The CHC landscape in Hywel Dda University Health Board
Hywel Dda operates the most geographically extensive health board in Wales, but with one of the smallest populations relative to area. Rural Ceredigion in particular is sparsely populated — villages are scattered across mountains, broadband is patchy in places, and transport links between population centres are poor. This directly affects CHC: families may struggle to attend MDT panel meetings in Carmarthen, specialist evidence gathering can require significant travel across county lines, and there is a shortage of specialist health professionals in remote areas, leading to delayed diagnoses and longer waits for investigations.
Hywel Dda's four main hospital sites are deliberately dispersed to serve the wide catchment: Glangwili in Carmarthen (the main DGH), Prince Philip in Llanelli, Withybush in Haverfordwest (Pembrokeshire's main hospital), and Bronglais in Aberystwyth (the only hospital serving rural Ceredigion). For families in remote parts of Cardigan or Teifi, reaching Aberystwyth for hospital care is itself a major undertaking — this burden is relevant to CHC assessment and should be documented in your advocacy materials as a functional limitation arising from the primary health need.
Welsh language is central to Hywel Dda's cultural context. Ceredigion and rural Carmarthenshire have among the highest Welsh speaker percentages in Wales (40–50% in some areas). Bilingual services are embedded in the health board culture. Your right to Welsh-language CHC assessment is absolute; in this region, it is also culturally expected. Request all materials in Welsh if that is your family's language, and note that Welsh-speaking staff are generally available without delays.
The health board's ageing population (many rural communities have limited younger working-age populations due to economic migration) means CHC demand is high relative to health board funding. Combined with geographic sparsity, this has led to documented service pressures and delayed assessments in some parts of the catchment. If your relative is referred for CHC assessment, expect potentially longer waits for MDT panel meetings in remote areas than in more densely populated health boards.
CHC approval statistics for Hywel Dda University Health Board
Source: NHS England official CHC statistics, 2024/25 · Rank — of 36 ICBs in England
Standard approval rate
—
National avg: —
Assessments completed
—
— found eligible
Fast-track approved
—
of — fast-track assessments
Local review requests
—
2024-25
Currently receiving CHC
—
Snapshot Q3 2025/26
England rank
— / 36
1 = lowest approval rate
How Hywel Dda University Health Board compares — 2024/25
How to apply for CHC funding in Hywel Dda University Health Board
Hywel Dda University Health Boardmanages Continuing NHS Healthcare under the Welsh national framework, which differs from England's in several important ways.
Step 1: Request a CHC screening
You can request a CHC Checklist screening at any time — in hospital, at home, or in a care home. Contact your GP or the Hywel Dda University Health Board CHC team on 01267 235 151 to start the process. In Wales, the Checklist is optional — the health board may move directly to a full DST assessment.
Step 2: The Decision Support Tool assessment
A multidisciplinary team (two health professionals and one social worker) will carry out a comprehensive assessment using the Decision Support Tool. This evaluates your needs across 12 care domains plus "Other Significant Needs."
Step 3: The eligibility decision
The health board makes the final decision on whether the person has a "primary health need." If eligible, the NHS funds the full package of care.
Advocacy tips for Hywel Dda University Health Board
These tips are specific to applying for CHC in the Hywel Dda University Health Board area.
action
Document rural travel burden explicitly. If your relative is housebound or has limited mobility and you live in Cardigan, Aberteifi, or other isolated areas, reaching hospital care in Carmarthen or Aberystwyth is a substantial barrier. The MDT should understand travel burden as a functional limitation directly related to the primary health need, not merely a logistical inconvenience. Calculate actual travel times and costs.
action
Request all CHC materials in Welsh if Welsh is your family's language. Hywel Dda's cultural context and legal obligation (Welsh Language (Wales) Measure 2011) mean Welsh-language services are well-established. Early request ensures smooth provision. Email hduhb.enquiries@wales.nhs.uk with your Welsh-language preference.
action
Engage early with your local Complex Care Specialist Nurse. These nurses understand both the health board's rural context and the Welsh framework. In dispersed areas, they are often the most responsive point of contact and can advocate internally for faster assessment if you are remote.
action
Gather evidence proactively from your GP, community nurse and any hospital services. In rural areas with limited secondary care, much of the clinical case for CHC may rest on primary care and community health records. Request these yourself rather than waiting for the health board to chase them — it can save weeks.
action
Be prepared for longer waits for MDT panel meetings in rural areas. The health board may hold panels less frequently in areas like Aberystwyth or Haverfordwest. Ask at referral how long the queue is; if it exceeds the national target of 4 weeks significantly, escalate to PALS and cite rural deprivation as a barrier to timely assessment.
Hospital trusts in Hywel Dda University Health Board
These are the main NHS trusts whose patients may be assessed for CHC in this area. If your relative is being discharged from one of these hospitals, ask the ward about CHC screening.
Hywel Dda University Health Board (operates all hospitals)
Glangwili General Hospital (Carmarthen), Prince Philip Hospital (Llanelli), Withybush Hospital (Haverfordwest), Bronglais General Hospital (Aberystwyth)
Contact Hywel Dda University Health Board
Phone
01267 235 151Website
Visit website →Address
Ystwyth Building, Hafan Derwen, St Davids Park, Jobswell Road, Carmarthen SA31 3BB
Children's CHC
hd.chc.children@wales.nhs.ukVisit the official Hywel Dda University Health Board CHC page →
Frequently asked questions
My relative lives in a remote Ceredigion village. How does distance affect my CHC assessment?
Distance is relevant to CHC assessment in two ways. First, if your relative cannot easily travel to hospital appointments or MDT meetings due to severity of illness or disability, document this — it demonstrates functional limitation directly related to the primary health need. Second, if delayed access to hospital services has postponed diagnosis or investigation, make this explicit to the MDT as context for why formal health documentation may be recent. The 12-month retrospective window applies regardless, so request retrospective CHC immediately if eligible.
Can I have my CHC assessment in Welsh?
Yes, absolutely. You have a legal right under the Welsh Language (Wales) Measure 2011 to receive your entire CHC assessment in Welsh — all documentation, panel meetings and correspondence. Request this at first contact. In Hywel Dda's catchment, Welsh-language provision is well-embedded and you should expect no delays. Email hduhb.enquiries@wales.nhs.uk with your request.
Which hospital should I contact for medical evidence, and how long will records take?
Contact the hospital where your relative was primarily treated: Glangwili (Carmarthen), Withybush (Haverfordwest), Prince Philip (Llanelli) or Bronglais (Aberystwyth). Request records in writing; the NHS target is 14–20 working days. Do this proactively as soon as your relative is referred for CHC assessment. In rural areas, hospital record systems can be less automated, so direct contact may be faster than waiting for the CHC team to request records.
I was told the MDT panel will take longer than 4 weeks because we're in a rural area. Is that acceptable?
The national target is 4 weeks from referral to completed assessment. Rural location is not a legitimate reason to breach this target. If the health board tells you to expect longer waits, escalate to PALS (01267 235 151) and reference rural deprivation and service equity. If you face significant delay (8+ weeks), escalate further to your local Llais Wales team — they can advocate on your behalf.