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BMA Cymru Wales to put pay offer to doctors in pay dispute 

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DOCTORS’ union the BMA has secured pay offers for doctors working in secondary care in Wales following pay talks with the Welsh Government. 

Members of BMA Cymru Wales including Junior doctors, SAS doctors and Consultants will now vote on whether to accept the three separate offers. 

Junior doctors have been offered a 7.4% additional uplift taking the total to a 12.4% uplift for the 23/24 financial year and will be back dated to April 2023. 

A revised consultant pay scale is proposed, which provides higher career earnings, significantly better starting pay, and an additional pay rise of up to 10.1% for some consultant doctors.  

For SAS doctors, pay offers for newer contracts include increases of 6.1-9.2%, as well as an additional uplift for associate specialists, senior doctors who are on closed contracts. 

The offers, which also include non-pay elements and reform of pay scales and contract terms,* are the result of weeks of pay negotiations which began in April this year after sustained pressure from BMA Cymru Wales including 10 days of strike action by junior doctors and planned industrial action by senior doctors which were suspended last month to start the talks. 

From Wednesday 12 June to 26 June members will vote on whether to accept the offers.  

Dr Oba Babs Osibodu and Dr Peter Fahey co-chairs of the BMA’s Welsh Junior Doctors Committee said:  “We entered pay negotiations in good faith to reach a deal that will put us on the path to achieving full pay restoration to address the years of erosion to our pay We’re satisfied that this offer delivers on our ambition. This offer puts us well on the path to pay restoration. 

“We are therefore encouraging members to vote to accept this deal. It is a testament to the resolve they have shown in taking part in industrial action to achieve a better future for the profession 

Dr Stephen Kelly, chair of BMA Cymru Wales’ Consultants committee said: “We are pleased to have been able to reach an offer that we believe honours our overwhelming strike mandate and offers significant improvements in pay for consultants across their careers.

“The offer is recognition of the hard work and dedication of senior doctors and signifies a commitment to attracting and retaining doctors in Wales by offering a fairer more competitive value for their service. 

“Whilst ultimately it will be up for members to decide, we believe the offer is a big step in the right direction for the profession and so we are recommending that members accept it. We will continue to work hard to improve your pay and working conditions, and we understand this is just the first step.” 

Dr Ali Nazir, chair of BMA Cymru Wales’ SAS doctor committee said: “We are pleased to be able to bring an offer worthy of the hard work and dedication shown by SAS doctors in Wales. We know voting to take industrial action was a very difficult decision for our members but in voting to strike they were choosing to stand up for themselves and their colleagues. 

“By taking part and getting us here they have played a part in securing a better future for SAS doctors in Wales. We are encouraging members to vote to accept this offer.” 

In August last year the BMA’s committees representing all secondary care doctors in Wales voted to enter a trade dispute with the Welsh Government after being offered another below inflation pay uplift of just 5% for the 23/24 financial year.  

The RCN in wales has responded. Helen Whyley, Executive Director of Royal College of Nursing Wales said: “All NHS workers deserve a proper pay rise, but nursing staff are still waiting at the back of the queue. They feel let down and misled by this government.”

“The repeated firm position from the Welsh government that there was no money in the pot for NHS nursing staff salaries was either untrue or demonstrates that they can’t
manage their finances. Either way it shows a total disregard to principle of equity of approach to NHS negotiations.”

“Actions speak louder than words. This announcement comes only
days after the First Minister opened our annual RCN Congress on home soil in Newport, speaking of his unwavering support for nursing staff. It shows his government support is merely hot air and no real commitment. His government have failed to fulfil the promises
made to nurses in last year’s pay award and now they add insult to that injury by substantially increasing only the doctors’ pay award for 2023/24.”

“Congress saw the RCN launch its general election manifesto, with the leading priority being a substantial pay rise for all nursing staff. The nursing workforce highlighted
inadequate staffing levels, treating patients in corridors, limited or no access to continuing professional development and the increased demands of delivering patient care. All of these pressures lead to severe moral distress, leading to an increase in nursing
staff so overwhelmed with pressure from work that they even considered taking their own lives. This is unacceptable.

“All health care staff deserve to be paid fairly and be recognised for the safety critical work that they do. Our members will be deeply discouraged to hear that their
sacrifices and unrelenting efforts during the RCN Wales pay campaign in Wales has been cast aside by Welsh government.

“We will be urgently raising this with the Cabinet Secretary for Health and Social Care and the First Minister urging them to address fair pay for nursing now.”

Eluned Morgan MS, Cabinet Secretary for Health and Social Care said on Friday (Jun 6): “We have today made a formal pay award offer to each of the three BMA branches of practices – junior doctors, SAS doctors and consultants – for 2023-24, following successful negotiations over the last two months.

“We would like to thank members of the BMA’s negotiating teams and NHS Employers for the constructive nature of the talks, which have enabled us to make these formal offers, which will now be put to the BMA membership for consideration. Each of the three BMA elected representative committees are recommending members accept the offers.

“While strike action has been paused during negotiations, if these offers are accepted, it will end this dispute and industrial action, meaning doctors will return to work in Wales for the benefit of patients and NHS services.

“The negotiations have been robust and while the aim was to end the 2023-24 dispute and prevent further disruptive strike action, these offers also ensure the additional investment in doctors’ pay is balanced against commitments towards operational reforms, which seek to address productivity and efficiency and achieving future contract reform. These pay awards, if accepted, will also help to address inequalities in the senior NHS medical workforce.

“These offers are at the limit of our affordability. We have been open and transparent about our financial constraints with our social partners during negotiations.”

The Welsh Government confirmed that for Junior Doctors, the offer consists of a 12.4% pay uplift, backdated to 1 April 2023. This includes the 5% pay lift for 2023-24, which has already been paid. If agreed, this offer is outside of the Doctor and Dentists Review Body (DDRB) recommendation for 2023-24. This offer is in line with the pay award accepted by junior doctors in Scotland.

It was confirmed that all parties will commit to re-entering contract negotiations as soon as practicable once a new BMA junior doctors committee is elected this year with the ambition of reaching an agreement that, subject to approval by BMA members, would begin implementation in 2025-26. The contract negotiations will build on the contract rejected in 2022, while recognising that significant changes will be required.

The Welsh Government and the BMA Welsh consultant committee have agreed the time is right to reform the current pay structure, which is more than 20 years old. A modern pay structure will better support recruitment and retention, better reward performance, address the gender pay gap, and support progression through the career of consultants in Wales. The new pay structure will be backdated to 1 January 2024. If this offer is agreed, it will be outside the DDRB recommendation for 2023-24.

The BMA rate card will be withdrawn if the offer is accepted with immediate effect at both local and national levels in Wales.

All parties have agreed to an all-Wales job planning policy being developed and implemented during 2024-25 along with an NHS Wales recruitment template for newly-recruited consultants in Wales.

It has also been agreed that scoping work will be undertaken during 2024-25 in preparation for contract reform talks. Any reformed contract will need to be fully modernised against current and future requirements of the NHS Wales for the benefit of patients and the wellbeing of consultants.

In 2021, a new specialty doctor contract was agreed in social partnership and implemented as part of a multi-year pay deal. This offer addresses the unintended imbalances in the pay scale for doctors on the 2021 contract and the 2008 contract to ensure consistency and fairness across the specialty doctor workforce.

This investment will encourage more doctors to take up the new contracts, which offer modernised terms and conditions to ensure that doctors and patients benefit from the reformed contract and working conditions.

In 2021, a new specialist doctor contract was agreed in social partnership and implemented as part of a multi-year pay deal. This offer addresses the unintended imbalances between the specialty doctor and specialist pay scales to ensure a career progression pathway is maintained across the workforce. It will resolve the current issue that exists where the top pay point of the 2008 specialty doctor pay scale is higher than the starting salary for the specialist grade.

The Welsh Government says it has listened to the BMA Welsh SAS committee and while recognising this is a closed grade, recognises the rationale for associate specialists to receiving comparable levels of pay against the consultant pay scale, given the skills and experience of associate specialists working on consultant rotas.

A spokesperson said: “The offer includes uplifting the 2022-23 pay scales by a further 4%, making a total of 9% for 2023-24 backdated to 1 January 2024 for associate specialists.

“The BMA rate card will be withdrawn if the offer is accepted with immediate effect at both local and national levels in Wales.

“Full details of each pay offer will be communicated through BMA Wales to their members.

“We would like to take this opportunity to encourage doctors who have any questions about the offer to speak to their BMA representatives as this is a fair offer to address the pay dispute.

“We look forward to working in social partnership with all NHS and health trade unions to discuss the 2024-25 pay award.”

Health

More than 400,000 visit pharmacies for common health issues

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THE WELSH public is being encouraged to visit local pharmacies for free advice and treatment for a wide range of illnesses. New figures reveal that over 400,000 people used the Common Ailments Service in the past year alone.

Pharmacies offer convenient access to healthcare professionals, often without the need for an appointment, freeing up GP slots for those with more complex or urgent medical needs.

Common ailments service

Available in 99% of pharmacies across Wales, the service provides free, confidential advice and treatments for 28 common illnesses, such as sore throats and urinary tract infections. Since its launch in 2013, it has supported nearly 1.25 million people.

Around 220 pharmacies now offer the Pharmacist Independent Prescribing Service, allowing pharmacists to treat conditions such as ear, skin, and respiratory infections, sinusitis, and migraines.

A survey found that 95% of patients who used the service would have otherwise sought help from a GP or other healthcare provider.

Prescribing services expanding

Each year, up to 100 community pharmacists in Wales undertake prescribing training. From 2026, all newly qualified pharmacists will be registered prescribers, enhancing the range of services available at local pharmacies.

Primary care reforms

The Cabinet Secretary for Health and Social Care, Jeremy Miles, highlighted ongoing reforms to deliver more care closer to home during a statement to the Senedd.

Key statistics include:

  • GPs handle around 100,000 calls and 68,000 appointments daily.
  • Optometrists conduct over 2,000 consultations each month.
  • More than 420,000 new dental patients have been treated since April 2022.
  • District nurses see approximately 31,000 patients each month, equating to 1% of Wales’ population.

Comments from key figures

Health Secretary Jeremy Miles said:
“We know there is very high demand for GP services in Wales, with around 1.6 million people contacting their practice each month.

“For most common health concerns, your local pharmacy is the best option, providing free and easy access to treatment.

“We are working with the NHS to provide more care in the community, closer to people’s homes, and to make it easier for people to choose the right service for their health needs.”

Gwawr Davies-Jones, a pharmacist at High Street Pharmacy in Barry, added:
“Since the new pharmacy contract was implemented in 2022, our role has changed considerably. Instead of being in the dispensary, we are now in the consultation room for most of the day, offering clinical services.

“On average, we carry out more than 20 consultations daily, from providing contraception to emergency medicine supplies.

“The demand for advice on common conditions is great, giving pharmacists an opportunity to share advice and treatment, including prescribing antibiotics and other prescription-only medicines without the need to see a GP. This helps free up much-needed appointments for more complex conditions.

“We feel we offer an invaluable service to our community. The services we provide alleviate pressures on the NHS, giving pharmacists great satisfaction knowing they are making a difference.”

Supporting NHS pressures

Pharmacies in Wales offer treatment for 28 common illnesses under the Common Ailments Service. Many also provide emergency contraception, annual flu vaccinations, and regular contraception services.

The Welsh Government has significantly supported this service expansion, increasing its investment by 24% since 2016-17, with an additional £9.9 million allocated this year.

Cabinet Secretary Jeremy Miles visited High Street Pharmacy in Barry today to meet pharmacist Gwawr Davies-Jones. 

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Health

Lymphoedema patients to benefit from online mental health support

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NHS Wales’ digital wellbeing service has teamed up with a pioneering clinic to help patients manage the mental health impacts of Lymphoedema and Lipalgia Syndrome.

The Lymphoedema Wales Clinical Network (LWCN) established a psychological support service – the only one of its kind in the UK – after patients spoke of the emotional challenges of living with these conditions.

Patients revealed how their physical symptoms were often accompanied by depression, anxiety and worries about appearance.

Support offered by the service’s two psychologists is now being complemented by direct referrals to SilverCloud® Wales, a suite of online, self-help courses based on Cognitive Behavioural Therapy (CBT).

Dr Jayne Williams, National Lymphoedema Consultant Psychologist for LWCN said: “This is an exciting time for us.

“We’re looking at different ways for people to access psychological therapies – SilverCloud being one of them. The aim is to provide timely, preventative support before people get to crisis point.

“As SilverCloud is online, it has the capacity to reach many more people than we could see face-to-face, and its flexibility means that it fits around busy work and family lives.

“Being able to offer something that patients can do in their own way, at their own pace is brilliant.”

NHS Wales online CBT project manager Fionnuala Clayton said the new referral pathway was inspired in part by feedback from a ‘Living Well with Lymphoedema’ event hosted by LWCN, where patients were asked what they would like from its emerging psychology service.

“Patients wanted to feel as though they were not alone and that they still had a healthy and happy life despite their condition,” said Fionnuala. “They wanted easy access to support for building resilience alongside help to help themselves.

“Coming away from the event, we knew a referral pathway would support many patients across Wales.”

Lipalgia Syndrome – also known as Lipoedema – is an abnormal build-up of adipose fatty tissue, usually in the lower half of the body, which more commonly affects women.

Lymphoedema is another incurable, long-term condition which develops due to a damaged or poorly-functioning lymphatic system. Damage can occur as a result of many factors including obesity, surgery, cancer treatment, infection or injury.

People who are sedentary are particularly vulnerable as the lymphatic system relies on movement to remain healthy and move the lymph fluid around the body. Symptoms include swollen and painful heavy limbs and a higher risk of skin infections and wounds.

Said Dr Williams: “These are conditions that people have to learn to live alongside forever, which can be incredibly difficult.

“They have to cope with swelling and pain, they may have to wear compression bandages or garments, carry out daily skin care routines and do lots of movement.

“We see lots of people with very low mood. There’s also a lot of anxiety around body image and intimacy.

“Feeling people are judging you, and perhaps not being able to find clothes or shoes that fit you, means your whole identity and your social confidence can be affected. You can feel more isolated and withdrawn.”

Around 25,000 people across Wales use LWCN services.

Local health board lymphoedema services can refer people to the psychology service within the National Lymphoedema Team, which is hosted by Swansea Bay University Health Board.

Dr Williams said several patients had been referred to SilverCloud’s Space for Positive Body Image programme after attending a body image workshop.

Other courses on offer include support for anxiety, depression and stress.

Anyone in Wales aged 16 or over can self-refer to SilverCloud, without seeing a GP and from the comfort of their own home.

Fionnuala Clayton added: “We’re delighted to onboard the Lymphoedema Wales Clinical Network. This has been a collaborative effort between services, working together to identify how best support patients living with Lipalgia Syndrome and Lymphoedema.”

For further information and support on Lymphoedema and Lipalgia Syndrome, visit https://lwcn.nhs.wales/

To self-refer to SilverCloud Wales, visit https://nhswales.silvercloudhealth.com/signup/

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Health

Tufnell talks tough on health care following ‘in-depth survey’

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TOP Hywel Dda health board officials are turning a blind eye to its escalating health care failings despite pocketing six-figure salaries.

So says Mid and South Pembrokeshire MP Henry Tufnell who is calling for an urgent meeting with Hywel Dda’s chief executive, Phil Kloer.

“The Hywel Dda Health Board needs to recognise that there’s a problem with health care outcomes and care delivery, but what is it going to take for them to recognise that?” Henry Tufnell commented this week.

His comments followed an in-depth survey of 1,000 people living in Pembrokeshire which confirmed that a staggering 62% have to wait more than a week for a GP appointment.  43% have cited a lack of available appointments as their biggest challenge, while no fewer than 87% claim healthcare services have worsened in recent years.

“But it’s the real stories that show the scale of the crisis,” continued Henry Tufnell.

“I know of a cancer diagnosis that has been delayed by over a year, while ambulance waiting times can be more than 13 hours, even for urgent cases.  Critical care needs are going unmet and this is forcing patients to seek private treatment.”

Tufnell has now submitted a Freedom of Information (FOI) request to Hywel Dda University Health Board demanding greater transparency on waiting times, service provision and a plan strategy to fix the crisis.

“Despite all the latest evidence, in addition to everything we gathered during the election campaign, there’s still no acceptance by the Board that there’s a problem,” he said.

“But it’s their responsibility to deliver health care within this county, and they’re failing.  The management is failing us here in Pembrokeshire and there’s a complete lack of transparency and accountability.  All these people sitting in management roles are being paid huge amounts of money, some bringing in six figure salaries.  But they’re failing.”

Mr Tufnell has now requested an urgent meeting with Hywel Dda chief executive Phil Kloer which is expected to take place on February 14.

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