THE biggest change in healthcare in Gwent since the creation of the National Health Service in 1948, is happening today.

The opening of the Grange University Hospital at Llanfrechfa, near Cwmbran, marks the culmination of the better part of two decades of planning, reshaping, and then building, a specialist and critical care centre to treat the area’s sickest patients.

The first of those patients are coming through the doors of the Grange today, making real - at long last - a project that might easily never have come to fruition.

When Gwent’s then health chiefs began to seriously consider the idea of what would become the Grange University Hospital, it is fair to say that none thought it might take so long to complete.

This is a project first made public - albeit in somewhat vague terms, and as part of a wider resetting of Gwent’s health services - 17 years ago.

That reset was and remains known as Clinical Futures, the programme which detailed the fundamental principles behind a hospital and healthcare modernisation programme for Gwent.

A specialist and critical care centre was the centrepiece of that programme, a means to enable the separation - the ring-fencing - of emergency healthcare, from the increasingly unpredictable ebbs and flows of routine, or elective care.

Clinical Futures envisages the delivery of much healthcare closer to people’s homes, with a network of local hospitals providing routine diagnostic and treatment services, around a single specialist and critical care centre.

The remodelling of the Royal Gwent and Nevill Hall Hospitals is as central to this vision as the Grange, and since plans for the latter were first aired, two other hospitals - Ysbyty Ystrad Fawr at Ystrad Mynach, and Ysbyty Aneurin Bevan at Ebbw Vale - have been built to support the Clinical Futures blueprint.

More remains to be done to bring more care closer to people’s homes, to reduce the reliance on hospital care, and in turn to make sure that those hospitals are not stretched to breaking point.

Investment in community care and the development of health and wellbeing centres, are key aspects of Clinical Futures too, with the Brynmawr Wellbeing Centre an early example of the sort of scheme that brings more services closer to communities - and just as crucially - relocates local GP and other health services into modern buildings.

Similar schemes are planned for Tredegar and the east of Newport in the next two or three years.


The Grange then, ought to be seen as part of a wider network of changes to healthcare in Gwent.

Its earlier-than-planned opening - next spring was the original target - will enable Aneurin Bevan University Health Board to better cope with the demand of what promised to be an already busy winter stalked by the spectre of coronavirus.

But longer term, it will put key services - paediatrics, obstetrics, neonatal, even A&E, to name but four - on a more sustainable footing, concentrated on one site.

Sustaining such services at both the Royal Gwent and Nevill Hall has proved increasingly difficult amid issues with recruitment to key medical posts, linked in turn to problems with staffing shifts. and maintaining safety and quality of care.

From today, the Grange University Hospital brings the likes of A&E, paediatric inpatients, neonatal intensive care, emergency surgery, and complex surgery under one roof.

Had early estimates of its completion been anywhere near accurate, the Grange could have been up and running as much as a decade ago.

But the early planning and consultation for Gwent’s specialist and critical care centre was done in the days before the 2007-08 financial crash that sent the world into economic downturn and recession.

By the time that misfortune developed, the public consultation had been completed, with a huge degree of support despite scepticism over its proposed location, and the project seemed set fair.

The said downturn however, brought many building projects in health and other sectors of the economy across the UK to a grinding halt, as governmental purse strings were tightened.

By late 2008, then health minister Edwina Hart had ordered that planning for projects such as the specialist and critical care centre be suspended whole while the then Welsh Assembly Government sought to determine the outlook of the economic and financial future.

It was March 2011 before the project got the nod again, though in the interim all sorts of compromises were considered, along with the doomsday scenario of not proceeding.

Detailed planning resumed, the project, its role, and its costs were reviewed several times, and successive health ministers in Cardiff Bay pondered over whether spending more than £300 million on a single hospital could be justified in an era of austerity.

The benefits in health and financial terms of the specialist and critical care centre project and Gwent’s wider Clinical Futures programme continued to show up loud and clear in those reviews, however.

By October 2016, the latest occupant of the health minister’s office – Vaughan Gething – had been convinced of its value and had convinced others in the Welsh Government too, and he confirmed that it could, at last, go ahead.

And by July 2017, as contractors Laing O’Rourke got to work at the Llanfrechfa Grange site, what had been known for more than a decade as Gwent’s specialist and critical care centre project had a new name – Grange University Hospital.

Mr Gething has since revealed that the Grange nearly did not happen, that he had “serious and difficult” discussions with Welsh Government colleagues over whether investing £350 million into the project was the right thing to do.

The Grange University Hospital that opens today is the direct result of that £350 m investment - plus a few million pounds more to ensure it could be opened ahead of the winter.

It has been touted as vital to the future of healthcare in Gwent. The future however, so the saying goes, never arrives.

The reality is the here and now, for the Grange University Hospital and the hundreds of staff and patients who now inhabit it, and that - winter pressures, coronavirus and all - is very challenging.

It is a reality too that marks a shift of focus from the planning and building of the hospital to the stuff that really matters - the life-saving and life-changing treatment and care that goes on inside it.