'Mistrust' over health care plans in mid Wales, says report
There is a "near-dysfunctional level of mistrust and misunderstanding" among people in mid Wales about plans for health care services, a report says.
It recommends that Bronglais General Hospital, Aberystwyth, is at the heart of future health care services, highlighting "enormous" public concern services are under "imminent threat".
And it calls for three health boards to unite to improve care in mid Wales.
The Welsh government commissioned the report and said action would be taken.
The study by the Welsh Institute of Health and Social Care (WIHSC) at the University of South Wales. spent nine months listening to the views of patients, the public and local NHS staff across mid Wales and reviewing the plans of Hywel Dda University Health Board.
Report co-author Prof Marcus Longley said: "People in mid Wales want a health service that delivers high quality, safe and accessible services that are sustainable.
'Dogged by uncertainty'
"I am pleased to be able to say that, in the main, care in mid Wales is still in good health and that patients are not getting second class treatment.
"We believe that Bronglais General Hospital is at the heart of these services, but a more co-ordinated approach between the three health boards covering mid Wales is needed to establish its future strategic role.
"The future of this hospital has been dogged by uncertainty for too many years, and this now needs to be resolved."
Analysis by BBC Wales health correspondent Owain Clarke
Bronglais hospital is unique. It is the only hospital in mid Wales, located 50 miles from its nearest neighbour.
For years there have been debates about its future, specifically whether a hospital serving a small rural population could sustain its specialist services.
The study found distrust among the public and clinical staff who felt health managers had been prioritising care to the north and south.
But this study says the hospital does have a future and specialist services such as cardiology or emergency surgery could be sustained if health boards, professional medical bodies and the public worked together.
It also calls on GP surgeries to cooperate more, and for technology such as video links to be more widely used, to allow more patients to be treated closer to home.
The report calls on the health boards of Hywel Dda, Powys and Betsi Cadwaladr, which covers north Wales, to form a partnership to serve mid Wales.
Hywel Dda chair Bernardine Rees said: "We welcome today's study that confirms the importance of Bronglais Hospital in providing safe, sustainable and high quality health care services to the population of Ceredigion and bordering counties.
A Welsh government spokesperson said: "We will begin work immediately on the options available to make sure all organisations involved in health care in mid Wales improve the way they work together.