THE blueprint for modernisation of health services in Gwent - the Clinical Futures programme - is as relevant today as when first conceived more than a decade ago, a review has concluded.

The programme envisaged a new model for Gwent's hospital provision, supported by strengthened primary and community services, with the aim of providing more treatment and care closer to patients' homes.

It was also an attempt to respond to workforce changes and shifts in the emphasis of medical training, which in recent years have rendered fragile a range of hospital services, in Gwent and further afield.

The Specialist and Critical Care Centre (SCCC), earmarked for the former Llanfrechfa Grange Hospital site near Cwmbran, was and remains Clinical Futures' flagship project.

Though building work has yet to start, 12 years since the idea was first mooted, its concentration of specialist services in one hospital, to treat Gwent's sickest patients, is as relevant, if not more so, today.

The review of Clinical Futures takes the form of what is known as a programme business case (PBC), to be considered by the Welsh Government.

Aneurin Bevan University Health Board, which has drawn up the PBC, maintains that Clinical Futures holds up to scrutiny.

"It represents a considerable amount of work over 10 or 11 years, by people across the health board," said Allan Davies, interim director of planning and performance.

"There has been a lot of development in the meantime, such as Ysbyty Aneurin Bevan, Ysbyty Ystrad Fawr, Monnow Vale, the Frailty Programme. The PBC reviews the original strategy and ensures that future services can work and be affordable.

Mr Davies said the fragility - due primarily to staffing issues - of two-site services such as paediatrics, obstetrics and neo-natal - particularly at Nevill Hall Hospital, highlights that the proposal for a radical solution such as the SCCC remains valid.

"Health policy in the UK in recent years indicates that Clinical Futures is the road we need to keep going down. That was spotted very early in the health community in Gwent, and is much more pertinent now.

"Clinical Futures is remarkably resilient and continues to be relevant and appropriate as a foundation for moving forward."

Inevitably, the programme has been modified, not least in response to severe financial restraints following economic downturn and recession.

The original Clinical Futures programme, proposed new hospitals for Newport and Abergavenny, to replace the Royal Gwent and Nevill Hall Hospitals, but these will instead be adapted for new roles when the SCCC opens in 2019.

Acknowledging that shift, health board chairman David Jenkins said: "We are scaling our ambition into the context of our austere times, and accepting we will have to make best use of what we have on the Royal Gwent and Nevill Hall sites.

"But the argument in favour of Clinical Futures and the SCCC remains critical to the provision of safe services to the people of Gwent.

"We feel confident that this meets the health needs of the population we serve."