Financial Waste
Tens of millions on programmes that never delivered, contracts awarded without proper process, consultancies hired to duplicate internal work, and a CEO who admits she cannot show what the public got for its money.
Digital Health and Care Wales channels several hundred million pounds of public money over its operational lifetime. Its direct revenue allocation for 2022-23 was approximately £31.4 million, with an additional £9.3 million in capital funding. Revenue pay costs alone reached £66.1 million in 2023/24. Yet when challenged at a public accountability meeting in January 2026 to demonstrate the return on this investment, CEO Helen Thomas admitted: "We don't have an ROI on all of our investments."
This page documents where that money has gone.
1. Programme Failures with Costs
Every major programme DHCW has attempted to deliver — under the oversight of Director of Programmes and Engagement Michelle Sell — has experienced significant delay, cost escalation, or outright failure. In March 2025, the Welsh Government escalated DHCW to Level 3 — the highest tier of its intervention framework — citing "serious concerns about the organisation's ability to effectively deliver a number of major programmes." Nine programme areas were placed under formal scrutiny. As of December 2025, that escalation remained unchanged.
WCCIS / Connecting Care — £42 million and counting
The Welsh Community Care Information System was launched in 2015 as a 12-year programme to connect health and social care records across Wales. By March 2022, over £30 million had been spent, with a further £12 million planned. According to Audit Wales, only 15 of 29 target organisations were live, and the vision was "still a long way from being realised." At least two local authorities were actively seeking to exit their contracts. Organisations were paying service charges for functionality they did not use.
The programme was rebranded as "Connecting Care" in 2024 following an independent strategic review, but the underlying delivery problems persisted. The business case for the replacement scope remains pending under Level 3 scrutiny. Over £42 million has been committed with no prospect of full national adoption.
RISP (Radiology Informatics System Procurement) — £47-56 million
A contract awarded in November 2023 at £47.2 million — potentially £56 million with extensions — for a seven-year Master Services Agreement. The system is intended to integrate picture archiving, patient dose management, and radiology information across all Welsh health boards. However, according to DHCW's own reporting, setbacks were encountered due to changes in the supplier's implementation plan within two years of award. Negotiations remain ongoing. A contract of this scale encountering implementation setbacks so early represents a significant risk to the Welsh public purse.
OpenEyes — £8.5 million and seven years
£8.5 million was allocated from January 2020 for the OpenEyes eye care digitisation programme. The national rollout target of March 2021 was missed. A revised deadline of March 2023 was also missed. Full rollout is now projected for early 2027 — seven years after funding commenced. CEO Helen Thomas was summoned to the Senedd Health and Social Care Committee in May 2025 specifically to account for OpenEyes delivery. She acknowledged that engagement with health boards "could have worked a lot better" — a significant understatement for a programme running seven years behind its original timeline.
LINC/LIMS — Eight years, one lab partially live
The Laboratory Information Network Cymru started in December 2017. The original target was full LIMS deployment by December 2024 — missed. The contract with the original replacement system supplier was terminated. The legacy TCL2016 system was extended through June 2030 — thirteen years beyond initial deployment. As of July 2025, only a reduced-scope go-live in a single laboratory (PenGU, microbiology) had been achieved. DHCW is seeking £1.6 million in additional funding from Welsh Government; if not secured, individual health boards bear the cost. This programme has been running for eight years with one lab partially live.
Primary Care — double migration, cost unpublished
In 2018, EMIS lost preferred vendor status after a procurement evaluation, forcing roughly half of Welsh GP practices to switch to VISION — generating significant GP complaints and Royal College of General Practitioners retention warnings. The current programme reverses this entirely: all practices are migrating back to EMIS between 2024 and 2027, each requiring a 12-week planning programme. Welsh GPs were forced onto a system, then forced off it again. The total cost of both migrations combined has never been published, but the waste is structural and considerable.
National Data Resource — a decade of development, target 2030
The NDR remains aspirational with a 2030 target horizon, effectively a decade-long delivery timeline. An internal audit for 2024/25 identified active restrictions on the ingestion and use of some NHS Wales data due to perceived conflicts with Welsh Government policy — meaning the data resource cannot actually access the data it was designed to hold. Funding challenges emerged in late 2024-25, prompting plan reviews across all delivery partners. No published budget or expenditure figure has been found in public sources.
Electronic Prescription Service — a decade behind England
EPS went live across all seven health boards by October 2024. By May 2025, it was live in approximately 50% of community pharmacies but only 15-20% of GP practices. For context: England completed EPS implementation over a decade ago. In January 2025, the CEO disclosed that EPS had been activated by only 7% of GP practices and 19% of community pharmacies. This is DHCW's strongest-performing escalated programme, yet Wales remains a decade behind England on the same capability.
2. Major Contracts
Several major procurement decisions raise transparency concerns.
GP IT systems — up to £80 million over five years. Awarded in 2022 to Cegedim, EMIS, and TPP, this is the largest single contract in DHCW's portfolio. Its scale is rarely discussed in public governance forums relative to its cost.
Channel 3 Consulting / Aire Logic — National Target Architecture. After nine months of Phase 1, only two reports (Current State and Initial Target State) had been delivered by October 2025. Phase 2, with Channel 3 alone, runs to March 2026. No contract value has been publicly disclosed. No competitive tender notice appears on Find a Tender or Contracts Finder — the procurement route has not been published. This programme is essentially producing strategy documents, not deploying systems. That it required Level 3 escalation to initiate is itself an indictment.
Cisco HIMSS INFRAM assessment — value undisclosed. No published contract value or procurement notice identified.
Atos stakeholder engagement review — value undisclosed. Audit Wales's structured assessment noted DHCW had only begun implementing Atos's recommendations. The cost of the review has not been published.
Promptly Health — £11 million. A patient outcomes contract awarded in 2024. At this scale, it represents a significant commitment with limited public scrutiny of the business case.
3. The ROI Admission
The most revealing exchange at the public accountability meeting of 29 January 2026 concerned return on investment. When challenged on whether the hundreds of millions spent had produced measurable benefits, the following admissions were made on the public record:
Helen Thomas, CEO: "We don't have an ROI on all of our investments."
When pressed further, she offered an analogy: comparing measuring digital ROI to asking "what are the benefits of having electricity or having water available to run our services?" This framing — equating digital programme delivery with basic utility provision — effectively concedes that DHCW cannot demonstrate that its programme investments produce returns distinguishable from keeping the lights on.
Clare Smith, Director of Finance, cited the Welsh Nursing Care Record as having delivered £0.5 million in "equivalent savings." She then immediately qualified: "You will ask me, I know, is that cash on the table? No, it's not. But it is time saved." Against hundreds of millions in total expenditure across the organisation's lifetime, the only concrete financial benefit DHCW could point to was a non-cash time saving of half a million pounds.
A Welsh Government official present at the meeting stated bluntly: "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."
The Cabinet Secretary's follow-up letter of 12 February 2026 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."
4. Consultancy Classification
DHCW's 2023/24 annual accounts disclose only £0.757 million as "external consultancy" expenditure. This figure appears artificially low for an organisation that has engaged Channel 3 Consulting and Aire Logic for the National Target Architecture (value undisclosed), commissioned an Atos review of stakeholder engagement (value undisclosed), brought in Cisco for HIMSS INFRAM assessment (value undisclosed), and made extensive use of external advisory services across its programme portfolio.
The classification boundary between "consultancy" and "programme expenditure" may obscure the true scale of external advisory spending. When specialist strategic work is categorised as programme delivery rather than consultancy, the headline figure for external advisory spend can be made to appear modest even when the underlying reality is extensive reliance on external firms.
According to tribunal proceedings, DHCW has allegedly spent hundreds of thousands on external consultancies for analyses its own staff were better skilled and informed to produce. One alleged engagement involved an external consultancy delivering a multi-month strategic analysis that produced nothing usable — essentially collating internal presentations — with results so poor they were never shared internally. These allegations have not been independently verified from public sources.
5. Executive Pay
DHCW's most recent verified remuneration data (2023/24 annual report) shows:
| Role | Salary Band | Total Package (with pension) |
|---|---|---|
| Helen Thomas, CEO | £160,000 - £165,000 | Up to £210,000 - £215,000 |
| Rhidian Hurle, Medical Director | £160,000 - £165,000 | Up to £210,000 - £215,000 |
| Claire Osmundsen-Little, Finance Director | £130,000 - £135,000 | Not specified |
Total revenue pay costs across the organisation reached £66.1 million in 2023/24 — a figure that reflects a workforce that grew by approximately 25% from around 960 staff at creation in 2021 to approximately 1,200 by 2023. When asked at the January 2026 accountability meeting what patient benefit corresponded to this growth, CEO Helen Thomas replied: "It would be lovely to sit here and be able to demonstrate the value."
A Welsh Government official at the same meeting responded: "That's obviously unsustainable. So, what's the organisation going to do to address that?" The CEO agreed: "Oh, yes."
No performance-related bonuses were paid to current senior managers. Thomas's total remuneration of up to £215,000 (including pension contributions) is paid throughout a period in which every major programme under her leadership has failed to deliver on time, the Welsh Government has escalated the organisation to its highest intervention tier, and the only quantified benefit the organisation can cite is £0.5 million in non-cash time savings.
6. Off-Payroll Costs
DHCW's 2022-23 staff report disclosed 23 highly-paid off-payroll workers earning £245 or more per day. Of these, 11 had been engaged for 1-2 years and 2 had been engaged for 2-3 years. These individuals are not named in any public accountability register, do not appear in board listings, and are not disclosed to the Senedd.
At £245/day minimum — though senior NHS IT interims commonly command £500-800 per day — these 23 individuals collectively cost the organisation an estimated £1.5 million to £4.5 million per year. They operate through personal service companies and are classified as procurement expenditure rather than staff costs, placing them outside the standard NHS workforce accountability framework.
In addition, the organisation spent £1.657 million on agency and temporary staff in 2023/24. When combined with the off-payroll contingent and the formally disclosed consultancy spend, the total external workforce cost significantly exceeds the headline consultancy figure of £0.757 million.
For an organisation under the highest tier of government intervention, with documented failures across every major programme, the presence of a substantial shadow workforce that operates below the threshold of public visibility raises fundamental questions about who is actually making operational decisions — and whether those people are accountable to anyone.
Source Note
All figures cited on this page are verified from Senedd proceedings, Audit Wales reports, Welsh Government written statements, and DHCW's own public accountability meeting of 29 January 2026. Where claims derive from Employment Tribunal proceedings rather than public records, this is explicitly stated. Financial figures are drawn from DHCW's published annual reports (2022-23 and 2023-24), Audit Wales audit opinions, and Welsh Government contract records.