An "honest conversation" about the future of health services in Powys will be needed in the wake of the coronavirus pandemic, a health chief has said.

But Carol Shillabeer, chief executive of Powys Teaching Health Board, speaking ahead of the first anniversary of the Covid lockdown on March 23 also said there was reason to feel "hopeful" about the year ahead.

In her letter, she warned that there will be new challenges emerging even if the pandemic continues to recede.

She said: "We have lived with a year of grief, loss and sacrifice. We have however also lived through a year of astonishing resolve, community spirit and friendship.

"The way in which people and organisations have responded to the pandemic in Powys has been frankly amazing. Health and emergency services, the military, the county council, voluntary and community organisations, local businesses, town and community councils, politicians, local media and most importantly the people of Powys have all played a vital role in the last year.

"The Testing and Tracing Service was established from scratch and here in Powys is one of the best in the UK. This is followed by the tremendous work establishing the biggest vaccination programme the country has ever seen. Thank you to everyone involved in both services."

She added: "Looking to the year ahead, as hopefully the pandemic recedes, there will be challenges. We also know that waiting lists for appointments and treatments have continued to rise and there will need to be an honest conversation across the county about how health services can support people differently.

"We will need to do this at a time when many people working in the NHS are understandably tired after a year responding to Covid.

"Despite all the challenges, I think we should feel hopeful about the year ahead. The vaccine is reducing serious illness and death from Covid-19 and with over 63,000 people already having received their first dose in Powys, we are on schedule to offer the vaccine to everyone over the age of 50 before the middle of April."

Ms Shillabeer also recalled the difficulties of a year in which more than 4,000 people in Powys have tested positive for coronavirus.

"It is now a year since our first confirmed cases here in Powys, since the sad reports of the first death of someone with Covid-19 was confirmed in Wales, and since the country entered the first lockdown," she said.

"When we first heard the reports of a new virus I am sure none of us imagined the impact this would have on our lives, and the impact quickly became apparent as we saw the virus spread across the world.

"Looking back on the last twelve months our focus here in the NHS, and in our joint working with all partners, has been to reduce the harm of the pandemic in terms of the virus itself but also the indirect effects of strained health services, and the impact of lockdown on people and business.

"Another reason for feeling optimistic is the spirit of the people of Powys; your friendship and support for each other and for your local health service has been tremendous. This will, I know, create excellent foundations for the time ahead.

"Thank you for everything you continue to do to Keep Powys Safe."