Operations have been cancelled for the third day at Aberystwyth's Bronglais and Carmarthen's Glangwili and two other hospitals in mid and west Wales.

A Hywel Dda University Health Board (UHB) spokesperson confirmed planned inpatient operations scheduled for today (Wednesday, January 8) have been cancelled, saying the situation "remains challenging".

Emergency surgery, day case procedures and outpatient appointments are continuing as normal.

Bronglais and Glangwili are two of four hospitals affected by the cancellations, alongside Llanelli’s Prince Philip and Haverfordwest's Withybush.

The spokesperson said: "These actions are in line with our escalation procedures to help manage patient flow and maintain patient safety during periods of peak pressure.

"We have contacted patients affected directly so please attend as planned if you do not hear from us. Otherwise, please do not contact our appointments or outpatient teams unless absolutely necessary as they are very busy at this time.

"Whilst the situation remains challenging, we are currently assessing our operating plans for the days ahead and, as per normal planning arrangements, these will be reviewed on a daily basis.

"We will issue an updated statement when a large proportion of planned operations resume.

"We apologise for any inconvenience this may cause patients who have had their operations postponed or who have had to wait longer than normal for their procedure."

Speaking to BBC radio this morning, Sion James, deputy medical director at Hywel Dda UHB, apologised to patients who have been affected by the cancellations.

Mr James said: "It looks likely there will be more postponements. We are still holding outpatient appointments. We are still doing emergency procedures and some on the day but more procedures will be postponed after today.

"We'd like to take this opportunity to apologise to patients that have been affected. This was the only option left for us. Patient safety is the most important thing for us.

"There's been a number of challenges across the health board. We've had the norovirus breakout, the flu breakout and it means there's more people in our hospitals. Our hospitals are full."

Patient watchdog Hywel Dda Community Health Council (CHC) responded to the cancellations, saying they were concerned and disappointed that this step has been taken.

Mansell Bennett, Chair the CHC, said: “This will be bad news for many and possibly distressing news for some. Patients and their families will have been waiting months for their operations and now their lives go on hold.

"We know patient safety is vital and we know that the NHS and its staff are doing their best in the face of extreme pressures this winter, but the Health Board must to do all it can to ease this situation”.

Mr Bennett added: “We’ll be speaking with the Health Board to understand exactly how this problem has developed but in the short term, we expect patients who have been affected to be communicated with effectively and sensitively.

"In the longer term we must have a system which is well staffed and splits urgent and planned care so that one cannot impact the other, because as we’ve seen, those impacts hit patients hard”.

A statement by the health board earlier this week asked the public not to contact the appointments or outpatients team unless absolutely necessary and said there may be long waits for GP appointments, and at A&E or MIU.

The public has been urged to use other services, like community pharmacies, where possible.

The health board has also asked people not to attend an emergency department or GP practice if they have symptoms of infectious illness such as diarrhoea, vomiting, fever or symptoms of flu.

“Flu and norovirus are circulating and for the majority of people, these can be treated safely at home,” a health board spokesman said.

However, the vulnerable - very young, frail elderly, living with long term or chronic conditions – or those with worsening symptoms should seek medical advice.