Emergency surgery would move from Prince Philip Hospital

The Royal College of Surgeons (RSC) believes Carmarthenshire NHS Trust should centralise all its emergency work at West Wales General Hospital.

A confidential report seen by the BBC said the continued use of both sites was 'uneconomical and unsustainable'.

The trust's board, which requested the RSC review, will discuss the report at a meeting at the end of this month.

Representatives from the RSC visited both hospitals in February.

We need to decide how to provide the best health care for the people of the county Martin Morris CHC

The report accepts that the proposed changes are 'politically sensitive', especially following a vocal campaign last year over night-time A&E services in Llanelli.

But the RCS says the changes would increase the number of operations and improve services at both hospitals and help the trust recruit and retain staff.

"The proposal to split emergency and elective procedures and to centralise emergency general surgery at West Wales General appears to be the only option," the report states.

"The volume of emergency general surgery admissions at Prince Philip is actually in the order of one per day and so the review team conclude that this service is uneconomical and unattainable."

It said if the proposals were implemented well then some elective surgery carried in the neighbouring Swansea hospitals could be done in Llanelli, reducing waiting lists in the region.

The report is due to be discussed by the trust board on 26 May

And it added that Carmarthen may be able to take on extra emergency work from hospitals in Haverfordwest and Aberystwyth.

The RSC has spoken to the hospital unions and local health board as well as consultants, anaesthetists and hospital management.

"The review team did not encounter any person or organisation who would disagree with this and no-one could supply an alternative to the plan," said the report.

Health watchdogs said there needed to be wide ranging debate on the recommendations.

Chief officer to the Llanelli Dinefwr Community Health Council, Martin Morris, said: "We need to sit down and consider and work through the report in detail and decide how to provide the best health care for the people of the county."

The report is set to go before a public meeting of the NHS Trust on 26 May.