End of Session Report - BMA Wales - 09 11 - FINAL - WEB

Cymru Wales
End of Session
Report to
BMA Members
in Wales
2014-15
British Medical Association

bma.org.uk
British Medical Association Title of document – Supporting title of document
1
Contents
Message from the Chair of BMA Welsh Council 6
Representing doctors at an all-Wales level: 7

Report from BMA Welsh Council 8
Representing doctors from the branches of medical practice: 13

Report from the General Practitioners Committee Wales 14
Report from the Welsh Consultants Committee 18
Report from the Welsh Committee for Public Health Medicine 20
Report from the Welsh Staff, Associate Specialists & Specialty Doctors Committee 22
Report from the Welsh Junior Doctors Committee 26
Report from the Welsh Medical Students Committee 30
Representing doctors locally: 33

BMA Divisions across Wales 34
Case Study: Clwyd North 35
Local Negotiating Committees 37
The Welsh Local Negotaiting Committee Forum 38
Local Medical Committees 40
Representing and protecting terms and conditions and providing

employment advice. 43
Representing the medical profession in the media, policy making

and political influencing. 47
2 British Medical Association End of Session Report to BMA Members in Wales 2014-15
About BMA We are the trade union and professional association

Cymru Wales for doctors and medical students in Wales.
We promote the medical and allied sciences, seek

to maintain the honour and interests of the medical
profession and promote the achievement of high
quality healthcare.
We have a long relationship with the National Health

Service; from its inception, we have championed its
vision of healthcare delivered on the basis of clinical
need, free at the point of use.
Ever since devolution in 1999, with your help, we

have been at the forefront of shaping healthcare
policy and services in Wales for the benefit of
patients and their relatives – and have worked to
secure the most advantageous working conditions
and workplace environments for all doctors working
in Wales.
Our office is located in the heart of Cardiff Bay,

a stone’s throw from the National Assembly for
Wales and the Senedd building. From here we
represent over 7,000 members across Wales and
promote both their and their patients’ interests.
3
‘We look after

doctors so
they can look
after you.’
Our representative structures Wales

Doctors and medical students are represented through our six branch of practice
committees, as well as Welsh Council.
In addition every member in Wales belongs to one of eight divisions, which represent
members in all disciplines geographically.
We have established a network of nine local negotiating committees (LNCs) in each

Health Board and NHS Trust throughout Wales. These committees make sure that the voice
of the profession is heard by management in the workplace – and your representatives
ensure that the interests of doctors are protected in negotiations on terms and conditions
of service through these LNCs.
Representatives of all LNCs in Wales meet three times a year as the Welsh LNC Forum to
discuss all Wales issues and to share best practice.
There are also five local medical committees (LMCs) across Wales, which represent
GPs in particular areas. These are independent statutory bodies with which health boards
(as holders of the GMS contract) must consult. Although not BMA committees, LMCs do
contribute to wider BMA Cymru Wales activities.
5
What we stand for

Our vision is a profession of valued doctors delivering the highest quality health
service where:
–– A ll doctors have strong representation and expert guidance, whenever and wherever
they need it
–– All doctors have their individual needs responded to, through career-long support and
professional development
–– All doctors are championed by the BMA and their voices are sought, heard and acted upon
–– All doctors can connect with each other as a professional community
–– All doctors can influence the advancement of health and the profession
Message from the Chair of BMA Welsh Council:

Dr Phil Banfield
On behalf of BMA Cymru Wales, I am delighted to present our report for the 2014-15 session.
This report highlights our activities and achievements in representing you over the past year,
I hope that you find it informative and relevant to you.
Importantly, this report also outlines how you can get involved in BMA Cymru Wales activity
– in your area and/or nationally – and how you can shape our work going forward over the
coming session, for the benefit of both the profession and patients.
For me, in the third year of my chairmanship of Welsh Council, it has been both a demanding
and rewarding twelve months. I have enjoyed every minute of working with colleagues on
Council and other BMA Committees to represent the profession collectively across Wales
and across specialities.
To say it has been a busy twelve months is somewhat of an understatement – the things that
stand out for me are the way that Welsh Council has adopted a truly collaborative approach
Dr Phil Banfield to furthering the professional agenda in Wales across all branches of practice and with
Chair BMA Welsh Council outside agencies, including Welsh Government.
I am particularly proud that our negotiators were able to sign off the new disciplinary
policy in Wales which means that each employed doctor will be treated in exactly the same
way, irrespective of where they work. This shows real commitment to delivering practical
improvements in the working lives of doctors in Wales.
A major challenge we laid down to Welsh Government and the NHS in Wales this session
was to deliver greater openness and transparency across the health service in Wales,
underpinned by a set of values that will narrow the ‘ward-to-board’ gap, so that staff
and patients feel able to speak up and suggest ideas within a supportive and responsive
environment. We have put forward a number of recommendations, some of which are being
taken forward, but I am very much aware that rhetoric and warm-words can outstrip reality
so this continues to be a key area of work for us.
In the course of the next twelve months we will work with our members, patients, partner
organisations and with policy makers from all political parties to ensure that our priorities
are sufficiently addressed by the next Welsh Government, following the 2016 elections in
Wales. As a professional association, BMA Cymru Wales has much to offer in fostering the
co-operation needed to place our National Health Service in Wales on a positive and more
sustainable footing.
Thank you for your continued support – and remember, our experience shows that medical
staff acting together in the best tradition of trade unionism remain a powerful and influential
force through which much can be achieved. Make sure you are part of it.
Dr Phil Banfield
Chair BMA Welsh Council
7
Representing
doctors at an
all-Wales level
BMA Welsh Council
Report from BMA Welsh Council

Welsh Council represents the profession as a whole, its job is to lead and to stand up for the
values and beliefs of the medical profession across Wales – it usually meets four times a year.
Welsh Council is the ‘professional’ front of BMA Cymru Wales, with most trade union
activities carried out by individual branch of practice committees. Since devolution, Welsh
Council has evolved to be a key professional voice, engaging actively with other stakeholders
and regularly with Government and health boards in the transformation of NHS Wales
Welsh Council’s strength and expertise is derived from the diversity of its membership,
which includes: junior doctors; hospital consultants; medical students; retired doctors;
medical academics; SAS doctors; public health doctors, general practitioners and other
doctors working in a variety of health care settings across Wales.
More than 50% of Welsh Council’s membership is elected every three years.
Our current membership for this session is:
Dr Phil Banfield (Chair) Dr David Bailey (Vice Chair)
Dr Manish Adke Dr Simon Poulter

Dr Robert Bleehen Dr Iain Robbé
Dr R Martyn Bracewell Dr David Saunders
Dr Jayan ‘G’ George Dr Michael Thomas
Mr Umar-Khetaab Hanif Dr Phil White
Dr Peter Horvath-Howard Dr Anthony Calland (observer)
Dr Sara Hunt Dr Mark Temple (observer)
Dr Charlotte Jones Dr Anthony Power
Dr Melanie Jones Dr Bethan Roberts
Dr Ram Kumar
Dr Stephen Monaghan
Mr Rajnesh Nirula
Dr Trevor Pickersgill
9
Here is a flavour of what Welsh Council has been

doing on your behalf over the last year:
Raising Concerns in the Workplace
Welsh Council’s report ‘Creating a Healthier NHS for Wales’ was launched on Wednesday
17 September 2014. It focuses on promoting openness, transparency and raising concerns
in NHS Wales – it is the culmination of two years of research, debate and reflection.
It was clear from Welsh Council’s policy day in 2013 that the themes from the Francis Report
carried huge resonance with front-line clinical staff working in the NHS in Wales. This was
further confirmed by the many publications since then (especially the 2014 Evans and
Andrews reviews), as well as the high-profile reports of the persistent failures of NHS systems
to respond to feedback or to the concerns of staff, patients and relatives.
This situation, combined with reports from individual members, led to the production of
‘Creating a Healthier NHS for Wales’ – this report considers how best to support individuals
who wish to raise concerns in the NHS in Wales and makes recommendations for change.
The publication of this work received extensive media coverage:
WORKING FOR DOCTORS | WORKING FOR HEALTH | WORKING FOR WALES
CREATING A
HEALTHIER NHS
FOR WALES
Openness, transparency
and raising concerns
A prescription from Welsh Council
CYMRU
BMA Cymru Wales – Supporting Doctors to Raise Concerns WALES
It also led to the establishment of a programme of bi-monthly meetings with Professor Mark
Drakeford, Minister for Health and Social Services, on how to improve NHS Wales in these
areas, and separately with the NHS Wales Chief Executive. A dedicated piece of work is also
now underway to define the core values of NHS Wales, and members of Welsh Council are
involved in taking that forward.
In April 2015, as part of this work, Welsh Council conducted a Wales-wide survey of doctors
working in secondary care to capture their experience of raising concerns in the workplace.
The responses, from over 500 doctors, reaffirmed our concerns about the negative and
unsupportive culture in which doctors are working.
Key results from the survey include:

–– 60% said they had experienced bullying or harassment as a direct result of having
raised a concern.
–– 58% said they had raised a concern about patient safety in the last three months,
but 40% said that as far as they were aware nothing had been done about it.
–– 33% said that unfilled staff vacancies had caused the patient safety incident,
26% said a higher than usual workload and 52% said systematic causes
(eg a drive to meet targets or inadequate facilities).
You can read the full results on our website.
We are currently using the results of the survey to continue to press for positive cultural
change across NHS Wales with Welsh Government, senior officials and with Assembly
members from all political parties – and are embarking on cross branch of practice work to
establish ways of eliminating bullying in the workplace in NHS Wales. Please contact us to
find out more about our work in this area and how you might like to contribute to it.
Scrutinising the Legislative Process

Welsh Council has established a subcommittee to consider all primary legislation introduced
in Wales or legislative proposals originating in Westminster which have a health or health
service component. Its role is to quantify the impact thereof upon doctors and patients in
Wales and determine if a BMA Cymru Wales response is required.
The sub-committee’s busy work plan reflects both the growing number of legislative
proposals being introduced as devolution evolves and the determination of BMA Cymru
Wales to positively influence those proposals by providing expert and authoritative
professional input.
The sub-committee has been advancing one of the BMA’s long held policies over this
session; the case for Health Impact Assessments (HIAs) to be established on a statutory
footing – we will be undertaking dedicated lobbying to argue for HIAs to be included in the
Public Health (Wales) Bill.
Other examples of legislative proposals considered by the sub-committee include the

Planning (Wales) Bill, the Wellbeing of Future Generations (Wales) Bill and the Safe Nurse
Staffing Levels (Wales) Bill.
Occupational Health
Welsh Council has developed a policy that calls for an occupational health service to be
established for all doctors in primary and secondary care in Wales.
The policy would require all employing organisations in Wales to offer a high quality,
comprehensive occupational health service to all workers. Welsh Council believes that the
service should offer access to accredited specialists in occupational medicine, either directly
or through an approved clinical network.
The policy was launched alongside the Chartered Society of Physiotherapy and the Royal
College of Nursing and has since gained widespread support. It has also been raised with the
Minister for Health and Social Services and the Chief Medical Officer for Wales.
A commitment has now been given by Welsh Government to introduce an occupational

health service for general practitioners. We continue to lobby, with other stakeholders, for
Welsh Government to extend this policy for all professionals working in the NHS in Wales.
11
Welsh Council Policy Priorities
In 2014, the newly-elected Welsh Council

identified three high-level strategic policy
topics that they felt should be the priority
work areas for the life of the current Council.
The three strategic areas, which are supported
by members from all branches of practice, are:
–– Promoting Professionalism;
–– Recruitment, Retention and Training;
–– Promoting Equality.
Welsh Council is undertaking a range of

activities to support the objectives of each
strategic area.
Please contact Welsh Council secretariat,

Sarah Ellmes, to find out more or to
get involved:
T: 029 2047 4604

E: sellmes@bma.org.uk
W: bma.org.uk/welshcouncil
13 British Medical Association Title of document – Supporting title of document
Representing
doctors from
the branches of
medical practice
BMA Cymru Wales has six Branch of
Practice Committees.
Each committee represents and acts for doctors in

that particular branch of medical practice, whether
they are BMA members or not.
Report from General Practitioners Committee Wales

The General Practitioners Committee Wales (GPCW) represents all General Practitioners
in Wales. It has the autonomy to deal with and negotiate on all devolved matters affecting
General Practitioners and their working lives in Wales – as well as matters relating to the
provision of wider primary care services and policy.
The work of GPCW includes undertaking complex negotiations with the Welsh Government
on elements of the General Medical Services contract; supporting Local Medical Committees
and GP practices on matters relating to the national GP contract; and acting on policy
from the Welsh Conference of Representatives of Local Medical Committees which is
held annually.
GPC Wales is made up of 15 representatives from the five Local Medical Committees in
Wales, and normally meet four times a year.
Our current membership for 2015-16 is
Dr Charlotte Jones (Chair) Dr David Bailey (Deputy Chair)
Dr Phil White (Negotiator) Dr Laurence Williams

Dr Charles Allanby (Negotiator) Dr Neil Statham
Dr Peter Horvath-Howard (Negotiator) Dr Susan Fairweather
Dr Om Aggarwal Dr Stephen Bassett
Dr Heather Evans Dr Ashok Rayani
Dr Jerome Donagh Dr Debbie Waters
Dr Jonathan Jones Dr Bethan Roberts
Dr Jay Nankani Dr Tony Calland (Co-opted Member)
Dr Has Shah Prof. Malcolm Lewis (Co-opted Member)
Dr Nimish Shah Dr Jane Fenton-May (Observer)
Dr Kay Saunders
Dr Eamonn Jessup
15
GPCW Highlights from the 2014 – 2015 session:

In 2014 GPCW published its strategy document ‘a prescription for a healthy future’.
Each of its eight chapters deals with a key issue – such as workforce, access, premises,
IT, and finance. It discusses the options for placing those areas on a sustainable footing
and makes recommendations for change to ensure that high quality general practice is
maintained. The strategy document can be found on our website bma.org.uk/gpcwales.
GPCW has agreed a new two year contract for Wales to provide practices with added
stability in terms of knowing what their GMS financial income will be for the next two years.
A number of changes and commitments have been agreed which underpin the reform
agenda set out in the Welsh Government’s plan for primary care services in Wales. This
includes, removing unnecessary bureaucracy and placing greater reliance and trust on
the professionalism of GPs to use their clinical judgement and allow them to spend more
time delivering direct patient care. GPCW held a series of contract roadshows across Wales
earlier this year, and we have now placed a detailed overview of the 2015-2016 GP contract
changes, including FAQ guides to the QOF and MPIG changes, on our website.
Recruitment and retention remains a key pressure facing General Practice, with a
significant number of doctors in difficult to recruit areas approaching retirement age and
many GPs reducing their commitment or leaving the profession early. This, coupled with
a less than complete fill of the GP Specialty Training Scheme, means that the problem is
only going to worsen. GPCW describes this as a ‘perfect storm’ and estimates that around
200 more GPs are needed to be trained in Wales alone to meet the needs of Welsh patients in
the future. Our strategy document highlights the full range of concerns for our workforce as
well as identifying solutions to attract and retain doctors to general practice in Wales. We will
continue to take these forward over the next session in the various forums in which we are
engaged with key decision makers.
The sustainability of practices has been a critical issue for GPCW given the start of MPIG
redistribution in April 2015 and other problems facing practices. Working with Welsh
Government, GPCW aimed to address sustainability concerns through the development of
an evidence based approach, including a risk matrix to assess the extent to which access
and continuity of services can be secured and improved where appropriate. This will be
particularly relevant in more rural and deprived communities, and those unavoidably small
and multi-site GP practices. In addition, GPCW continues to urge practices to liaise with
their LMC and negotiate additional payments for the services they provide over and above
GMS work.
It has also been agreed that Welsh Government will commence a review of the item of
service fee for vaccinations and immunisations. Further areas, such as a review of the
care homes and diabetes enhanced services, have been agreed for 2016-17.
Following detailed negotiations with Welsh Government officials, the revised Premises
Cost Directions have been formally approved. They include an agreement for the full
reimbursement of trade waste costs and a notional rent supplement will be put in place
in respect to borrowing costs. On behalf of the profession, GPCW has agreed to inform
practices that they should now co-operate with business rate reviews and that practices
should be encouraged to look at whether they can negotiate (individually or via clusters,
or by LMC) improved trade waste costs.
GPCW has been involved in the development of the single lead employer for GP specialty
trainees. It is being rolled out to all current and future GP trainees in Wales, enabling them to
be employed by a single employer for the duration of their training (rather than by individual
practices). This will help resolve some issues which have arisen as a result of trainees
changing employers a number of times during their training, and having difficulty securing
financial services, including mortgages. It will also allow trainees to access expert HR advice
and support throughout their training in Wales.
GPCW has continued to raise concerns about the sustainability of Out-of-Hours (OOH)
services across Wales and the ongoing lack of investment which is needed to continue to
deliver high quality primary care to patients. We are in the process of collating information
on unfilled shifts and site closures and will utilise this to highlight the need to address this
issue urgently given that we will shortly enter the winter pressure period.
The 111 emergency service in Wales is being developed. GPCW is a member of the
programme board and is engaging with key workstreams, as a “critical friend,” utilising
knowledge and learning from our involvement in unscheduled care at both a Welsh and UK
level. There is a concern that a commitment for necessary resource to develop this service
appropriately in Wales has yet to be announced. GPCW will be monitoring this.
Welsh risk pool indemnity remains in place for GPs working for health board-run
OOH services. It is not available for those working for private providers. Welsh risk pool
indemnity covers the clinical negligence aspects of a complaint but does not cover GPs
for any disciplinary, GMC or criminal elements of a claim. All GPs still require additional
indemnity to ensure that they remain fully covered in the event of a complaint.
GPCW has been involved in the revisions to the GP returner scheme and is pleased to see
that the Minister for Health has accepted the recommendations that include a more flexible
approach to returning to practice as well as new innovative ways of remaining on the Medical
Performers List for those undertaking GP work abroad by undertaking appraisals remotely
(for example, via Skype). The workforce recruitment and retention problem remains a grave
concern, and GPCW has put forward a number of proposals for Government to consider.
Clusters are groupings of GP practices covering a defined geographical area. The GP leads
from practices work together with other community partners to assess the needs of its
population and develop plans to address these. The rationale and potential for cluster
working has been outlined in our strategy document. Welsh Government has committed
£10 million recurring for 4 years specifically for cluster development and a further
£30 million to develop primary and community care. These monies are to be welcomed
and GPCW will be working to ensure that they deliver positive and transformative change.
My First Year on GPCW by Swansea GP Jerome Donagh

Well it’s been a whole year as a GPCW member, I can’t believe it! The time has flown
by. It’s been a real eye opener, Chapeau, to the stalwarts of GPCW. I am in awe of their
knowledge of medico-legal issues, policies and protocols.
Most GPs go through their career insulated from the political maelstrom that rages all
about, this year I have glimpsed into the abyss – and I have enjoyed it immensely.
I am sure that without GPCW, and its honorable members, general practice in Wales as we
know it would be no more than a smouldering pile of ash, with GP partnerships run into
extinction by the unprecedented challenges it faces from increased demand, reduced
resources, a recruitment crisis and an aging workforce. I genuinely believe that GPCW has
saved us and patients from a fate worse than death.
Still I know that there is a lot of work left to do..... But, for myself, I feel that I have learnt and
experienced so much in my first year – and I’m still learning, trying wherever possible to
contribute to areas where I have knowledge or an opinion. Who knows one day I may get
mano a mano with a Minister or AM – that will be exciting, ‘til then to infinity and beyond!
Jerome.
17
The priorities for GPCW over the

next session will be:
–– Ensuring that general practice is at the
forefront of public and Welsh Government
opinion when designing and delivering
services and policies for the Welsh population
(with specific focus on rural services,
unscheduled care, and GP workforce
challenges).
–– Working to deliver more resources to general
practice and primary care (including working
to increase funding of OOH services).
–– Supporting cluster networks to reach their
full potential.
–– Addressing the recruitment and retention
challenge and promoting general practice
as a career option through: supporting
extended training; ensuring retainer
and returner schemes are in place; and
specifically looking at drivers to both recruit
and retain GPs in Wales.
–– Supporting sessional GPs.
Please contact Danielle Maidment, Secretariat

for GPCW, to find out more about the work of
the committee and how you can get involved:
T: 029 2047 4614

E: info.gpcwales@bma.org.uk
W: bma.org.uk/gpcwales
Report from the Welsh Consultants Committee (WCC)

WCC represents all consultants working in Wales and considers all matters affecting those
who are engaged in medical consultant practice.
WCC works closely with the BMA’s UK Consultants Committee and collaborates and
coordinates with them on all relevant UK matters. WCC has full authority to negotiate on
devolved matters.
Dr Sharon Blackford, a consultant dermatologist at Singleton Hospital in Swansea, has

recently stepped down as WCC Chair after holding the post for 5 years, and in that time
steering the committee through a number of important issues and negotiations.
For the start of the 2015/16 session WCC will welcome Dr Trevor Pickersgill, a consultant
neurologist from the University Hospital of Wales in Cardiff as the new Chair. Dr Pickersgill,
has been Vice Chair of WCC for a number of years, and also sits on BMA UK Council.
WCC usually meets four times a year, please contact us to find out more about our work and
how you can become involved.
Dr Trevor Pickersgill (Chair) Dr Sara Hunt (Vice Chair)
Dr Manish Adke Mr John Llewelyn

Dr Argirios Asderakis Dr Penny Owen
Mr Steven Blackhouse Dr Diane Susan Parry
Dr David Baker Dr Anja Pinhorn
Dr Robert Bleehen Dr Simon Poulter
Dr Sharon Blackford Dr Tony Roberts
Dr Martyn Bracewell Mr David Saunders
Dr Peter Evans Dr Ilona Schmidt
Mr Simon Hodder Dr Jean-Marc Soukias
Dr Sara Hunt Dr Anders Skarsten
Dr Christopher James Mr Hiro Tanaka
Dr Stephen Jolles Dr David Tilsley
Dr Stephen Kelly Mr Philip Toon
Dr Windsor Young Dr Timson Appana
Dr Everard Bennett
19
Highlights from the 2014 – 2015 session:

The Consultant Contract in Wales – The contractual arrangements for consultants in
Wales differ from those in other nations of the UK. In October 2014 the DDRB (pay review
body) was asked to make observations on proposals for reforming the consultant contract to
better facilitate the delivery of healthcare services seven days a week in England, Northern
Ireland and Wales. Prior to this the Welsh Government had not attempted negotiation
with the BMA, although we have consistently highlighted that our door remains open
for meaningful talks. The DDRB published its report on 16 July 2015 making a number
of observations, including suggesting that there should be no right to opt out of non-
emergency weekend working and that pay progression should be linked to achievement of
excellence. The report said, however, that these observations only applied to England and
Northern Ireland. It also said that the Welsh Government should enter into negotiations with
us on reforming the contract in Wales. As things currently stand formal negotiations are
due to start for consultants in England and Northern Ireland. Welsh Government plans to
“observe” the outcome of these talks before considering what, if any, changes they will seek
to make in Wales.
Med3 – following a successful campaign by WCC, Med3 Forms (also known as ‘fit-notes’) should
now be available on hospital wards and in out-patient departments so that patients are not
unnecessarily referred back to their GP. If this isn’t happening in your hospital/clinical area, please
let your Local Negotiating Committee know about it.
Upholding Professional Standards in Wales – came into effect on 1st September. Following
lengthy negotiations the revised disciplinary procedure sets out, for the first time, a standardised
procedure to address concerns about capability, performance and conduct.
Remediation – WCC has been an active participant in the Wales Revalidation Steering Group and
fully supports the Remediation Guidance Document, which was agreed in March 2015. The Wales
Revalidation Delivery Board agreed that the guidance document would be reviewed in March 2016.
WCC continues to call for remediation to be appropriately funded by health boards in Wales.
WCC Strategic Priorities – at the start of the 2014/15 session, WCC held a workshop to agree the
focus and direction for its future work. The themes identified, which will be taken forward over this
session, include:
1. Safe Seven Day Services – WCC has begun work to define what any move to enhanced
seven day services in Wales might look like, and to shape any debate about seven day services
using robust evidence. We believe that NHS care should be of the same high quality across all
seven days of the week, and that implementation of ‘safe seven day services’ should prioritise
urgent and emergency care. Clearly, to maximize the positive effect a consultant can have on
patient care, they must have access to the full range of clinical and support services.
2. Professional Empowerment – this priority area for WCC seeks to ensure that consultants
have a voice in the workplace, are listened to and are able to influence at all levels. It comes
amidst a growing number of reports about consultants feeling isolated and de-valued in the
workplace. WCC will be working to ensure that consultants are able, and supported, to lead
effective clinical teams and that they are engaged in day-to-day, as well as strategic, decisions
at their places of work across Wales.
3. Trade union – The Joint Welsh Consultant Contract Committee is WCC’s only subcommittee.
It negotiates with Welsh Government and employing NHS organisations across Wales to
review the consultant contract in Wales and its implementation. WCC will be seeking to
engage with Welsh Government to ensure that, in Wales, the contract remains able to offer
appropriate arrangements for consultants and patient care.
Please contact Sarah Ellmes, Secretariat for WCC, to find out more about the work of the
committee and how you can get involved:
T: 029 2047 4604

E: sellmes@bma.org.uk
W: bma.org.uk/wcc
Report from the Welsh Committee for Public Health

Medicine (WCPHM)
About us:
The Welsh Committee for Public Health Medicine Committee (WCPHM) represents all public
health doctors in Wales.
The WCPHM normally meets three times a year to discuss all matters relating to public
health medicine and those affecting public health physicians in Wales. The last meeting of
every session is usually an open one, whereby any public health doctor working in Wales can
attend – irrespective of whether they are a BMA member or not.
The WCPHM regularly engages with the BMA UK Committee for Public Health Medicine to
keep them informed of the circumstances related to practice in Wales and to help to shape
BMA UK policies on public health matters.
At the BMA’s 2015 annual public health conference, which is held each spring, Dr Michael
Thomas presented A Vision for Public Health Services in Wales to delegates, and two motions
from Wales were passed (on graduated driving licences and water fluoridation), therefore
becoming UK policy.
Dr Michael Thomas Dr Marysia Hamilton-Kirkwood

(Chair) (Vice Chair)
Dr Ciaran Humphreys
Dr Jörg Hoffmann
Dr Robert Atenstaedt
Dr Peter Stevenson
Dr Graham Brown
Dr Stephen Monaghan
Dr Dyfed Huws
Dr Jo McCarthy
Dr Mark Temple
Dr Nigel Monaghan
21

This session, WCPHM has considered a number of important matters relating to public health
medicine in Wales and those affecting public health doctors:
Job Planning remains high on the committee agenda – WCPHM has held job-planning
workshops and training for consultants in public health, and has worked closely with
Public Health Wales NHS Trust to ensure that appropriate and timely job planning training
is delivered to all consultants and managers.
WCPHM has been made aware of inaccuracies in the Electronic Staff Record (ESR) system.
Having raised this at meetings of the Joint Medical and Dental Negotiating Committee,
NHS management are considering how best to address this and are now providing
enhanced training.
You will be aware that Public Health Wales NHS Trust has been undertaking an accommodation
review called the ‘Our Space Project’. The committee continues to monitor and engage with
the project around a number of concerns, not least the absence of Trade Union staff at Project
Board meetings and the issue of dealing with confidential patient identifiable information in
open plan working environments. This latter concern relates to three areas in particular: health
protection, child protection and health care quality. WCPHM has flagged the need to look at
retaining a locality presence for those staff whose work revolves around these areas, and also
for those that work with local clinicians.
The recruitment and retention of adequate numbers of public health doctors in NHS Wales
is a longstanding priority for the committee. WCPHM continues to undertake a number
of activities to encourage people to join the profession and to raise the worrying lack of
public health doctors in Wales with key decision-makers, such as the Chief Medical Officer.
Discussions have also taken place at the Joint Medical and Dental Negotiating Committee
(JMDNC) and with the Director of Workforce and Organisational Development. Newly
introduced ‘Taster Days’ in public health for Junior Doctors are a welcome development –
WCPHM is now asking for them to be enhanced and made available right across Wales.
WCPHM has been working to influence and help to shape the Welsh Government’s
Public Health (Wales) Bill as it makes its legislative passage through the National
Assembly for Wales. The Bill contains a number of provisions relating to alcohol, smoking,
pharmaceutical services and nutrition among others.
WCPHM undertook work in conjunction with BMA Welsh Council to produce the paper
‘Service Reviews: what they are, their aims and how they should happen’. The document
defines the purposes of service reviews, outlines the principles underlying them and indicates
who should carry them out. It is available on our website.
WCPHM received a number of presentations over the last session, including from:
–– Mr Paul Laffin, EU Policy Manager, BMA European Office – who explained the role of
the European Office, the legislative procedure and outlined a number of key policy
areas of interest.
–– Mr Peter Davies, Sustainable Futures Commissioner – this presentation was on the
provisions and aims of the Wellbeing of Future Generations (Wales) Bill, and gave
members an opportunity to provide comment and suggestions.
Dr Lika Nehaul (a consultant in communicable disease control) retired this year. We would
like to thank him for his contribution and as a previous chair of the WCPHM for 8 years.
We wish him a very long and healthy retirement.
Please contact Nadia Hughes, WCPHM Secretariat, to find out more about the work of
the committee and how you can get involved:
T: 029 2047 4610

E: nhughes@bma.org.uk
W: bma.org.uk/wcphm
Report from the Welsh Staff and Associate

Specialist and Speciality Doctor Committee
(WSASC)
About us:
WSASC represents all staff, associate specialist and specialty doctors working in NHS Wales.
The committee usually meets four times a year and consists of SAS doctor representatives
from all Health Board areas in Wales.
We work closely, and keep in regular contact, with the BMA’s UK SAS Committee to ensure
that they are informed of the situation in Wales and to work together to improve the working
practices and environments of SAS doctors across the four nations.
Dr Ram Kumar (Chair) Dr Prathap Reddy (Vice Chair)
Dr Dwijendra Baruah Mr Rajnesh Nirula

Dr Anand Ganesan Dr Shubha Pathadey
Dr Janet Harris Dr Sitaram Podila
Dr Amer Jafar Dr Shrinivas Prabhu
Dr Julie Jones Dr Shrishail Sanikop
Mr Jit Lodhi Dr Bharat Shah
Mr Khalid Mahmood Dr Jane Turton
Dr Lowri Myrddin Mr Christodoulos Chatzidimitriou
23
Highlights from the 2014 – 2015 Session

At the beginning of the 2014-15 Session, WSASC undertook a survey of all SAS doctors in
Wales who are BMA members. The WSASC survey covered a number of issues including; working
practices, bullying, harassment or victimisation, job plans, recognition, support and appraisals.
A total of 230 responses were received – equivalent to 61% of the total initially contacted.
One of the main areas of concern coming from the survey was the reported incidence of
bullying, harassment and victimisation experienced by SAS doctors. A cross branch
of practice working party has been established by BMA Welsh Council to discuss ways of
tackling some of the issues raised by the survey. There is no place for bullying in any part
of the NHS in Wales and WSASC has been taking a full part in these discussions – putting
forward suggestions on how to best address the issues raised.
The matter of the coding of SAS doctors’ work has been raised with Welsh Government.
SAS doctors are concerned that, as their work is usually undertaken under the name of a
consultant, they will have problems in quantifying their own work for revalidation purposes.
Discussions are being held with the appropriate officials in NHS Wales and this work will
continue to be followed up in the 2015/16 Session.
Management roles for SAS doctors is another area which WSASC has raised with Welsh
Government and NHS Wales. SAS doctors are eligible to apply for management roles, as long
as they have the appropriate experience. However, we heard reports this session that SAS
doctors are not often aware that these posts are being advertised. This has now been raised
with Workforce Directors to ensure that this happens in practice. WSASC will be monitoring
progress closely.
WSASC is in the process of agreeing a SAS Charter with Welsh Government and NHS Wales.
It is proposed that many of the issues which are being addressed by WSASC, such as coding
and management roles, will be included in the Charter. Getting the Charter agreed will be
one of the main priorities in the new session.
During the last session, Dr I Mazhar stood down as the Chair. The Vice Chair, Dr Prathap
Reddy acted as Chair for the remainder of the session. Elections have recently been held and
Dr Ram Kumar was elected as WSASC Chair for a triennial period.
The new Chair’s priorities for the coming session are as follows:
–– T o have a procedure to help avoid bullying and harassment in the workplace and, if such
incidences occur, how to address them.
–– To introduce a SAS Charter in Wales.
–– SAS Doctors to receive recognition of their skills and competencies and to work
autonomously where appropriate.
–– Ensure that there is greater transparency in the coding of SAS doctors’ work.
–– Ensure that management roles in health boards are offered to all.
–– Ensure that SAS terms and conditions of service are up to date.
–– Promote quality job planning.
–– Encourage SAS doctors to be trained as appraisers.
Please contact Sarah Miller, WSASC Secretariat, to find out more about the work of the
T: 029 2047 4610

E: smiller@bma.org.uk
W: bma.org.uk/wsasc
From a SAS doctor’s perspective…..

WSASC member, Dr Dwijendra Baruah,
recently retired from his full time SAS role.
Here, he reflects on the changes he has
seen during his career of nearly 40 years
in NHS Wales.
On an August morning in 1978 when I joined the Obstetrics & Gynaecology department at
Singleton Hospital, Swansea as a Locum SHO, I never could imagine that I would end my full
time working career in Swansea almost 37 years later. I became a Staff Grade doctor then an
Associate Specialist some time ago and became part of the grade now known as Staff Grade,
Associate Specialist and Specialty Doctors (SAS) – or ‘the workhorse of the NHS’. I have seen
profound changes over this time; some are good and some not so good.
The NHS has grown tremendously that is for sure; hospitals and departments are bigger –
with many more consultants, other doctors and staff serving the NHS.
When I first joined, the hospital administration was headed by a Hospital Secretary and a
deputy Hospital Secretary, these have now been replaced by hospital managers. This has
resulted in all medical staff having less opportunity to be involved in decision making, and
therefore less of a voice in the workplace. This is one of the biggest changes I can see in NHS
– growing professional isolation – which I consider to be a negative one.
When I started as a SAS doctor, there was little or no recognition of us or of our work.
Although this is changing slowly, we are still at a lower level of recognition. Even now, our
clinical work goes under somebody else’s name. So, a lot of work still needs to be done.
However, positive changes are happening. Firstly, it’s clear that the number of doctors in
my branch of practice has increased over the years, and with continued hard work and
the dedication by many SAS doctors, and with the support of other colleagues across the
profession and from the BMA, more positive changes are on their way. Recently, SAS doctors
have gained recognition in the form of taking on key roles – such as Associate Dean,
Associate member on Health Boards, Clinical leads, Clinical supervisors, Clinical tutors,
LNC lead, and the Chair of Medical Staff Committee.
I love working directly with patients, it’s why we go into medicine. Increasingly, however,
public expectations about what the NHS can deliver need to be addressed. Similarly
politicians of all political parties should not make false promises or use the NHS as a
political football. With all its shortcomings, our NHS remains a fantastic service for the
people of Wales.
I have been selected as the President of Wales Obstetrics and Gynaecology Society for
this year. This is an honour – the first president from the SAS group of doctors. I would not
have imagined this happening even in the more recent past. Until the mid-nineties this
organisation was exclusively for consultant Gynaecologists. No other doctor could have
been its member. This is a good sign of a culture change, a step in the right direction.
I have now retired from my full time job and have come back as a semi-retired doctor doing
two days of colposcopy work a week, which I love most. Hopefully I can continue to work
for a great organisation like NHS Wales and serve the patients and the country the best way
I can.
25
‘We look after

doctors so
they can look
after you.’
Report from the Welsh Junior Doctors Committee

(WJDC)
About us:
WJDC is committed to representing and acting upon issues that affect junior doctors in
training in Wales. The committee works with, and regularly makes representations to, the
Welsh Government, the Postgraduate Deanery and Local Health Boards on behalf of junior
doctors in Wales.
We also work very closely with the BMA UK Junior Doctors Committee on issues that impact on
all junior doctors in the UK, such as the junior doctor contract, and also keep them informed of
the particular matters relating to training and working in Wales.
We normally meet four times a year at the BMA Cymru Wales office in Cardiff Bay.
Dr Bethan Roberts (Chair) Dr Jayan ‘G’ George (Vice Chair)

Dr Maimoona Ali Dr Samihah Aslam
Dr Eu Lee Seow Dr Klara Brzyska
Dr Sarah Wright Dr Beatrice Gout
Dr Nick Williams Dr Natalie Thomas
Dr Chantelle Wiseman Dr Rupert Thurston
Dr Dave Bosanquet Dr Julia Kramer
Dr Puskar Bura Dr Rebecca Cushen
Dr Elizabeth Farr Dr Ritu Nirula
Dr Jade Harrison Dr Kristina Leppik
Dr Aled Jones Dr Ioseff Davies
Mr Rakan Kabariti
Dr Hayley Lawrence
Dr Juliette Lewis
27

This session we have considered a number of important matters:
WJDC had previously sought to maintain the UK junior doctor contract and former WJDC
Chair, Dr Elliott King, spent many days in London representing Wales in those initial contract
talks before they broke down last October. You will be aware that the UK Department of
Health announced its intention to impose a new contract for trainees in England by August
2016. WJDC pressed the Welsh Government not to impose a contract here, and in September
2015 officials issued a statement to us indicating that they will retain the current junior
doctor contract in Wales. Obviously this is great news for our current and future trainees and
we are pleased that our constructive working relationship with Welsh Government has led
us to this position. The UK Junior Doctors committee recently decided to ballot members in
England for strike action; we will continue to offer our full support to colleagues there, and
keep members in Wales informed of any further developments.
WJDC has lobbied for the continuation of the Junior Doctor Review Group (JDRG). Currently
it is the only forum in Wales at which junior doctor issues (other than training) can be
discussed with Welsh Government and provides the reporting structure for the Monitoring
Scrutiny Group and the Accommodation Review Group. We feel that in future the JDRG can
play a role in reviewing junior terms and conditions and ensure that agreements reached
at the UK Joint Negotiating Committee (Juniors) are effectively communicated across the
service and implemented in Wales.
WJDC is reviewing a re-drafted All-Wales Rota Monitoring Process which contains a

number of provisions that are not acceptable to WJDC. We are continuing to negotiate the
policy via our membership of the Monitoring Scrutiny Group.
Members of WJDC will continue to review whether the new standards for hospital
accommodation introduced in 2012 are being implemented by health boards and will
contest the threat from Welsh Government to remove the benefit of free F1 accommodation
that is currently still available in Wales and is seen as a positive benefit of working here.
WJDC is negotiating a new Trainee Relocation Policy. Once this has been introduced WJDC
will be publicising the policy to ensure that juniors in Wales are aware of, and benefiting from,
its provisions.
New Banding Appeals Guidance in respect of banding appeals has been agreed in Wales.
For more information, contact the committee secretariat, Lynn Steer. (Details overleaf).
WJDC meeting dates for 2015-16
Upcoming meetings
Thursday 1st October 2015, 1:30pm, BMA Cymru Wales
Thursday 21 January 2016, 1:30pm, BMA Cymru Wales
Thursday 17 March 2016, 1:30pm, BMA Cymru Wales
Thursday 9 June 2016, 1:30pm, BMA Cymru Wales
About the WJDC and me, by Dr Bethan Roberts:

It is a privilege to be the newly elected chair of the Welsh Junior Doctors Committee and to
be able to write to you in our end of session report.
The committee considers matters pertaining to the education, training and employment
of junior doctors in Wales and represents the views of junior doctors to all Health Boards,
the Deanery and Welsh Government, as well as at a UK-wide level through the UK Junior
Doctors Committee.
We will be very busy over the next few weeks and months dealing with matters relating to
the junior doctors’ contract. The Review Body on Doctors’ and Dentists’ Remuneration
(DDRB) released their recommendations on the junior doctor contract which if enforced,
will have a significant impact on our working conditions, remuneration and work-life balance.
These are important and challenging times and there has been an uproar about the report
among juniors on social media; it is therefore a crucial time to engage our members. Given
the Welsh Government’s announcement, that it will not impose a contract here, we need to
maintain our working relationship with them.
One of my aims as chair is to promote what we do as a committee, widen participation in the

WJDC and to encourage anyone who is thinking about getting involved to do just that. It may
seem daunting at first but we all have to start somewhere. I only started getting properly
involved with the BMA last year after becoming frustrated by working a difficult rota that my
colleagues and I believed not to be compliant. We had a lot of help from BMA Cymru Wales
after a valid monitoring exercise showed we were working more hours than the hospital
thought we were, which ultimately led to a successful banding appeal. I wasn’t satisfied by
sorting out a single rota for myself and my colleagues and wanted to do more. I stood for
election as GP trainee representative for Wales and rejoined WJDC after winning that election
to try and make a difference on a national level for junior doctors in Wales.
I found WJDC to be a very welcoming and friendly committee when I started last year
and I would actively encourage any junior doctor living or working in Wales who wants
to get involved to sign up. Members can also participate remotely by video or telephone
conferencing if required. For those attending in person, appropriate expenses are
reimbursed. We also have active discussions between meetings by e-mail.
Junior doctors of all grades and all specialties are welcome, and the only real entry
requirements are enthusiasm and a willingness to be an active participant in the work of the
committee. While it’s not obligatory to be a BMA member – I would encourage everyone to
join the BMA for all the protection and benefits it affords. You never know when you might
need it, and I am grateful for all the help and support I’ve received which I wouldn’t had
access to without membership.
If you would like to be part of our work, particularly after the release of the DDRB report, then
drop us a line and get involved. New members are always welcome at our meetings.
Please contact Lynn Steer, WJDC Secretariat to find out more about the work of the
T: 029 2047 4625

E: lsteer@bma.org.uk
W: bma.org.uk/wjdc
29
‘We look after

doctors so they
can look after you.’
Report from Welsh Medical Students Committee

(WMSC)
About us:
The WMSC represents medical students at Cardiff and Swansea Universities and acts upon
all matters affecting their interests. It does this by informing, lobbying, liaising and where
appropriate collaborating with the Welsh Government, Cardiff and Swansea medical schools,
health boards and the Wales Postgraduate Deanery.
The committee also works closely with BMA Welsh Council and the UK Medical Students
committee (MSC).
WMSC normally meet four times a year at the BMA Cymru Wales’ office in Cardiff Bay.
Umar Hanif (Chair) Lorenzo Giacci (Vice Chair)
Cardiff 1st Year Reps Nominations to be sought in September

Swansea 1st Year Reps Nominations to be sought in September
Cardiff 2nd Year Reps Faris Hussain, Amelia Tee
Swansea 2nd Year Reps Richard Edwards, Emily Simon Thomas
Cardiff 3rd Year Reps Kirsty Anderson, Adam Mounce
Swansea 3rd Year Reps Isobel Giblin , Hannah Gregson
Cardiff 4th Year Reps Amy Butlin, Richard Moore
Swansea 4th Year Reps Rhodri Clancy, Rachel Wallice
Cardiff 5th Year Reps Louise Crilly, Elen Hughes
Intercalating Rep Paul McNulty

31

This session we have considered a number of important matters:
Members of the committee have continued to seek improvement in standards of education

and administration in both Cardiff and Swansea medical schools and have supported fellow
students during the ongoing changes to the curriculum and following the introduction of the
four-year course in Swansea.
WMSC also lobbied hard to achieve improvements in the standard of accommodation

for students whilst on GP placement. This work followed a motion that was debated and
carried at the BMA’s MSC conference, which was held in London in 2014. New minimum
accommodation standards have recently been published for students in Cardiff and we are
pressing for similar standards to be adopted in Swansea. Find out more about the standards
on our website: bma.org.uk/accommodationstandards.

WMSC contributed to the Service Increment for Teaching (SIFT) funding review calling
for greater transparency and better performance management in the allocation of funding.
Currently, NHS Wales is allocated SIFT funding to compensate hospitals for the additional
costs incurred through supporting the teaching of medical and dental undergraduates.
The committee is looking forward to seeing a more robust and transparent funding structure
put in place.
The independent Shape of Training (SHoT) Review, considered whether changes are
required in postgraduate medical training to ensure that it continues to meet the needs
of patients and health services in the future. You may be aware that the report made
19 recommendations for change. WMSC contributes to the BMA-wide work on Shape of
Training, and while we support some recommendations, others cause considerable concern
– particularly in respect of the proposal to move the point of registration with the GMC to
the time of graduation, instead of at the completion of F1. The BMA is part of the UK SHoT
Steering Group, and in Wales we are engaging with the Welsh Government to incorporate our
views on any future changes in Wales.
WMSC has lobbied for the introduction of an accredited Immediate Life Support (ILS)
course following the withdrawal of such training which had previously been provided during
the 5th year at Cardiff Medical School. A motion for accredited training to be provided at
all medical schools across the UK was carried at the 2015 MSC Conference and WMSC will
pursue this during the coming session.
WMSC meeting dates for 2015-16

Upcoming meetings
Wednesday 7th October 2015, 6.30pm, BMA Cymru Wales, Cardiff
Wednesday 9th December 2015, 6.30pm, BMA Cymru Wales, Cardiff
Wednesday 17th February 2016, 6.30pm, BMA Cymru Wales, Cardiff
Wednesday 25th May 2016, 6.30pm, BMA Cymru Wales, Cardiff
If you want to know more about the work of WMSC, or would like to get involved, please
contact Lynn Steer, WMSC Secretariat:
T: 029 2047 4625

E: lsteer@bma.org.uk
W: bma.org.uk/wmsc
Representing
doctors locally
BMA Cymru Wales Divisions
Local Negotiating Committees
Local Medical Committees

BMA Divisions across Wales
Clwyd
North
North West Wales
North East
Wales
Gwent and
South Powys
West and
South West Wales
West
Glamorgan Mid
Glamorgan
Cardiﬀ and the

Vale of Glamorgan
All BMA members belong to a local Division. These bodies provide an opportunity for
members to discuss issues that impact on all branches of practice and to debate local
matters with other members in the area.
Honorary secretaries for each division:

Cardiff and the Vale of Glamorgan Dr Sanjiv Banerjee
Clwyd North Dr Julie Jones
Gwent and South Powys Dr Vincent Staples
Mid Glamorgan Mr Raj Nirula
North West Wales Professor Michael Rees
West and South West Wales Dr Catherine Burrell
West Glamorgan Dr Sharon Blackford
North East Wales Dr Farookh Jishi
For more information please contact:

Nadia Hughes
E nhughes@bma.org.uk
T 029 2047 4610
35
Focus on: Clwyd North Division
This year the BMA’s Clwyd North Division

was instrumental in ensuring a meaningful
public consultation on the future of
consultant-led maternity services
at Ysbyty Glan Clwyd in North Wales.
What happened and why was it successful?
Background
Betsi Cadwaladr University Health Board suddenly announced in February that consultant-
led obstetric and gynaecology in-patient services at Ysbyty Glan Clwyd would cease for 12-18
months while it tried to manage a shortage of doctors across all three main hospital sites. Many
local doctors believed that this decision had been taken inappropriately, in secret and without
proper consultation, with likely collateral impact on other key clinical services at Ysbyty Glan
Clwyd. In March the BMA’s Clwyd North Division, representing all doctors in the local area, called
an urgent meeting to consider the implications of this plan for both primary and secondary care,
where a vote of no confidence in the Health Board was passed overwhelmingly. The meeting also
requested BMA Cymru Wales to investigate whether the Health Board had complied with both
the law and its own procedures in relation to its consultation obligations.
BMA Cymru Wales obtained an opinion from a QC in relation to the process that the Health
Board had followed, which concluded that the process was significantly flawed and that the
Health Board had not met its legal obligations in terms of the established engagement and
consultation process. At the same time, an entirely separate campaign had been established
by local people, supported by local doctors, to continue services at Ysbyty Glan Clwyd. This
provided an opportunity for BMA Cymru Wales to identify two local campaigners, who became
claimants in the subsequent High Court request for Judicial Review, supported by BMA Cymru
Wales. Consequently, the High Court issued an injunction to prevent the Health Board from
implementing their original plan and a new consultation process had to be established.
It is important to distinguish the ambitions of the local campaign group from the action
requested by the BMA’s Clwyd North division, as BMA Cymru Wales holds no policy position on
whether consultant-led obstetric and gynaecology services should be delivered on any one
or more hospital sites in north Wales. Our aim was limited to supporting a Judicial Review of
whether the Health Board has followed its own procedures when conducting a significant service
change, including consultation with relevant professionals and conducting an equalities impact
assessment. The actual configuration of services across the three sites in the Health Board area
was, quite properly, not part of our brief.
However, BMA Cymru Wales expects every Health Board to fully comply with their own processes
when taking decisions leading to major service reconfiguration. Whenever doctors are not
consulted by a Health Board about the services that they deliver, then it is in our members’
interests that the BMA challenges that approach. Our successful action in the High Court will now
ensure that a comprehensive, transparent consultation about the future of maternity services
across North Wales can now take place within an agreed framework.
This case has sent a strong message to other Health Boards and NHS Trusts in Wales about the
need to use agreed consultation processes and procedures with their staff and with the public.
Whatever the future of this service at Ysbyty Glan Clwyd, both the doctors providing it and the
community who use it will now have a meaningful opportunity to express their views within a
properly-constituted process.
Why the local division’s approach was successful

There was a functioning BMA division where the department/hospital was located and the local
BMA members who sought action were from a range of inter-related disciplines, not just the
primary service at risk. It promptly convened a meeting to discuss the underlying issue, which
was relatively tightly focused because this was effectively a challenge about process and not
outcome. If the focus had been more on the outcome, it is more likely that members of the
division would have been split in their support/response. Once an outline opinion had been
received from our QC that there was scope for a legal challenge, the division’s ability to link into
the pre-existing local campaign group enabled early identification of two claimants to take the
Judicial Review process forward - one being a GP, the other being a mother who had experience of
the local service. Members of the division also established a motivated, energetic clinical group,
who engaged regularly and frequently with other partners in the process, and the value that this
clinical group brought to the process cannot be understated, as it enabled effective challenge to
the Health Board’s stance on the consultation process.
This episode demonstrates the value of an active BMA division, with representation from both
primary and secondary care doctors, as well as all of the interrelated specialties in the hospital.
It also shows how BMA Cymru Wales engages effectively with its membership to challenge
behaviours by a Health Board where we believe these are contrary to best practice and/or
the public interest. Once the Health Board agreed to undertake a new consultation process,
consistent with the requirements of the High Court, BMA Cymru Wales has properly stepped back
to allow local people to influence/determine the future of their own services.
37
Local Negotiating Committees and

the Welsh LNC Forum
Welsh Ambulance
Service NHS Trust
(No LNC)
Betsi Cadwaladr
University HB
Powys
Teaching HB
Hywel Dda University HB
Cwm Aneurin
Taf Bevan
University University
Abertawe Health HB
Bro Morgannwg Board
University HB Public Health
Cardiﬀ and Vale Wales Trust
University HB
Velindre NHS Trust
Local Negotiating committees (LNCs) are established in each Health Board and Trust in
Wales, where doctors are employed. They make sure that the voice of doctors is heard in the
workplace and that the interests of the profession are protected in local negotiations.
LNC committee chairs:

Betsi Cadwaladr University HB Dr David Saunders
Powys Teaching HB Dr Anna Pascall
Hywel Dda University HB Dr Christopher James
Abertawe Bro Morgannwg University HB Dr Simon Poulter
Cwm Taf University HB Dr Stephen Sarasin
Aneurin Bevan University HB Mr Hiro Tanaka
Public Health Wales NHS Trust Dr Mark Temple
Velindre NHS Trust Dr Owen Tilsey
Cardiff and Vale University HB Dr Robert Bleehen
The Welsh LNC Forum meets three times a year to discuss all Wales issues. It consists of
representatives from each LNCs.
For more information, or to get involved in your LNC, please contact:

Sarah Miller
E smiller@bma.org .uk
T 029 2047 4610
Welsh Local Negotiating Committee Forum (WLNCF)

About us:
The Welsh LNC Forum is made up from LNCs across Wales, it comes together to:
–– Co-ordinate and support the work of individual Local Negotiating Committees
–– Gather information on each employer’s approach to engaging doctors
–– Issue guidance to Local Negotiating Committees on relevant topics
Dr Simon Poulter (Chair) Dr Rob Bleehen (Vice Chair)
WLNCF meets three times a year in Cardiff to discuss issues of relevance and those
affecting Local Negotiating Committees. Usually, the same issues are being faced across
Wales and it is helpful to adopt a common approach, share best practice and agree a
workable way forward.
The committee consists of the Chair from each Local Negotiating Committee and
two additional representatives from each LNC. The WLNCF Chair is also a member of
Welsh Council.
The outgoing Chair is Mr David Saunders, a consultant ophthalmologist from Betsi Cadwaladr.
He has been Chair for the last 3 years and has steered the committee through a number of
important issues. We wish to express our thanks for his valuable contribution to the work of
WLNCF.
Our new Chair, from September 2015, is Dr Simon Poulter a consultant anaesthetist from
Abertawe Bro Morgannwg.
39
Highlights from the 2014-15 Session

During the past year, WLNCF has been proactive in addressing concerns over follow-up
not booked outpatient appointments across Wales. A freedom of information request
was made in June 2014 to obtain figures from Health Boards as to how many patients were
waiting for their follow up review appointments results. It showed that 148,977 patients
were more than 25% overdue the requesting clinician interval, and 134,853 were more
than 50% overdue. Since this was undertaken, Health Boards have been mandated to
report the figures to Welsh Government. WLNCF has recently undertaken another freedom
of information request, a year from the original, to monitor for improvements and we are
currently working with other stakeholders to seek more clinically-derived, outcomes-
focused, targets for NHS Wales.
Committee members were concerned about access to digitalised medical records that
were incomplete during a pilot of the electronic patient record systems in South Wales and
the patient safety risks associated with incomplete records. These concerns have been
escalated to the Chief Medical Officer.
WLNCF continues to encourage junior doctors to become involved with their LNCs.
Improved links have been made between WLNCF and Welsh Junior Doctors Committee
(WJDC) by the Chair attending WJDC meetings and communicating the work of WLNCF to
the WJDC. Work continues to try to engage junior doctors in LNC activity.
WLNCF members have expressed concerns over the provision of SPAs across all LNCs and
the downward pressure on the number of SPAs being given to SAS doctors and consultants.
LNCs are keen to obtain information on the number of SPAs being given, which will become
easier once the job planning process is linked with the electronic staff record. WLNCF will be
making it a priority to monitor this during the next session.
With ongoing proposals to reconfigure services in North Wales, and with changes which
have already been introduced elsewhere in Wales, WLNCF ensures that doctors have
individual support and advice when faced with service reconfiguration. LNC members
provide assistance, but also ensure that members are referred to the BMA for expert advice
and support.
During the next session, the new Chair will continue to focus on the follow-up not booked
outpatient appointments and ensure that the coding of SAS doctors work is undertaken
more accurately. He will also be continuing to strengthen the links between WLNCF and
junior doctors.
Please contact Sarah Miller, WLNCF Secretariat, to find out more about the work of the
T: 029 2047 4610

E: smiller@bma.org.uk
Local Medical Committees
North Wales LMC
Dyfed Powys LMC
Morgannwg Gwent LMC

LMC
Bro
Taf
LMC
There are five LMCs in Wales, each representing GPs within their areas. LMCs are
independent statutory bodies which offer professional advice to GPs, NHS bodies and
Health Boards. The LMC conference takes place annually, and locally LMCs hold various
social and educational events throughout the year.
Please contact your LMC

committee chairs to find out more:
North Wales LMC Bro Taf LMC

Dr Eamonn Jessup Dr Akram Baig
E northwaleslmc@yahoo.co.uk E brotaflmcltd@btinternet.com
W northwaleslmc.co.uk W brotaflmc.org.uk
T 01745 825780 T 02920 899381
Dyfed Powys LMC Gwent LMC

Dr Laurence Williams Dr Neil Statham
E janet.k.powell@btinternet.com E vcgwentlmc@btconnect.com
W dyfedpowyslmc.co.uk W gwentlmc.org.uk
T 01597 860565 T 01495 764455
Morgannwg LMC
Dr Nimish Shah
E morgannwglmc@btconnect.com
W morgannwglmc.org.uk
T 01792 815954
41
Welsh LMC conference

The 2015 annual Welsh LMC Conference was
very successful in highlighting the issues of
staffing across Wales and also encouraging
debate on the way General Practice will be
delivered in the future.
The need to encourage young colleagues to

actively participate in medical politics has never
been more important, and it was encouraging
to see many new delegates to conference this
year and to witness such full participation.
Chief Medical Officer Dr Ruth Hussey’s keynote

speech clearly focused on a vibrant future for
General Practice in Wales which was reassuring
to hear. Most of all there were fun moments
from beginning to end with GPCW’s own folk
rock band making a star performance and
bringing the conference to a close.
Divider page
Representing
and protecting
doctors’ terms
Title of document
Chapter title
and conditions
& providing
employment
advice
Casework:
From September 2014 to July 2015 BMA Cymru Wales has handled 529 individual cases
from members across Wales, advising on terms and conditions of service, taking up issues
with employers and representing members in disputes and disciplinary hearings.
Cases handled by BMA Cymru Wales from September 2014 – July 2015, by branch of practices:
2%
16%
4% 28%
Consultants
24% General Practice

Junior Doctors
26% Medical Academics
Staff and Associate Specialists
Other
Upholding Professional Standards in Wales

BMA Cymru Wales, NHS Wales Employers and Welsh Government recently reached an
agreement on a revised disciplinary procedure “Upholding Professional Standards in Wales”
for doctors employed by the NHS in Wales.
The procedure sets out the approach for addressing concerns about capability, performance
and conduct. For the first time, a single disciplinary procedure will be utilised by every
employer in NHS Wales and each employed doctor will be treated in exactly the same way,
irrespective of where they work, who their employer is, or which grade or branch of practice
they are employed in.
All doctors employed in NHS Wales would then in future be assured that no less favourable
procedures will be utilised when they work across Health Board boundaries or move
between Health Boards to take on new positions. For doctors in training, the procedure
would dovetail neatly with the Wales Postgraduate Deanery’s own procedures to ensure an
integrated approach to those doctors who are in the initial stages of their career.
A ballot of members, conducted by BMA Cymru Wales, received a 97% positive response
– clearly showing strong support for the new procedure, which comes into effect on
1st September 2015.
45
Medical Student and Junior Doctor

Engagement Events
One area of responsibility for the Employment Advisers at BMA Cymru Wales is a core
programme of recruitment and engagement activities aimed at medical students. Each
year is punctuated by specific events which highlight the range or services and support
available to BMA members and to recruit new members. These events include: Freshers
Fairs; GMC Registration events and Preparing for Work Seminars – which are held at both
Cardiff and Swansea medical schools. The Employment Advisors organise and attend other
ad-hoc events throughout the year. These core programme events are an important part
of BMA Cymru Wales overall activities. As a result of our efforts, BMA membership levels for
our medical schools are some of the highest across UK. As at June 2015 71% of Medical
Students in Cardiff were members, and similarly 84% for Swansea.
In addition to the core programme of activities for medical students, every year the
Employment Advisors arrange an F1 Induction Recruitment Campaign, where BMA Cymru
Wales staff visit as many F1 inductions as possible across Wales. The purpose of these events
is to not only attract new members but to also remind existing members of the benefits of
membership available to them now that they are employees and to inform them of role of
the Local Negotiating Committee. This year BMA Cymru Wales staff visited 13 hospital sites
during the period from 30 July to 10th August, meeting 291 F1 doctors. Of this number
186 were members and of the 103 non-members. 66 new members were recruited (64%).
Attracting, retaining and engaging with junior doctors members is vitally important
for the BMA as a whole, especially at this time of uncertainty around the future of the junior
doctor contract, so this a great achievement for the team.
“Members who have accessed our support services continually tell us how grateful they are
that they chose to become BMA members.
Whatever your grade or specialty, BMA membership should always be a priority – We are here
to support you through every step of your training and career.”
Joining is easy – either call 0300 123 12 33 or visit bma.org.uk/membership/join-us

Representing
the medical
profession
Title of document
Chapter title
in the media,
policy making
and political
influencing
Divider page
Policy and Public

Affairs
We aim to be leaders of debates and a
prominent authority on healthcare policy in
Wales. We do this by promoting understanding
of complex issues and influencing policies
impacting on the medical profession and
patients, working in partnership with a number
of stakeholders and partner organisations.
We also represent the profession in the media

and externally at a number of forums, meetings
and key national events. Throughout the last
twelve months we have held a number of events
across Wales, some highlights include:
Title of document
Cymru’n Cofio – Wales
Chapter title Remembers.

BMA Cymru commissioned a plaque to
commemorate doctors from Wales who took
part in World War One. Display panels showing
how the wounded were treated in the war were
also produced and exhibited at a launch event,
where the First Minister unveiled the plaque.
The boards went on display at the Territorial

Unit base in Cardiff and then at the
National Assembly for Wales in Cardiff Bay and
will shortly tour other areas of Wales.
A book was also published listing details of

doctors from Wales who were associated with
the Great War. Copies of ‘Blood Guts and Heroes’
by Mr John Jenkins (former Head of Public
Affairs for BMA Cymru Wales) are available from
BMA Cymru Wales.
49
2015 Clinical Teacher of the Year Awards

Clinical teachers play a pivotal role in the medical workforce; driving innovation, educating
our future doctors, and providing clinical leadership and expertise to ensure high-quality
care to patients across the health service.
To that end, BMA Cymru Wales, with BMJ Learning, has established the Clinical Teacher of
the Year Awards to recognise the critical importance of clinical teaching in hospitals and the
community, and to celebrate the excellent teaching standards in Wales.
The awards are hosted by the medical and clinical schools at Cardiff and Swansea, as well as
the Wales Deanery, with the evening culminating in the overall Clinical Teacher of the Year
Award chosen from the winners of the individual institutions’ awards.
This year’s awards went to:
–– C onsultant urological surgeon Mr. Owen Hughes from University Hospital Wales was
been named Clinical Teacher of the Year 2015.
–– Helen Houston of Cardiff University School of Medicine received the outstanding
achievement award for her work in training GPs.
–– Cardiff clinical senior lecturer in medical biochemistry and metabolic medicine
Duncan Cole was named Rising Star.
–– Cardiff GP partner Simon Braybrook, who also teaches at the city’s university, was
presented with the award for teaching and learning innovation.
–– The BMA Cymru Sherman Fund Award went to – Abby Nolasco Wilson (shown below):
The BMA Cymru Sherman Fund Award 2015

Third year medical sciences student Abby Nolasco
Wilson was named as recipient of the BMA Cymru
Wales Sherman Foundation award, which promotes
widening access to the profession and promotes
the advancement of research and education in
medicine in Wales.
The South Wales University student won £500 to go

towards supporting her in her studies.
The 2015 Awards ceremony Winners of the 2015 Clinical Dr Phil Hammond – the comedian and doctor
was opened by Deputy Health Teacher of the Year Awards who provided some after dinner entertainment
Minister Vaughan Gething AM
Developing and Promoting Policy

BMA Cymru Wales has responded to a number of important external inquiries, consultations
and legislative proposals over the last session. Where there is existing BMA policy, this is
considered, but often members in Wales help Welsh Council and Committees to develop
specific responses and policy applicable to the devolved matter at hand.
Our webpages provide details of all the current areas that we are seeking your views on, as
well as hosting copies of all the policy responses that we have submitted. They can be found
at bma.org.uk/working-for-change/policy-and-lobying/welsh-assembly
Here is a taster of the topics we engaged with on behalf of members this session:
Consultations
–– Plan for Primary Care Service for Wales

–– Smoking in private vehicles carrying children
–– Active Travel Action Plan and Guidance
–– All-Wales Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) policy
–– Policy implementation guidance on mental health services for prisoners in Wales
–– Together for health – neurological conditions delivery plan
–– Health Inspectorate Wales – Strategic Plan 2015-18
–– Report of the Health Professional Education Investment review
–– New approach to surveys in Wales: consultation on topics
–– Regulations under the Human Transplantation (Wales) Act
–– Community Health Council in Wales – proposed changes
Inquiries
–– R eview of higher education funding and student finance arrangements in Wales

–– Review of the policy interventions needed to tackle substance misuse in an ageing
population
–– Health and Social Care Committee inquiry into the GP workforce
–– Health and Social Care Committee inquiry into alcohol and substance misuse
–– Health Professional Education Investment Review
–– Welsh Affairs Select Committee inquiry into Cross-border Healthcare
–– Independent Review of Healthcare Inspectorate Wales
–– Review of the advisory structure for health
–– Health and Social Care Committee inquiry into access to medical technologies in
primary care
–– Health Service Reconfiguration – Lessons Learned Review
–– Health and Social Care Committee inquiry into how the NHS handles concerns
–– Constitutional and Legislative Affairs Committee inquiry into making laws in the
fourth Assembly
–– Health and Social Care Committee inquiry into the contribution of Community
Pharmacy to Health in Wales
Legislative proposals
–– The Safe Nurse Staffing Levels (Wales) Bill

–– Planning (Wales) Bill
–– The Well-being of Future Generations (Wales) Bill
–– Public Health (Wales) Bill
51
Social media
communities.bma.org.uk/bmacymruwales/b/weblog
twitter.com/BMACymru
uk.youtube.com/user/bmacymrutv
flickr.com/photos/bmacymruwales/
Contact details
To get in touch with BMA Cymru Wales’ Policy or Public Affairs teams, please contact:
Lucy Merredy
Head of Policy and Committee Secretariat
T: 029 2047 4646
E: lmerredy@bma.org.uk
Carla Mahoney
Acting Head of Public Affairs
T: 029 2047 4626
E: cmahoney@bma.org.uk
Rodney Berman
Senior Policy Executive
T: 029 2047 4631
E: rberman@bma.org.uk
BMA Name of Committee
British Medical Association, BMA House,
Tavistock Square, London WC1H 9JP
bma.org.uk
© British Medical Association, 2015
BMA 20150623
BMA Cymru Wales
British Medical Association, BMA House,
Tavistock Square, London WC1H 9JP
bma.org.uk
© British Medical Association, 2015
BMA 20150623

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Cymru Wales

British Medical Association

Message from the Chair of BMA Welsh Council 6

Representing doctors at an all-Wales level: 7

Representing doctors from the branches of medical practice: 13

Representing doctors locally: 33

Representing and protecting terms and conditions and providing

Representing the medical profession in the media, policy making

About BMA We are the trade union and professional association

We promote the medical and allied sciences, seek

We have a long relationship with the National Health

Ever since devolution in 1999, with your help, we

Our office is located in the heart of Cardiff Bay,

‘We look after

Our representative structures Wales

We have established a network of nine local negotiating committees (LNCs) in each

What we stand for

Message from the Chair of BMA Welsh Council:

Report from BMA Welsh Council

Our current membership for this session is:

Dr Phil Banfield (Chair) Dr David Bailey (Vice Chair)

Dr Manish Adke Dr Simon Poulter

Here is a flavour of what Welsh Council has been

The publication of this work received extensive media coverage:

WORKING FOR DOCTORS | WORKING FOR HEALTH | WORKING FOR WALES

Key results from the survey include:

Scrutinising the Legislative Process

Other examples of legislative proposals considered by the sub-committee include the

A commitment has now been given by Welsh Government to introduce an occupational

Welsh Council Policy Priorities

In 2014, the newly-elected Welsh Council

Welsh Council is undertaking a range of

Please contact Welsh Council secretariat,

T: 029 2047 4604

Each committee represents and acts for doctors in

Report from General Practitioners Committee Wales

Our current membership for 2015-16 is

Dr Charlotte Jones (Chair) Dr David Bailey (Deputy Chair)

Dr Phil White (Negotiator) Dr Laurence Williams

GPCW Highlights from the 2014 – 2015 session:

My First Year on GPCW by Swansea GP Jerome Donagh

The priorities for GPCW over the

Please contact Danielle Maidment, Secretariat

T: 029 2047 4614

Report from the Welsh Consultants Committee (WCC)

Dr Sharon Blackford, a consultant dermatologist at Singleton Hospital in Swansea, has

Our current membership for this session is:

Dr Trevor Pickersgill (Chair) Dr Sara Hunt (Vice Chair)

Dr Manish Adke Mr John Llewelyn

Highlights from the 2014 – 2015 session:

T: 029 2047 4604

Report from the Welsh Committee for Public Health

Our current membership for this session is:

Dr Michael Thomas Dr Marysia Hamilton-Kirkwood

Highlights from the 2014 – 2015 session:

T: 029 2047 4610

Report from the Welsh Staff and Associate

Our current membership for this session is:

Dr Ram Kumar (Chair) Dr Prathap Reddy (Vice Chair)

Dr Dwijendra Baruah Mr Rajnesh Nirula

Highlights from the 2014 – 2015 Session

T: 029 2047 4610

From a SAS doctor’s perspective…..

–– R eview of higher education funding and student finance arrangements in Wales