-based mental health services as currently provided. Services to support step-up and step-down care for patients not well enough to be cared for in the community but do not require immediate or 24/7 access to critical care or specialist clinical services or who require intensive specialist rehabilitation.

General rehabilitation and ongoing medical inpatient care – stepped down from UHW or local residents from other regional hospitals.

Surgery:

Surgical centre of excellence for non-complex planned surgical care for high volume, low-risk short stay surgery.

Specialist services:

Specialist neuro and spinal rehabilitation services will transfer in 2023, and cystic fibrosis will be delivered from new purpose built facilities.St David's Hospital

The health board says it wants to develop St David's Hospital "as centre of excellence for rehabilitation, aimed at supporting people not quite ready to go home but who do not need to be in an acute hospital". It says it's already set up an additional rehabilitation ward there.

Care at home:

The health board wants more people to access care services at home – either through e-services on new digital platforms or through new community teams to help them remain independent at home.

Health and wellbeing centres:

The health board is planning to open three health and wellbeing centres, first in Cardiff Royal Infirmary, then at Barry Hospital, and another in north west Cardiff.

The centres would provide services such as:

rapid assessment of patients with specific conditions to reduce the need for emergency admissions; range of point-of-care testing services and plain film X-rays; outpatient services; community mental health teams and children's services, and; a range of health and social care services tailored to meet the specific needs of the local area.

Wellbeing Hubs:

A network of smaller health centres, named wellbeing hubs, is being planned in Maelfa, Ely and Penarth to open by the end of 2021.

Services would include:

GP services, Community midwifery, Health visitors, Primary mental health services, Community children's services.

Why is the health board planning this?

The population of Cardiff and the Vale is growing – with the number of children in the area expected to grow by 20% by 2029.

There is also an increasingly older population who need to support to manage one or a combination of chronic conditions.

And the main causes for premature death in adults in the area are cancer and circulatory diseases – where people's unhealthy lifestyles are a significant contributing factor.

It means the health board believes "it is clear that the current shape and way we provide services is not fit for purpose to meet the future demand".

The health board says: "To meet the changing needs of our population we need to change how our services are provided.

"Where possible our services will be delivered predominantly in patients' homes or from facilities in the community.

"Our hospital-based services need to be reshaped to support the future healthcare service needs of our local, regional, and tertiary population within modern and fit-for-purpose infrastructure.

"The ambition for the two major acute hospital sites in Cardiff and Vale UHB is to clearly define their future roles in ensuring that patients are admitted for the shortest time for the provision of care that can only be delivered in a hospital environment."