Nine Programmes, Zero Delivery: The Full Scale of Failure

Digital Health and Care Wales manages nine Level 3 programmes — the most significant digital investments in NHS Wales. Not one has been delivered on time. Not one has been delivered on budget. Not one has produced a published, independently verified return on investment.

This article examines each programme individually: what was promised, what was spent, and what Wales has received. Every figure is drawn from public records — board papers, Senedd committee evidence, Audit Wales reports, Welsh Government correspondence, and DHCW's own published documents.

The nine programmes at a glance

1. NTA / Enterprise Architecture

What it is: The National Technical Architecture programme, intended to define the overarching technical framework for NHS Wales digital services.

Who is delivering it: Two consultancy firms — Channel 3 Consulting and Aire Logic — were engaged for Phase 1.

Channel 3 Consulting is a private-equity-backed firm based in Cardiff. In 2021, its management completed a reported £10 million management buyout supported by WestBridge Capital. Aire Logic is an employee-owned consultancy headquartered in Leeds.

What has been produced: Nine months of Phase 1 activity resulted in two reports. The contract value has not been disclosed publicly. No competitive tender notice for this engagement has been identified on Find a Tender or Contracts Finder, the UK government's official procurement portals.

What it means: Wales is paying undisclosed sums to external consultancies to produce architecture documents for an organisation that has existed in some form since 2003 (as NWIS) and employs approximately 1,200 staff. The question is not whether external architecture expertise is sometimes necessary. The question is why, after over two decades, the organisation does not possess this capability internally — and why the cost of acquiring it externally is not being disclosed.

2. NHS Wales App

What it is: A citizen-facing mobile application intended to give Welsh residents access to their health information, appointment management, and other NHS services.

Timeline: Conceived 2021-22. By early 2025, it was in beta with approximately 1,000 users across 10 GP practices. By late 2025, DHCW claimed 345,000 registered users.

What was said at the accountability meeting: Nick Wood, Deputy Chief Executive of NHS Wales, described the App in unambiguous terms:

"[The NHS Wales App has] been mired in delay, non-delivery."

— Nick Wood, Deputy Chief Executive, NHS Wales, DHCW Public Accountability Meeting, January 2026

"People are clearly not adopting it, because it's not there for what they want it to be there for."

— Nick Wood, Deputy Chief Executive, NHS Wales, January 2026

Sam Hall, Director at DHCW, was asked when the App would reach critical mass:

"I think it's really hard to put a time point on when we'll hit that critical mass."

— Sam Hall, Director, DHCW, January 2026

The Cabinet Secretary responded:

"I'm not getting a great deal of confidence that we know what the critical path is for the app."

— Jeremy Miles, Cabinet Secretary for Health and Social Care, January 2026

The exclusion: 653,000 people on NHS Wales waiting lists are excluded from the App's data. The citizens with the greatest need for visibility into their care journey cannot use the App for that purpose. Registration numbers are meaningless if the service does not serve the people who need it most.

Budget: No total programme budget has been published.

3. Connecting Care (WCCIS)

What it is: The Welsh Community Care Information System, a shared record system for health and social care. Rebranded to "Connecting Care" in 2024.

Cost: Over £42 million. Audit Wales reported that £30 million had been spent by March 2022. A further £12 million was planned.

Timeline: Launched in 2015 as a 12-year programme.

Status: 15 organisations are live on the system. Six remain uncommitted. Two are actively seeking to exit. The programme has not achieved its core ambition of universal adoption across Welsh health and social care.

Audit Wales assessed the programme directly:

The ambition of WCCIS is "still a long way from being realised."

— Audit Wales

What it means: Eleven years in, with over £42 million spent, the system that was supposed to unify Welsh community care records is being abandoned by some of the organisations it was built to serve. The 2024 rebrand to "Connecting Care" changed the name. It did not change the trajectory.

4. NDR / Data Architecture

What it is: The National Data Resource, intended to create a unified data platform for NHS Wales.

Cost: No budget has been published.

Target: 2030.

Status: An internal audit found that active restrictions had been placed on data ingestion — the core function of a data platform — due to perceived conflicts with Welsh Government policy. Funding challenges were reported in late 2024-25.

Leadership: The programme is led by DHCW's Chief Data Officer, who has spent approximately 19 years entirely within NWIS and then DHCW. This is not inherently disqualifying, but it is relevant context when assessing whether the organisation has access to sufficiently diverse perspectives on data architecture — a field that has been transformed several times over during that period.

What it means: The national data platform cannot ingest data. Its target date is four years away. Its budget is undisclosed. Its leadership has operated entirely within the institution it is supposed to be transforming. This is the programme that is supposed to underpin the entire digital future of NHS Wales.

5. RISP / Radiology

What it is: The Radiology Informatics Strategic Programme, procuring a new radiology information system for NHS Wales.

Cost: £47.2 million, with potential extensions bringing the total to £56 million. The contract was awarded in November 2023 under a 7-year Master Service Agreement.

Status: DHCW's own reporting has acknowledged "setbacks encountered due to changes in the supplier's implementation plan." The supplier has not been publicly named in DHCW's programme updates despite the scale of the contract.

What it means: This is the single largest disclosed contract in DHCW's portfolio. It was awarded less than three years ago and is already encountering implementation setbacks driven by the supplier's own changes. The Welsh public is entitled to know which company holds a contract worth up to £56 million of their money, and why changes to the supplier's plan are causing delays to a programme that serves every radiology department in Wales.

6. LINC / LIMS

What it is: The Laboratory Information Network Cymru — a replacement for legacy laboratory information management systems across NHS Wales.

Timeline: The programme started in December 2017. The original target was full LIMS deployment by December 2024.

Status: The December 2024 target was missed. The original supplier contract was terminated. The legacy system has been extended to June 2030. After over seven years of programme activity, one laboratory is partially live — PenGU, running microbiology only. DHCW is seeking an additional £1.6 million from the Welsh Government.

What it means: A programme that began in 2017 with a 2024 delivery target has, by early 2026, produced one partial deployment in one laboratory for one discipline. The original supplier relationship failed. The legacy system — which the programme was supposed to replace — now has a longer remaining lifespan than the replacement programme has had to date. Wales's laboratories continue to rely on ageing infrastructure while the programme that was supposed to modernise them requests yet more public money.

7. Primary Care (GP Systems)

What it is: The programme to provide and manage GP clinical systems across Wales.

The reversal: In 2018, EMIS — then the dominant GP system provider — lost its preferred supplier status. GP practices across Wales were required to migrate to VISION, the alternative system. The current programme reverses this decision entirely: all practices are being migrated back to EMIS between 2024 and 2027, at a rate of 12-week planning periods per practice.

Cost: The GP IT contract is worth up to £80 million over five years. The cost of the original forced migration to VISION has never been published. The cost of the current reverse migration back to EMIS has never been published. Wales has therefore funded two migrations — in opposite directions — within the space of approximately six years, with no published accounting for either.

What it means: GP practices were told to move to VISION. They have now been told to move back to EMIS. The disruption to practices, the cost to the public purse, the lost productivity, the clinical risk during transitions — none of this has been quantified or published. This is not a technology decision. It is a policy failure that was imposed on general practice twice.

8. EPS / Digital Medicines

What it is: The Electronic Prescription Service, enabling digital transmission of prescriptions between GPs, pharmacies, and dispensers.

Status: The service went live across all seven health boards by October 2024. By May 2025, approximately 50% of community pharmacies and between 15% and 20% of GP practices were using it. However, at the January 2025 accountability meeting — just months earlier — the CEO stated that only 7% of GP practices were live.

Context: England completed the rollout of its Electronic Prescription Service over a decade ago. Wales's service is live but far from universal, with the majority of GP practices still not using it as of the most recent published figures.

What it means: Electronic prescribing is not an experimental technology. It is mature, proven, and operational across the border. Wales began late and is rolling out slowly. The gap between 7% (January 2025) and 15-20% (May 2025) suggests acceleration, but even the higher figure means that four in five GP practices in Wales were not using digital prescriptions as of mid-2025. Every paper prescription that could have been electronic represents an avoidable inefficiency and a preventable source of error.

9. OpenEyes

What it is: An open-source electronic patient record system for ophthalmology, intended to replace paper records across Welsh eye care services.

Cost: £8.5 million from January 2020.

Timeline: The original delivery target was March 2021. That was missed. The revised target was March 2023. That was missed. Full rollout is now projected for early 2027 — six years after the original target.

Accountability: In May 2025, the CEO was summoned to the Senedd to give evidence on OpenEyes. She admitted that engagement with clinical staff "could have worked a lot better."

What it means: A programme funded in January 2020 with an 18-month delivery target is now projected to take seven years. The budget was £8.5 million. No updated total cost has been published. The CEO has acknowledged that the organisation failed to engage properly with the clinicians who would use the system — a failure so fundamental that it calls into question how the programme was approved in the first place.

The total picture

Nine programmes. Several hundred million pounds of public money, with significant portions undisclosed. Not one delivered on time. Not one delivered on budget. Not one with a published, independently verified return on investment.

When the CEO was asked to quantify the return on this expenditure, she said:

"We don't have an ROI on all of our investments."

— Helen Thomas, CEO, DHCW Public Accountability Meeting, January 2026

The only quantified benefit cited at the accountability meeting was approximately £0.5 million in non-cash "equivalent savings" from the Welsh National Care Record — time saved, not money released. Clare Smith, Director of Finance, acknowledged this directly:

"You will ask me, I know, is that cash on the table? No, it's not. But it is time saved."

— Clare Smith, Director of Finance, DHCW Public Accountability Meeting, January 2026

Half a million pounds of notional savings. Against several hundred million in expenditure. In an organisation of 1,200 staff. Delivering nine programmes, none of which are on track.

A Welsh Government official at the same meeting offered the clearest assessment:

"There is a tipping point where, actually, if we have delays and reprofiling, the benefits reduce... the benefits might be zero by the end. If we'd have known that, we'd have never started."

— Welsh Government official, DHCW Public Accountability Meeting, January 2026

And in February 2026, the Cabinet Secretary confirmed:

"The organisation remains some distance from being able to consistently quantify return on investment, articulate realised benefits across Wales or demonstrate the scale of digital investment is matched by measurable improvements for citizens and clinicians."

— Jeremy Miles, Cabinet Secretary for Health and Social Care, letter to DHCW, February 2026

These are not the words of campaigners. These are the findings of the Welsh Government, its auditors, and DHCW's own leadership. The programmes are failing. The money is being spent. The benefits are not materialising. And the people of Wales are paying for all of it.

All figures, timelines, and quotations in this article are sourced from DHCW board papers, Senedd committee evidence, Audit Wales reports, Welsh Government correspondence, and the DHCW Public Accountability Meeting of January 2026. A full source index is available on request.