BREAST services for Gwent patients could be provided from 2021 at a purpose-built centre of excellence at Ysbyty Ystrad Fawr in Ystrad Mynach.

Aneurin Bevan University Health Board is seeking approval from the Welsh Government to develop an outline business case for the project, which is likely to cost several millions of pounds.

The principle of creating a single-site breast service was originally agreed by the health board late in 2016.

Current services at the Royal Gwent and Nevill Hall Hospitals are well thought of by patients, but the health board faces a series of challenges in maintaining them.

Demand for outpatient services for breast patients far outweighs the current capacity available, according to a report to go before the health board's board members tomorrow, with extra clinics the only means of keeping down waiting times for tests and scans.

It warns too, that although waiting list initiative schemes are set to deal with an extra 1,440 cases, meeting the 31-day and 62-day cancer waiting times targets is not possible on a sustainable basis.

There are also shortages in the radiology workforce, while the need to maintain breast services at the existing two hospitals "has resulted in a lack of radiology cover for a number of clinics."

It is also impossible at the moment to offer patients one-stop diagnostic breast clinic assessments, which is seen as the best model of care by UK breast and cancer experts.

"One-stop diagnostic clinics are now a requirement for centres providing breast cancer

services," states the report.

"The Welsh Breast Cancer Services Peer Review Team has formally expressed their concern at the lack of a one-stop diagnostic clinic within the health board."

Waiting times for appointments are a concern for patients, as are car parking difficulties and dignity and respect issues at current cramped hospital sites where there is little or no room for expansion or redesign.

Creating a single site breast service would enable the development of a single multi-disciplinary breast services team, and consistent care pathways, states the report.

It cites research from other parts of the UK that "conclusively demonstrates the relationship between multi-disciplinary team working and improved cancer survival rates. In particular, the evidence to support this is particularly strong for breast cancer."

There was positive feedback for the idea of a breast services centre of excellence two years ago, during a public engagement programme, and the health board now wants to start drawing up detailed plans.

Emerging as a preferred option - from a number under consideration - is a new-build project at Ysbyty Ystrad Fawr, co-located with operating theatres, and with an estimated £6.5m price tag.

A timetable estimates that this could be open by early 2021, while acknowledging that it may be subject to change.