Best Place to Work(-Related Stress) — Articles — Campaign for Responsible Leadership in NHS Wales

In 2022, Digital Health and Care Wales (DHCW) won the British Computer Society's "UK Best Place to Work in IT" award. The judges praised the organisation's commitment to diversity, inclusion, and career development. DHCW's CEO Helen Thomas called it "a real accolade for DHCW and the people who work here."

In 2024-25, DHCW was shortlisted again. It also retained the Gold Corporate Health Standard. It was recertified for the BS76000 Valuing People Standard. It won a Highly Commended Award for Equality, Diversity and Inclusion at the Healthcare People Management Association National Awards.

In the same year, stress and anxiety were the leading cause of lost working days at DHCW. Over half the workforce — 53.25% — took sickness absence. Long-term sickness had risen 59% in three years. Its own staff survey engagement score fell to 76%. The board, when told that sickness had reached its highest recorded level, took no action.

CareNHS has now analysed every DHCW board meeting transcript from April 2021 to March 2026 — 2.6 million words across 37 meetings. The pattern that emerges is not a workplace that declined. It is a workplace that was configured to fail from its founding, with every warning made, recorded, and then deleted from the public record.

This is the story of an organisation that collects wellbeing awards while its own people are breaking — and that systematically erases the evidence that they are.

The numbers DHCW publishes

DHCW reports its sickness absence rate at 2.9% as of March 2025, with a yearly average of 3.42%. Both its 2022-23 and 2024-25 annual reports use the same phrase: the rate "benchmarks very favourably across NHS Wales."

This comparison is structurally misleading. NHS Wales sickness absence rates are dominated by clinical workforces — nurses, paramedics, hospital staff — doing physically demanding shift work with high baseline sickness. DHCW is a desk-based IT organisation. Comparing its absence rate to frontline healthcare staff is like a software company comparing its injury rate to a construction firm. The benchmark DHCW should be measured against is other digital and technology employers. Against that comparator, a workforce where over half the staff are absent each year and stress is the leading cause of lost days is not a success story.

But 2.9% is the headline number. It is the number that wins awards.

The numbers behind the headline

The same annual reports contain a second set of figures — in the back pages, in tables that are rarely read.

	2021-22	2022-23	2024-25
Total days lost to sickness	8,684	10,999	15,846
Long-term sickness days	5,426	6,459	8,632
Short-term sickness days	3,258	4,540	7,214
Staff headcount	964	1,133	1,253
% of staff with absence	46.1%	53.8%	53.25%

Total days lost to sickness nearly doubled in three years — an 82% increase. Headcount grew approximately 30% over the same period. Sickness grew nearly three times faster than the workforce.

Long-term sickness — the kind that signals sustained psychological or physical distress — rose 59%, from 5,426 to 8,632 days. Short-term sickness more than doubled.
And the leading cause? DHCW's own 2024-25 annual report states it plainly: "the highest number of lost working days were stress and anxiety."

Not physical injury. Not seasonal illness. Stress.

(The 2023-24 sickness table is not included as the annual report for that year does not publish the same breakdown.)

The trajectory the board hid

The annual report figures above are snapshots. The board meeting transcripts — obtained through systematic transcription of every public DHCW board meeting — reveal the trajectory between them. Every milestone in this timeline was said at a board meeting. Most were deleted from the published minutes.

Month 2 (May 2021): The very first revenue surplus — £300,000 — is driven by vacancies. An independent member spots it immediately.

The mechanism is simple: the organisation has budget approval to hire staff, but delays or avoids filling those posts. The unspent salary money is then reported as a "saving." On the balance sheet it looks like financial prudence. On the ground it means fewer people doing the same work — or more. This is not an efficiency gain. It is a capacity cut disguised as a financial surplus.

Month 6 (September 2021): £456,000 underspend from vacancies at a workforce of 808. Staff appraisal completion rate reported red. The cumulative risk of running five major programmes simultaneously with the same staff was raised by an independent member — acknowledged, not acted on.

Month 8 (November 2021): Annual leave buyback approved.

Staff cannot take their leave due to workload. At seven months old, the organisation is already buying back untaken leave — the earliest measurable burnout signal. Deleted from the published minutes.

Month 13 (May 2022): Vacancy savings are now a planned budgetary strategy — designed into the financial plan, not an accidental windfall. The organisation has institutionalised not-hiring as a financial management tool. Entire finance report deleted from minutes.

Month 17 (September 2022): The board unanimously adopts "compassionate leadership" as a core value. Board members sign a values pledge. In the same meeting, the CFO acknowledges the vacancy position's dual nature: financial gain but delivery risk. "It's a prettier picture than it was last month."

The Chair warns that making "recurrent savings from non-recurrent" will "heap misery on misery every year." The Chair's warning is deleted.

The compassionate pledge is published.

Month 20 (November 2022): DHCW wins the BCS "Best Place to Work in IT" award. It is celebrated at the same board meeting where LIMS is flagged as highest corporate risk and service desk call abandonment exceeds target due to staff turnover. Savings of £2.5 million delivered through vacancy and pay efficiencies.

Month 24 (March 2023): Audit Wales warns that vacancy risks threaten staff wellbeing. The CFO admits the vacancy "hedge room is gone for next year." Entire finance report deleted from minutes.

Month 28 (July 2023): Vacancy savings have reached 84% of annual target by the end of the first quarter. The CFO admitted the organisation may "proactively not recruit." Deleted.

Month 32 (November 2023): Savings over-delivered at £5.2 million — £1.8 million ahead of plan — "really because of vacancies." The savings target is overshot while delivery targets are missed. Deleted.

Month 39 (July 2024): The board meeting that compressed five years of contradiction into a single afternoon. In a single session: a compassionate leadership pledge approved in under 15 seconds with zero questions. A staff survey showing 80% engagement celebrated as vindication. And — buried in the detail — 65% of staff reporting burnout or close to burnout.

The board secretary described the 65% burnout figure as a "benchmark" before the Building Our Future transformation programme. The People & OD Director departed after this meeting. The 65% figure does not appear in the published minutes.

Month 46 (January 2025): Sickness increase driven by stress and depression. £1.5 million savings target met through vacancy management.

Month 48 (March 2025): Level 3 escalation imposed. Samantha Morgan discloses that staff in some areas are at "burnout or close to burnout." Selway draws the explicit causal line: vacancy savings → reduced headcount → reduced delivery → escalation. Gardner: "We deliver things with thin air and... there's been no investment, it tends not to be monitored, measured, and declared a success."

Month 50 (May 2025): Sam Lloyd admits staff are "overworked" with "a high volume of change" and "a significant demand of work on top of that." Staff survey results are discussed only in private session — hidden from the public meeting. Neill's "initial disappointment and frustration" at escalation is rewritten by Copilot AI as "Positive Engagement."

Month 52 (July 2025): Burnout has increased by 3.9%. The specific figure is stripped from the published minutes.

Osmundsen-Little admits staff "can't finish at 5pm" — contractual working hours are fiction. Hall describes how work "expanded into the evening" during COVID and "it's almost become ordinary." Gardner warns the organisation is "stretching on knicker elastic." In the same meeting, compassionate leadership is cited as a staff survey "strength."

Month 60 (March 2026): Welsh Government mandates a recruitment freeze. The CFO has left. The most technically competent independent member has left. The organisation is at Level 4.

The vacancy savings machine that generated burnout from month 2 is now government policy. The compassionate leadership that was pledged at month 17 is cited as a strength at month 52 while the burnout it was supposed to prevent rises 3.9% — and the measurement is deleted from the record.

What the board was told

At the DHCW Board meeting of 25 January 2024, Claire Osmundsen-Little (Chief Finance Officer, deputising for the absent CEO) presented the Integrated Performance Report. The CEO and Medical Director had both sent apologies.

The report noted:

"Overall sickness has increased to the highest level this year, whilst short term sickness remains around the average there is a rise in long term sickness with 43 cases recorded during December and 35 in November."

Forty-three people on long-term sickness in a single month, in an organisation of approximately 1,200 at the time. That is roughly one in every twenty-eight employees.

The board's recorded response: "Received & Discussed."

The recorded action: "None to note."

What the awards don't measure

The BCS "Best Place to Work in IT" award is based on an employer application. The organisation describes its own workplace culture, policies, and employee programmes. Judges assess what the organisation tells them.

The award does not require independent verification. It does not survey employees directly. It does not cross-reference the application against the organisation's own sickness data, staff survey results, or exit interviews — because the award body does not have access to them.

DHCW won this award in 2022 — the same year that:

The Welsh Public Accounts Committee's 2018 finding that its predecessor was "the antithesis of open" remained unremedied
Long-term sickness days stood at 6,459 — already rising
More than half the workforce (53.8%) recorded sickness absence

The Gold Corporate Health Standard and BS76000 Valuing People certification follow a similar model: the organisation applies, presents evidence of its policies and programmes, and is assessed against a framework. The assessments measure whether policies exist — not whether the lived experience of employees matches what the policies promise.

Both the BCS workplace award and the BCS Fellowship through which Thomas obtained her FBCS credential rely on self-reported applications without independent verification. Neither is structurally capable of detecting the problems documented in this article. The BCS assesses what an organisation says about itself. The evidence in this article comes from what the organisation's own data shows.

What the staff surveys claim — and what changed

DHCW's 2023 internal staff survey reported that 80% of staff rated it an "excellent or very good place to work."

By 2024, the NHS All Wales Staff Survey — using standardised methodology across all NHS Wales organisations — showed DHCW's overall engagement score had fallen to 76%. DHCW itself acknowledged that the score "reduced slightly," attributing it to a trend affecting 10 of 14 NHS Wales organisations.

In the same 2024-25 annual report, DHCW claims 91.3% of staff "would feel secure raising a concern about unethical behaviour."

The charity Protect — the UK's whistleblowing advice line — reported in 2023 that 73% of people who contacted them experienced victimisation after raising concerns. When the national rate of whistleblower victimisation is 73%, a single organisation claiming 91.3% safety demands scrutiny, not celebration.

CareNHS is aware of at least two cases in which individuals who raised concerns about DHCW were subject to adverse consequences. One is now the subject of an Employment Tribunal claim that includes allegations of whistleblower detriment. Another former employee told this campaign she left the organisation because of "the toxic culture there." Neither case appears in DHCW's published whistleblowing data — because DHCW does not publish whistleblowing data.

What the people inside say

The board minutes and annual reports are public documents. Glassdoor reviews and anonymous submissions to this campaign describe the same workplace.

Glassdoor — DHCW holds a 4.2 out of 5 rating based on 39 reviews. The headline appears positive. The individual reviews do not:

"Horrendous culture of bullying with management sweeping any issues under the carpet."

"Bullying and micro managing... caused multiple staff to leave the team and the organisation."

"Petty politics and toxic environment."

"Vet middle and senior managers as much as they vet you in interview. If you have a bad one, you will be alone with no support whatsoever."

Anonymous submissions to this campaign describe the same patterns:

"The most toxic leadership system I've worked in"
"The toxic culture there" — from a former employee who felt she had to leave
A group of former senior digital health colleagues, all of whom have left or retired, who confirmed the site "mirrored our own experiences"
Staff forced to organise their own project funding, causing anxiety and the departure of the best employees
A team leader who suffered severe burnout and quit into early retirement

DHCW's own Executive Director of Operations, Sam Lloyd, confirmed the pressure at successive board meetings. In May 2025: "we're asking a lot of people. There's a high volume of change within the organisation... there's a significant demand of work on top of that."

Nine months later, in February 2026: "the workload is really high and continues to be, and we operate in a quite challenging environment." Neither admission appears in the published minutes. The condition is not a moment — it is persistent.

Glassdoor reviews are individual and unverified. Campaign submissions are anonymous. But the themes — management-perpetrated bullying, institutional indifference to complaints, staff departure as the primary coping mechanism — are precisely the patterns the Welsh Public Accounts Committee identified in 2018. The evidence page on toxic culture examines the full pattern.

The asymmetry

DHCW discloses its awards prominently. The 2022-23 annual report devotes a full section to workplace accolades. The 2024-25 report leads with the shortlisting. The Gold Corporate Health Standard and BS76000 are cited as evidence of organisational health.

DHCW does not publish:

Whistleblowing disclosure data (how many concerns were raised, and what happened to the people who raised them)
Disciplinary statistics
Exit interview findings or leavers analysis
Any breakdown of sickness by directorate, cause, or trend

The favourable information is amplified. The unfavourable information is suppressed. The result is an organisation that appears healthy from the outside — healthy enough to win awards — while the people inside it are, by its own admission, sick with stress.

The question for the award bodies

The BCS, the Gold Corporate Health Standard assessors, and the BS76000 certification body all rely on information provided by the applicant. None of them are known to have reviewed:

DHCW's sickness absence data showing record levels and stress as the leading cause
The Atos review showing 13.3% positive sentiment
The Welsh Government's Level 4 (Targeted Intervention) — the highest level ever applied to a non-health-board NHS body in Wales, imposed without public announcement
The Welsh Public Accounts Committee's finding that the predecessor culture was "the antithesis of open"
Multiple independent accounts from former staff describing a toxic, retaliatory workplace

If they had, would DHCW have won?

Sources: DHCW Board Meeting Minutes, 25 January 2024 (item 6.2); DHCW Annual Report 2024-25 (Sickness Absence section preceding Table 10; Table 10; Table 11; Great Place to Work section); DHCW Annual Report 2022-23 (Fig 17; Table 10; Awards section); Atos Stakeholder Review (obtained via FOI); CareNHS systematic analysis of 37 DHCW board meeting transcripts, April 2021 to March 2026, approximately 2.6 million words. All board meeting transcripts are from publicly broadcast meetings recorded by DHCW and published on its YouTube channel.

CareNHS invites responses from DHCW, the BCS, the Gold Corporate Health Standard assessors, and any individual or organisation named in this article. If received, we will publish them in full.