The Chair Who Walked Away: DHCW's Board, Two Months After the Annual Report

At half past three on the afternoon of 30 July 2026, Digital Health and Care Wales (DHCW), the body that took over the NHS Wales Informatics Service and its leadership in 2021, held its annual general meeting. It lasted 22 minutes.

The chair set the tone: the AGM was "an opportunity to focus on some of the achievements that we've had." Helen Thomas, who led NWIS before becoming DHCW's founding chief executive, said she was "delighted" to present the annual report, "reflecting on our achievements and challenges", and reminded the board that it "must be fair, balanced, and understandable", for which, as Accountable Officer, "I take personal responsibility." The medical director said the National Data Resource was "adding value everywhere." The operations director called DHCW "a learning organisation that's committed to continual improvement." The chair closed: "I think it's really clear that we can see how much we have achieved over the year."

In those 22 minutes, Targeted Intervention was named once, in passing, in a sentence about strengthening governance. Otherwise escalation appeared only as "requirements" DHCW had been "responding to". The Welsh Government's twenty-five published concerns, the independent review of DHCW's leadership and the intensive-care programme went unmentioned. Nobody asked a question. "I hope that's down to the clarity of the annual report and accounts," the chair said.

The annual report itself told the same story at greater length: 94 per cent of milestones delivered, "no significant control or governance issues", and Level 4 mentioned once in 231 pages, as "further scope to strengthen and improve how we work across the system."

On 24 September 2026 the same board met in public again. It was not a celebration. Over nearly four hours, DHCW's executives and independent members described an organisation whose intensive-care programme had lost its chair, whose plan for the year had piled up in its final quarter, whose staff were off sick at the highest rate in a year, and which was still waiting for decisions it could not make for itself.

None of it is secret. Both meetings were held in public, and DHCW publishes the recordings itself. Some of the most important parts of the September meeting were said in Welsh, and DHCW publishes no translation. This article sets the two accounts side by side.

The chair who walked away

The Welsh Intensive Care Information System (WICIS) is the system meant to support care in Wales's intensive care units. In the board's own words, from its medical director Rhidian Hurle, its purpose was "to utilise the scarce resource of intensive care beds, which are the most expensive and most vital part of care … It was a patient focused, clinically engaged programme."

It has a history. In 2024 an external review commissioned by the Welsh Government found the deployed system "not clinically acceptable in its current form". The programme was paused. The review was never published.

On 24 September the board's chair asked why it was still stuck: "I do struggle a bit with why we're still in the same position that we've been in for a year now on WICIS."

Helen Thomas, who led NWIS before becoming DHCW's founding chief executive, answered. Advice had been drafted for the minister, she said, but "I've got no update on whether it has actually gone up to the minister." There had been "an agreement in principle without the funding." Five health boards had agreed to support the next phase. Then: "the supplier's moved their squads onto new work. They've had to, they couldn't maintain that. And just earlier this week, the independent chair has written to me to say that she no longer feels that she is able to lead that program because … she's not seen any kind of signs of us being able to move it forward."

The independent chair, Thomas said, had executive experience and a nursing background, and had done "a tremendous job" bringing clinical leads together. "It is immensely disappointing, actually … it is a big risk for us."

The board's reaction is worth reading in full, because it shows where the room put the blame.

The vice chair, who chairs DHCW's Portfolio Delivery Committee, said the risk his committee had flagged "has materialized", and called for an escalation to the Welsh Government "which is basically you've taken far too long to make a decision. It's had an impact on the supplier's ability to deliver and the chair's ability to continue in post."

The strategy director, Ifan Evans, described a programme losing its grip: "we are now in a sticky position because of the time that has elapsed … the commitment is waning away, the chair stepping down is an example of that."

Hurle spoke for the clinicians: "The people involved in this have day jobs. They often give up their time. Not all of them are funded. And when things don't happen, they walk away. And it's very hard then to re-engage clinicians."

The chair's reply was the frankest line of the day: "I wouldn't blame the programme chair in the slightest for stepping down. I'm only surprised probably that she didn't do it sooner."

The Welsh Government's slowness is real, and DHCW is entitled to say so. But the board's account of WICIS began in 2025, with a funding decision. The programme's troubles began earlier, with a system an external reviewer judged not clinically acceptable, delivered by the organisation now asking the government to hurry. In the finance report later the same day, £3.83 million of capital for critical care was listed as still "subject to funding confirmation".

Ninety-four per cent, re-baselined

The annual report's 94 per cent was built on a plan that grew in-year from 345 milestones to 381, with milestones "reprofiled where necessary". The September board showed what the next year's plan looks like.

After the Welsh Government's pause and review of its digital investment fund, DHCW re-baselined its plan through August. The paper reporting the result gave a headline figure of 13 per cent of milestones affected. The vice chair said that number was "understating the impact that this has had on our ability to deliver", because most milestones relate to business as usual and the pause did not touch those.

The sharper figure was given in Welsh. Introducing the paper, Ifan Evans told the board (our translation from the Welsh-language recording) that 28 of the milestones in the core plan had changed, that "the risk is that the work has piled up in quarter four", and that "we now see that more than half of the milestones we have for the year are in quarter four", a number of them "already identified as milestones under pressure." That is a risk, he said, "to our confidence in delivery."

In English, a few minutes later, he called the pattern "out of pattern" and "significantly greater" than usual. The vice chair was blunter: "I'm really, really concerned about piling everything into quarter four … in my experience of doing this stuff in the private sector, that's just … a recipe for staff burnout."

Then came the only time in nearly four hours that anyone at the board talked about pride. Evans explained, first in Welsh and then in English, why plans pile up: "teams are keen to be able to deliver because they're proud of what they do. They're under pressure from stakeholders, they're under pressure from left, right, and center, they don't want to give up the things that they do. And so there's an optimism bias which is inherent in it, and that's one of the things that we need to challenge."

That is a candid description of how a plan becomes undeliverable. It is also, almost word for word, the Welsh Government's own finding of "optimism bias and late challenge", published in July and absent from the annual report.

The people paying for it

The annual report presented a stable, engaged workforce. The board heard from its staff partnership forum that two things had changed.

The recruitment pause imposed by the Welsh Government has no end date. The forum reported that it "is contributing to delivery pressures and staff morale concerns". Sickness absence had risen to "the highest level in the last 12 months, with increases in stress, anxiety, depression". And DHCW's investment in developing its staff stood at "around £785 per employee compared to an external benchmark of approximately £1,700."

The board reached for reassurance. One independent member offered "a point of context": the typical NHS sickness rate is "somewhere between 6.5 to 7%", and the board was told the latest NHS Wales figure was 6.3 per cent. But he prefaced it himself: "we are a very different NHS organisation." NHS averages are driven by ward staff on shifts, exposed every day to the infections their patients carry. DHCW is a largely desk-based digital organisation, and the fair comparison is with other office and public-sector work. Across the UK in 2025, the Office for National Statistics put the sickness absence rate at 2.0 per cent for all workers and 2.9 per cent in the public sector. DHCW's rate, reported to the board at around 4.2 per cent, is roughly double the national average, and the forum reported rises in stress, anxiety and depression, with a general feeling that the recruitment pause was "possibly what's contributing". Staff turnover, at least, has fallen. The people director's warning was plain: "our staff are very resilient … But I do worry that if this is prolonged, that that might become unmanageable." Asked how many staff are on fixed-term contracts that run beyond their programme funding, the interim finance director put it "in the region of 150", a figure he asked to be validated.

The recruitment pause also reached the National Data Resource, the flagship data platform. Evans told the board that during the first quarter DHCW "couldn't recruit and neither could we buy in the capacity", and that it had that day told the wider NHS of "a pause on new requests" to the platform.

The intervention, in the board's own words

The annual report reduced Level 4 to a single forward-looking sentence. The September board, to its credit, gave it an agenda item. The board secretary confirmed that DHCW was escalated on 8 April 2026 over "concerns around delivery, accountability and leadership", and that an independent well-led review is under way, with its report due to NHS Performance and Improvement "by the end of November."

Three details from that item matter.

First, the escalation meetings have stopped. DHCW last had an escalation board with the Welsh Government on 9 June. "No further escalation boards have taken place since moving to level four targeted intervention," the board heard, although "normally they would be scheduled to take place every two months." The reason given is that the independent review is in progress. An accountability meeting with the Welsh Government was due on 5 October.

Second, the organisation under intervention for leadership still has no permanent leader at board level. "There has been no update on the recruitment of a permanent chair for DHCW," the chair said. "That role should have interviewed by now, but has not."

Third, a risk was removed from the corporate risk register. The risk covering the funding pause and review came off, because, the board heard, "it's moved from a risk to understanding the implications and managing those as a board." Meanwhile the finance report put £13.5 million of programme funding at risk, most of it conditional on milestones and assurances the Welsh Government has yet to accept. Removing a risk once it has turned into a problem is a habit this campaign has documented before.

"Every June"

The board also heard about the data centre. The operations director, Sam Lloyd, pointed to the drop in availability from the outage in June, and the one in the June before: "I'm not sure what means we have incidents every June. Hopefully, there's not some repeating pattern there."

There is a repeating pattern, and this campaign has set it out in full: data-centre failures every year from 2021 to 2026. The independent member who chairs the Digital Governance and Safety Committee added another gap in Wales's resilience: the need "to plan nationally for a cyber security breach", something that, as far as he understood, "remains something that is simply not available to us yet."

What went well

The record deserves balance, and the board heard good news too. The NHS Wales App passed its year-end target of 350,000 users early, at 366,000. DHCW's service-management indicators were all green in August for the first time, with availability of 99.998 per cent. The finance director reported the organisation on plan, with savings on track. A GP from Cardiff showed how the Primary Care Information Portal helps practices find patients at risk earlier, at a software cost of about £55,000 a year. Three clinical incidents remained under review, some of them related to pathology and the new laboratory system, with no patient harm identified to date.

None of that is in dispute. The question is why the annual report told the public only that half of the story.

Lost in translation

DHCW is a bilingual organisation, and board members are free to speak Welsh, as they should be. The meeting offers live English interpretation to those joining on Zoom. The recording DHCW publishes on YouTube carries only the original audio, so anyone who doesn't speak Welsh and watches afterwards misses those sections. Ifan Evans delivered much of his strategic update in Welsh, including the paper on the impact of the funding pause, and the plainest statement of the quarter-four risk was made only in Welsh.

CareNHS recovered the Welsh-language sections of the recording and translated them. They include, alongside the quarter-four figure, Evans's description of the laboratory programme (LIMS) as "a very, very, very important programme" where "everyone knows it's challenging work". We have done this before, and it keeps turning up candour that never reaches the English record. DHCW could close this gap easily by publishing the interpreted English audio alongside the original.

Two stories

In July DHCW told its story twice, in a 231-page report and a 22-minute AGM: 94 per cent delivered, no significant governance issues, achievements celebrated, an intervention mentioned once in each. In September its board told a different one: a programme chair gone, a supplier gone, clinicians drifting away, more than half the year's work stacked into its last three months, staff at a twelve-month high for sickness, escalation meetings stopped and a permanent chair still not appointed.

The September version is closer to the truth, and it came from DHCW's own board. That is to its credit. But the annual report and its AGM are the version DHCW chose to present as its account of the year, and the board meeting is the one almost nobody watches.

The independent reviewers examining DHCW's leadership will report by the end of November. They will have both documents. They will have to decide which one describes the organisation Helen Thomas has led since it was created from NWIS.

The documents

• DHCW public board meeting, 24 September 2026: recording on YouTube (chief executive's report; committee highlight reports for the Local Partnership Forum, Portfolio Delivery Committee and Digital Governance and Safety Committee; strategic priorities update; impact of the DPIF pause and review; escalation update; finance report; performance report and corporate risk register). Quotations are transcribed from the recording and checked against the audio. Welsh-language passages are translated by CareNHS.
• DHCW, board papers for 24 September 2026, including the escalation status report (item 6.1).
• DHCW annual general meeting, 30 July 2026: recording on YouTube (22 minutes; posted 5 August 2026). Quotations checked against the audio.
• DHCW, Annual Report and Accounts 2025-26, signed 25 June 2026. See Deeper Into Delusion.
• Office for National Statistics, Sickness absence in the UK labour market: 2025, released 1 May 2026.
• Welsh Government, DHCW oversight and escalation framework, May 2026, published 9 July 2026.

Related pages

• Deeper Into Delusion: the annual report this meeting contradicts
• The Organisation That Cannot Learn: the data-centre failures, every year from 2021
• The Safety Case DHCW Made Against Itself: WICIS and the patient-safety record
• The Verdict Nobody Reported: the Level 4 framework and its 25 concerns

Digital Health and Care Wales is under Level 4 (Targeted Intervention) by the Welsh Government. CareNHS invites responses from Digital Health and Care Wales and the individuals named in this article on the matters that concern them. If received, we will publish them in full.