Unique: Nearly 300 of Wales’ most senior medics met to agree this letter elevating considerations in regards to the Cardiff and Vale college well being board and the flagship College Hospital of Wales, Heath, Cardiff
That is the complete textual content of the letter despatched by the senior guide physique on the College Hospital of Wales, expressing “deep anxiousness” about how the well being board is being run. You’ll be able to learn the context across the letter right here.
Expensive Mrs Williams [the health board’s recently appointed chairwoman, Kirsty Williams],
On behalf of all members of the Senior Medical and Dental Workers Committee (SMSC) and the Native Negotiating Committee (LNC), we welcome your appointment as chair of Cardiff and Vale College Well being Board.
We look ahead to your management and to working with you to protect and improve the standard of healthcare for the folks of Wales.
The SMSC represents all consultants in medication and dentistry throughout the Well being Board’s secondary care companies, encompassing medical, surgical, intensive and acute care, dental, diagnostic, and public well being specialties working each domestically and regionally.
We meet commonly to debate points that immediately or not directly affect affected person care. At our most up-to-date extraordinary assembly on 21 October 2025, attended by practically 300 consultants, quite a few critical, long-standing considerations had been raised.
The overwhelming majority expressed deep anxiousness in regards to the present state of affected person care and agreed on the necessity for pressing motion as the present state of affairs will not be sustainable.
It was additional agreed that these considerations ought to be formally communicated to the Board and Govt Group, with a chance for a written response inside two weeks, previous to SMSC writing to the Welsh Authorities (WG).
Under is a abstract of the problems on your and the Govt Group’s consideration:
1. Restricted Medical Engagement in Administration
Consultants reported that scientific enter is ceaselessly overridden by managerial choices made with out sufficient session.
Operational administration usually prioritises non-clinical views, resulting in restricted and superficial scientific engagement in key choices that immediately have an effect on affected person care.
2. Lack of Seen Management
There’s a rising notion of disconnect between the manager management and frontline scientific groups. Whereas relocation of the senior administration to Woodland Home will not be the only real purpose, it has contributed to decreased visibility and engagement.
Little has been executed to bridge this hole or preserve efficient communication with SMSC members. The Govt Group’s reported shock at points recognized within the latest theatres overview is one among a number of examples cited of restricted management presence and consciousness.
3. Administration Strategy and Tradition
Many consultants described a “firefighting” tradition, targeted on short-term fixes quite than sustainable options. Issues had been raised in regards to the proliferation of center administration, frequent round conferences with out outcomes, and a scarcity of seen long run strategic path.
Determination-making seems concentrated amongst a really small group of senior people, which has led to frustration, disengagement, and a notion of exclusion amongst scientific and even senior management groups.
4. Hospital Infrastructure
The deteriorating situation of hospital infrastructure throughout all websites stays a critical concern. Persistent points together with sewage leaks, water harm, and poor cleanliness proceed regardless of repeated studies from senior scientific workers.
Years of inadequate upkeep and capital funding have compounded these issues, and no clear strategic plan has been shared to deal with or mitigate the related dangers.
Current studies that the UHW2 [a long-mooted new hospital] improvement challenge could have been paused or cancelled, with none communication to clinicians, are notably alarming. This uncertainty has heightened considerations in regards to the Well being Board’s capability to ship secure, trendy healthcare companies.
We’d respect pressing clarification on whether or not planning has certainly ceased, and in that case, the explanations for this choice. Within the medium to long run, progressing with such a improvement is important, as persevering with operations within the present estates is more and more uneconomical and unsuitable.
5. Workforce Morale
Morale amongst consultants and the broader workforce is at an all-time low. Excessive attrition charges, mixed with a notion of inaction on workers suggestions and wellbeing, are resulting in burnout, recruitment challenges, and dangers to affected person security.
The style by which the workforce has been handled lately, as highlighted in a number of evaluations, has eroded belief and engagement. Proposals from the LNC to the Govt Group haven’t resulted in any significant change.
Selections made with out scientific enter have additional undermined confidence. Seen, empathetic management and energetic listening, as an alternative of the announcement of already made choices, are urgently required to rebuild morale and belief.
6. Data Know-how (IT)
Dependable IT programs are basic to secure and environment friendly care. Persistent system failures, outdated {hardware}, and the lack to make use of digital instruments successfully are immediately compromising affected person care and workers productiveness.
A complete overview and focused funding in digital infrastructure are urgently required.
7. Recruitment Freeze
The latest choice to freeze recruitment, following a year-long emptiness freeze, is deeply regarding. The acknowledged intention to scale back the workforce by round 350 posts to launch £4.2million by March 2026, with additional reductions to observe, was made with out session with the SMSC or LNC.
Such measures danger exacerbating burnout, disengagement, and poor scientific outcomes. Indiscriminate freezes are an unsustainable response to monetary pressures and fail to deal with the underlying causes of the fiscal disaster.
Proof from different settings reveals that these approaches can result in unsafe situations, antagonistic affected person outcomes, and demanding exterior evaluations.
8. Funding and Monetary Preparations
The Well being Board continues to ship tertiary and national-level companies inside an outdated and inequitable funding framework.
The present mannequin fails to seize the complexity and true value of contemporary healthcare supply. Present Joint Commissioning Committee (JCC) preparations entrench historic inequities and haven’t been topic to strong scrutiny.
The dearth of a coherent, evidence-based strategy to funding tertiary companies has left the Well being Board chronically underfunded, undermining service high quality, infrastructure, and long-term sustainability.
Sufferers ceaselessly transfer between Well being Boards, but funding not often follows them appropriately — and when it does, it seldom reaches the service offering the care.
In consequence, the Well being Board delivers tertiary and nationwide companies for quantities beneath marginal, not to mention precise, value.
Addressing this imbalance requires pressing motion from the Welsh Meeting, working collaboratively with Well being Boards throughout Wales to determine a good, clear, and sustainable funding mannequin that displays the true value of care.
Issues had been additionally raised about skilled behaviours inside some areas of senior and center administration.
The SMSC emphasised that addressing these points is important to make sure that all managerial leaders, like clinicians, mannequin professionalism, respect, and accountability.
In Abstract
The SMSC firmly believes that the problems outlined above are immediately affecting the standard and security of affected person care.
Our function in elevating them is to make sure that this basic precept, affected person security and high quality, stays on the coronary heart of all choice making.
We respectfully request that the Board and the Govt Group overview these issues and supply a written response inside two weeks.
We look ahead to working collectively. As senior clinicians we wish to work productively to strengthen the Well being Board and to ship the absolute best take care of our sufferers.
Thanks on your consideration.
Yours sincerely,
Chair, Senior Medical and Dental Workers committee; Co-chairs, Native Negotiating Committee.
You’ll be able to learn our report on the context across the scathing letter right here.
If you want to contact us about a problem we ought to be investigating, e mail us at conor.gogarty@walesonline.co.uk
