Dear Editor, - I welcome the opportunity of responding to the letter you have received from consultant staff at Withybush Hospital.

I can confirm that wards 11, 12 and 14 are all fully open and that ward two has closed (with gynaecological services reprovided on ward four), which will allow for the important development of a much larger and better equipped endoscopy unit.

To offset the net reduction of 23 beds on ward two (compared with the 2002 bed numbers), we currently have two new high dependency unit beds shortly to be increased to four beds.

We anticipate that this will reduce the number of patients cancelled due to previous limited critical care capacity at the hospital. In addition, we are using between six and eight beds in the day surgery unit as additional beds during the week for patients requiring overnight stay only.

Combined with the increasing numbers of patients being treated as day cases, these developments are pivotal to modernising how we deliver hospital health care.

I also recognise with consultant colleagues that there is a need to reduce the number of patients no longer requiring health care intervention, but remaining on wards inappropriately (occupying an average of 12 hospital beds at any given time).

This, together with improved discharge planning and increased acute care at home and community hospital provision, will provide a key element in reducing the high levels of bed occupancy currently being experienced.

It is also worth noting that a small reduction in our average length of stay would achieve the 85% bed occupancy level we all aspire to.

In the event that bed capacity has to be increased, a number of short-term options are available to us and in the medium term, the proposed new A&E development will incorporate ten observation beds.

Led by our medical director, we are encouraging our consultant colleagues to participate in the development of the long-term service development plan for the hospital.

If a permanent increase in bed capacity were needed, this would also be incorporated into these developments.

FRANK O'SULLIVAN Chief executive Withybush Hospital, Haverfordwest.