CARE HOME providers urged the Welsh Government to follow through on a key commitment to ensure care workers are paid the real living wage.

Giving evidence in the Senedd, Care Forum Wales, which represents more than 450 care homes, warned funding did not reach all parts of the sector in 2024/25.

The non-profit organisation said funding for the real living wage (RLW) was not ringfenced, so some councils chose to spend the money on libraries and teachers’ salaries instead.

Care Forum Wales raised concerns about “nobody taking responsibility”, with the Welsh Government claiming to have provided the money and councils saying it was insufficient.

Labour’s manifesto for the 2021 election contained a pledge to “ensure care workers are paid the real living wage during the next Senedd term”.

But Sanjiv Joshi, Care Forum Wales’ treasurer, warned the Welsh Government’s push for care workers to receive the real living wage has become an aspiration rather than a reality.

He told the local government committee: “The first year when it was announced … providers had to give an undertaking to commissioners that we were paying the real living wage.

“Since then, that’s now become aspirational as commissioners have not had the funds – or so we are told – to follow through and maintain those real living wages.”

Giving evidence on April 3, Melanie Minty, policy adviser at Care Forum Wales, said: “The real living wage, as Sanjiv said, isn’t reaching the sector necessarily.”

But, describing the RLW as a drop in the ocean, she warned care homes cannot compete with councils and the NHS which pay a higher rate than used in costing commissioned care.

Under the Welsh Government’s 2025/26 budget, funding for the real living wage is allocated to councils within the revenue support grant, meaning it can be spent on other areas.

Ms Minty also voiced concerns about an increasing number of councils receiving grants to build care homes that “will never recover their costs”.

She pointed to the example of Carmarthenshire Council building a £19.5m residential home despite free capacity in the county’s independent sector.

Cautioning that commissioning too often focuses on cost over outcomes, she said: “I’ve heard of commissioners going into homes and saying ‘you’re spending too much on food’.

“Things like holidays have been drastically cut back for younger people.”

Mr Joshi, who runs the Caron group of care homes in mid and south Wales – which includes Valley View Care Home in Hengoed – warned of a £9,000-a-year difference in nursing fees between neighbouring councils.

He said: “We’re talking about Cardiff and RCT … imagine the pressure that puts on and it’s not driven by the needs, the needs would not be that different.”

Pressed about the minimum level of profits required to make services feasible, Mr Joshi replied that he targets an 11% return which is unachievable in parts of Wales.

Warning of an “irrational” policy direction, he said: “We have the private sector delivering incredible value for money [yet] being eroded by underfunding. Then we have the public sector spending four or five times that amount, it doesn’t make sense.”

Mr Joshi told the committee families are increasingly having to make up a difference in costs that should be provided by councils and health boards.

Warning charity providers are exiting the market, Ms Minty said: “Most of our third-sector members have sold their care homes because they are not viable.”

Ms Minty called for a fee methodology that can be applied consistently across Wales, with some councils far more transparent and understanding of the costs than others.

“Cardiff, while giving a really good increase this year, has been very honest in admitting they know it’s not going to meet all the changes,” she said. “Whereas other local authorities … have been known to make an offer and say this will cover all sorts of things.”

She said the sector has stabilised since the pandemic and Brexit but increasing employer national insurance contributions have added to the pressure.

She told the committee: “I think we’ll see an unintended consequence will be that employers are forced to suppress pay increases … and some will be forced to make redundancies.”

A NEW deal between the NHS and the public is at the centre of a plan to drive down the longest waiting times for healthcare in Wales.

Health Secretary Jeremy Miles is expected to unveil a strategy this week aimed at reducing the overall waiting list by 200,000 patients by March 2026. The plan also sets targets to eliminate two-year waits for planned treatments and restore a maximum eight-week wait for diagnostic tests.

A key part of the announcement is the introduction of a new “patient deal”, which aims to improve transparency, reduce missed appointments and ensure better preparation for surgery. This deal will be incorporated into updated referral-to-treatment guidelines due later this month.

What the new deal includes:

• Faster access to planned care with patients told how long they can expect to wait once added to the list.
• Waiting time tracking through the NHS Wales App, with updates available from June.
• Only fit and well patients will be added to surgical waiting lists, in line with evidence showing they recover more quickly and have better outcomes.
• Support to get surgery-ready, with help to improve health before treatment.
• Appointment changes, where patients will be offered two dates. If they miss both without good reason, they will be removed from the waiting list.
• Alternatives and risks explained, so patients are fully informed before deciding on surgery.

Each year, around 700,000 outpatient appointments in Wales are either missed by patients or cancelled. Health boards will now be under stricter obligations to reduce these disruptions, and to minimise the number of cancellations made by the NHS itself.

Mr Miles said: “The NHS will do all it can to prioritise faster access to treatment. In return, we are asking the public to prioritise and keep their appointments so that, together, we make the best possible use of scarce NHS resources.

“We cannot continue losing one in seven appointments due to no-shows or other avoidable reasons. These missed slots delay care for everyone and waste vital resources.

“Evidence shows people in better health recover more quickly and require shorter hospital stays. By preparing patients properly and ensuring they understand all treatment options, we can deliver better outcomes and greater efficiency.”

The Welsh Government hopes the new plan will bring waiting lists closer to pre-pandemic levels. As well as reducing overall waiting list size by 200,000 by March 2026, the government has pledged to ensure no one waits more than two years for planned treatment and to restore the eight-week target for diagnostic testing.

Health boards will be expected to continue transforming how they deliver planned care over the next 12 months. This includes adopting more regional working models and implementing recommendations from the Ministerial Advisory Group on NHS Performance and Productivity, due to report later this month.

HYWEL DDA University Health Board has today announced the appointment of Sharon Daniel as its new Executive Director of Nursing, Quality and Patient Care.

Sharon has held the role of Director of Nursing, Quality and Patient Experience at the health board on an interim basis since January 2024, pending the appointment of a substantive Chief Executive Officer.

A well-known and well-respected leader within the organisation, Sharon brings a wealth of experience to the role, having dedicated her entire professional career to healthcare in the Hywel Dda region. Her journey spans clinical, academic and managerial roles — from her early days as an adult nurse to positions in site management, lecturing, infection prevention and control, clinical governance, and general management.

Since 2015, Sharon has served as Assistant Director of Nursing, working across areas including infection prevention and control, professional standards and regulation. She stepped into the role of Deputy Director of Nursing in May 2023 and was appointed interim Director of Nursing in early 2024. Her appointment to the permanent position recognises her leadership and deep commitment to the local population and workforce.

Professor Phil Kloer, Hywel Dda University Health Board Chief Executive, commented:

“Sharon has demonstrated outstanding commitment and leadership throughout her career with Hywel Dda. Her passion for nursing, deep knowledge of our services, and genuine connection to the people we serve make her an exceptional choice for this role. I am delighted to announce her appointment, following a competitive and open process, and look forward to continuing to work alongside her as we drive forward our ambitions for high-quality, compassionate care.”

Speaking on her appointment, Sharon said: “Hywel Dda is home to me. My family and I are part of the population, and I have worked within healthcare here since I finished my formal training.

“I’m incredibly proud to lead such a dedicated and passionate nursing workforce and I’m excited to work with colleagues to celebrate our achievements and build on them as we look to the future. Together, we’ll explore opportunities for interprofessional team working to help deliver our clinical strategy and the very best care for our communities.”

Sharon’s appointment marks a significant step forward in the Health Board’s ongoing commitment to strengthening professional leadership and improving outcomes for patients and communities across Carmarthenshire, Ceredigion, Pembrokeshire.

Swyddfa’r Cyfryngau | Media Office
Cyfathrebu | Communications 
Bwrdd Iechyd Prifysgol Hywel Dda | Hywel Dda University Health Board
mediaoffice.hyweldda@wales.nhs.uk