Almost 1,500 ambulance workers across Wales are to go on strike for the second time in less than a month, with unions invited to discuss a one-off cash payment to break the deadlock.

Paramedics, emergency care assistants, call handlers and other staff will stage a major walkout on Wednesday, picketing at 19 locations including in Wrexham, Cardiff, Pembroke Dock and Llandudno.

It comes as strikes are also being held by ambulance staff across England.

GMB Union said workers with the Welsh Ambulance Service voted in favour of industrial action over the Government’s 4% pay award, which they described as “another massive real-terms pay cut”.

To end the dispute the union says it needs a concrete offer to help resolve the NHS’s recruitment and retention crisis.

It is understood the Welsh Government has invited health unions to discuss a one-off cash payment over and above the 2022-23 pay award, as well as a series of non-pay issues including agency staffing and employee welfare and wellbeing issues.

Members of the public have been asked to consider carefully what activities they take part in on the strike day and to only call 999 in a life-threatening situation.

Rachel Harrison, GMB national secretary, said: “GMB cancelled a planned strike over the Christmas period to say thank you to the public for their incredible support.

“It also allowed time for the Government to talk to us about pay, but ministers have dithered and postured, wasting valuable time.

“To end this dispute, GMB needs a concrete offer to help resolve the NHS’s crushing recruitment and retention crisis.

“The public expects the Government to treat this dispute seriously – it’s time they got on with it.”

Ambulance staff who are members of Unite the union are are also to stage 24-hour strikes over pay and staffing on January 19 and 23.

Unite announced the plan last week and said 88% of more than 1,000 members voted for strike action.

A Welsh Government spokesperson said: “We recognise why so many ambulance workers voted the way they did and the anger and disappointment many public sector workers are feeling at the moment.

“We will continue to work with the NHS, unions and partners to ensure life-saving and life-maintaining care is provided during the industrial action, patient safety is maintained and disruption is minimised.

“But it is vital that all of us to do all we can to minimise pressure on our health service during the industrial action and consider carefully what activities we take part in.”

Welsh health minister Eluned Morgan was criticised in the Senedd on Tuesday by Plaid Cymru’s Rhun ap Iorwerth after she said strikes had increased pressure on an already overburdened NHS.

Ms Morgan said investment had been made in June to help increase capacity in the ambulance service to deal with winter pressures, including the recruitment of 100 additional frontline staff.

After the Welsh Conservatives pointed out the Labour-led Senedd had been responsible for the Welsh NHS for 25 years, Ms Morgan added: “We have had 10 years of austerity that has starved us compared to what was previous to that and under Labour.

“That was a policy, a deliberate policy decision. That is part of the reason we’re in the situation we’re in today.

“Just in terms of how we compare to England, the Nuffield Trust tells us that we spend 5% more than England on health – that was pre-Covid – and 30% more than England if you include social care.

“We do that because we’ve got an older and sicker population.”

Mr ap Iorwerth accused her of only giving a “status update” on the NHS rather than a plan to improve it, adding: “This is not what people in Wales want to hear – where’s the action that shows that the Government is genuinely in crisis mode here?”

In an interview with BBC Wales, Ms Morgan called on the public to take more responsibility for their own health, warning the NHS may have to offer fewer services.

Welsh NHS waiting lists for planned treatments have decreased for the first time since the start of the coronavirus pandemic, according to new figures.

Ms Morgan revealed there were more than 500 confirmed patients with Covid in Welsh hospitals and still more than 900 people in hospital beds who are ready to leave. Sickness absence rates among staff have increased to 6.9%.