I was interested to see the article on Kent and Canterbury Hospital (News, page 7, 26 February). Across the UK there are many proposals for reconfiguring acute services, and local communities are understandably concerned about the potential loss of their district general hospital. There are, however, successful and proven ways of making progress.

In 1995, Neath General Hospital moved from being a DGH to a local general hospital. This caused much anguish and concern to the local communities. After two years, we can demonstrate the success of a new model which continues to provide emergency medical care alongside elective surgical services with low-risk obstetric services, a paediatric ambulatory centre and a comprehensive range of outpatient and day-case provision. We have developed many new open-access and one-stop services, and clinical staff are using their skills in innovative ways.

We were told at the time such a model was not possible, but we have demonstrated not only that it can work but that it does so without detriment to patient care.

It is now supported by representatives of all specialties, both at Neath General and the adjacent larger hospitals in Swansea and Bridgend.

The secrets of success are a core of committed clinical staff, strong support from the trust board, local GPs and the health authority, and the ability to link with three other trusts locally which are prepared to support the new pattern of services.

We no longer provide comprehensive DGH services, and for some emergency surgical and trauma services patients do have to travel further. But we do provide all services that can safely and economically be provided locally.

There is an alternative between the DGH and a cottage/community hospital, but we have discovered that it is only when you finally let go of the past that you can concentrate on the planning and delivery of new patterns of care appropriate for the millennium.

Andrew Bellamy,

Chief executive,

Glan-y-Mor trust,

Swansea.