BMA SAS Doctors BMA SAS Doctors

Restoring pay for SAS doctors in Wales

Specialists, associate specialist and specialty doctor pay in Wales has dropped by nearly a third in real-terms over the last 15 years. Whilst waiting lists continue to be high, now more than ever we need to restore pay to retain and attract to the SAS workforce and protect the integrity of our profession.

Where we are currently

In February 2023, the Welsh Government committed to the principle of full pay restoration back to 2008 levels. However, during pay negotiations in August for 2023/24, the first and final offer the Welsh Government made was to uplift pay for those on the 2008 SAS contract by just 5% and for those on the 2021 contract by 1.5% in addition to the multi-year pay uplift already received due to contract reform. This represents another real terms pay cut for SAS doctors on both contracts and was the worst offer in the UK. The offer was even below the recommendation of the pay review body for doctors and dentists (the DDRB).

We cannot allow the pay of hardworking SAS doctors to erode further. We rejected this offer and, with no other offer on the table, we felt our only choice was to ballot members for industrial action.

The ballot closed on 4 March with members voting in favour of taking industrial action and a 48-hour strike called commencing on 16 April 2024.

As a result of sustained pressure from three round of junior doctor strikes and the looming action from senior doctors, the chairs of Welsh SAS committee, Welsh consultant committee, and the co-chairs of the Welsh junior doctors committee met the first minister of Wales, Vaughan Gething and the cabinet secretary for health, Eluned Morgan. During this meeting, all three groups of secondary care doctors were invited to enter negotiations to resolve their separate pay disputes. 

The first minister has pledged new funding towards these negotiations. We were assured that this funding is a significant investment that will form a strong basis for productive pay discussions.  

We have now formally agreed to enter negotiations with the Welsh Government. To allow time and space for negotiations to take place, we have made the decision to suspend the 48-hour strike action which was planned to take place between 7am Tuesday 16 April and 7am Thursday 18 April.

We retain a mandate to call for strike action if negotiations are stalling and it is vital that you should remain ready to take strike action if necessary.

Read our guidance on taking strike action.

Ballot results

SAS doctors in Wales have voted in favour of taking industrial action over pay.


  • Number of individuals who were entitled to vote in the ballot: 477
  • Number of votes cast in the ballot: 276
  • Votes cast in the ballot as a % of individuals who were entitled to vote: 57.86%
  • Number of spoilt or otherwise invalid voting papers returned: 1

Result of voting

  • Yes: 259 (94.18%)
  • No: 16 (5.82%)

Why we need full pay restoration

Since 2008/09, our basic pay has experienced a real terms (RPI) pay cut of up to 29.6%.

In 2022/23, despite the Welsh Government providing an additional uplift and making a commitment to the principle of full pay restoration, our pay still continued to erode in real terms. Once again in this pay year (2023/24) the offer to us was sub-inflationary. For those on the 2008 contract the offer was to uplift our pay by 5% and for those on the 2021 contract, due to the uplift already in place as part of the multi-year pay deal, it was just 1.5%. These sub-inflationary uplifts will only increase our pay erosion further.

The real terms reduction in our pay is devaluing SAS roles. We know that it’s making more SAS doctors retire early, reduce hours or consider moving overseas. To put it plainly, it’s making the role of a SAS doctor less appealing to those already in the role and for those who might consider a SAS career in the future. With the number of patients waiting to start treatment in Wales nearly three times higher than it was in 2009*, we need to take a stand now to prevent the further devaluing of SAS roles and ensure a strong SAS workforce to support the NHS in Wales. That’s why we’ve called for a ballot of SAS members in Wales.

*Number of patients waiting to start treatment in October 31 2009 was 224,717. Number of patients waiting to start treatment in August 2023 was 760,285. Data from StatsWales on Patient pathways waiting to start treatment by month.
Data source

How have we reached this point?

As shown in the below graph and table, due to sub-inflationary pay uplifts, over the last 15 years our pay has steadily eroded to the point where we have now experienced up to a 29.6% real terms pay cut.

Pay negotiations with Welsh Government

February 2023

We joined additional last-minute pay talks alongside other health unions, where the Welsh Government offered to increase the 2022/23 pay uplift from 4.5% to 6% and provide a one-off payment of 1.5%. These talks were to avert further strike action from other health unions. At that point, the BMA was not in a trade dispute with Welsh Government. As part of this, the Welsh Government also committed to the principle of full pay restoration to 2008 levels.

Although this pay award did not go anywhere near restoring SAS doctors’ pay, we made the decision to vote to accept this offer. We did so because we were nearing the end of the 2022/23 pay year and because the Minister agreed as part of the offer to enter immediately into pay talks for 2023/24. We did not feel this would stymie our campaign for SAS pay restoration going forward and felt members could benefit from receiving additional pay in the 2022/23 pay year.

April 2023

We were invited to attend pay talks for the 2023/24 pay year.

May 2023

We made internal preparations to enter pay negotiations with the Welsh Government.

July 2023

Alongside colleagues from the other secondary care branches of practice, we entered pay talks with the Welsh Government. Government officials attended but with no pay envelope in which to negotiate, noting that a cabinet meeting was still required to consider this. We used the opportunity to outline the importance of providing a fair pay offer to doctors and of restoring pay to 2008/09 levels.

August 2023

Pay talks resumed. The Welsh Government provided an opening and final offer of 5% for SAS doctors on the 2008 contract, and 1.5% for those on the 2021 contracts in addition to the existing multi-year pay deal. This was the worst pay offer for SAS doctors in the UK and was below even the DDRB recommendation for 2023/24. Our negotiation team withdrew from talks on the basis that no credible pay offer was on the table.

WSASC held an extraordinary meeting to consider the pay offer and unanimously decided to ballot members on taking industrial action. 

The BMA’s UK Council then considered and approved the WSASC application to ballot for industrial action.

September 2023

We wrote to the Welsh Government confirming BMA UK Council approval for balloting and making clear our willingness to come back to the negotiation table if a credible pay offer was made.

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