Financial Waste

DHCW's annual budget exceeds £78 million of public money. Over its operational lifetime, the organisation has channelled several hundred million pounds into digital programmes for NHS Wales. When challenged at a public accountability meeting in January 2026 to demonstrate what the Welsh public received in return, CEO Helen Thomas admitted: "We don't have an ROI on all of our investments."

The only concrete benefit she could cite: £0.5 million in non-cash "equivalent savings" from a single system.

This page documents where that money has gone.

1. The Aggregate Picture

Before examining individual programmes, consider the scale.

Identifiable programme costs approach £200 million:

Major costs that remain undisclosed:

The true total is substantially higher than the identifiable £189-198 million. Six of the nine Level 3 programmes have never published any expenditure figure at all. This is not an oversight — it is a pattern. An organisation that does not publish what it spends cannot be held accountable for what it wastes.

The £50 million commitment. In 2019, the Welsh Government announced a £50 million digital health investment to support DHCW's predecessor and the transition to a new organisation. How this money was allocated and spent has never been publicly broken down by programme. FOI-005 targets this directly.

Re-procurement waste. DHCW's programme portfolio involves cyclical re-procurement of systems and services — estimated at £20-28 million per year across the organisation. This is money spent on procurement exercises for systems that replace, renew, or re-tender existing contracts, rather than on new capability. The WPOCT programme exemplifies this pattern.

2. Programme Failures

Every major programme DHCW has attempted to deliver has experienced significant delay, cost escalation, or outright failure. In March 2025, the Welsh Government escalated DHCW to Level 3 (Enhanced Monitoring) of its five-tier 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.

The financial dimensions of each programme failure are summarised below. For full programme-by-programme analysis including delivery timelines, technical details, and leadership context, see The Scale of Failure.

Six of the nine Level 3 programmes have never published any expenditure figure at all. This is not an oversight — it is a pattern. An organisation that does not publish what it spends cannot be held accountable for what it wastes.

Governance transfers and discarded work. Two of the undisclosed-cost programmes — the NHS Wales App and Digital Medicines (EPS) — share a common history that compounds the waste concern. A source with direct knowledge of DHCW operations stated that both programmes were originally managed outside DHCW, with delivery led by external parties: Kainos for the App and commercial software suppliers and NHS England for medicines. He stated that DHCW's senior leadership "persuaded WG to let them take them over" and that "delivery against agreed timelines has stalled for both since." A separate anonymous submission alleged that the Kainos work on the App was "fully discarded and restarted by permanent staff" — if accurate, this would represent a direct destruction of public investment in externally delivered work. The cost of the Kainos engagement is captured in the FOI consultancy data but the cost of restarting the work from scratch — in permanent staff time, lost momentum, and delayed benefits to patients — has never been quantified.

For context: Northern Ireland deployed Epic — a unified electronic health record — across all five Health and Social Care Trusts under a contract originally valued at £275 million, serving 1.9 million people. England has committed £10 billion to NHS digital transformation by 2028/29 and reached over 90% EPR coverage. Wales has spent approaching £200 million in identifiable programme costs and has no national EHR, no timeline for one, and no demonstrated return on investment. The EHR decision now facing Wales is the most consequential spending question in the history of NHS Wales digital — and the organisation that will shape it cannot account for the money it has already spent.

3. Major Contracts and Procurement Transparency

Several major procurement decisions raise transparency concerns — not only individually, but as a pattern.

GP IT systems — up to £80 million over five years. Awarded in 2022 to Cegedim, EMIS, and TPP. 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 — NTA. The NTA contract value remains undisclosed, but FOI data reveals Channel 3 received £1.53 million across five DHCW contracts covering Digital Medicines (£649K), WCCIS (£374K), Mental Health Discovery (£300K), Community Solution Review (£110K), and Powys Cross Border (£98K). No competitive tender notice for NTA found. Channel 3 is private-equity-backed (WestBridge Capital £10M MBO). Nine months of Phase 1 produced two reports.

Promptly Health — £11 million. A patient outcomes contract awarded in 2024, with no publicly visible business case or procurement documentation. The irony is acute: an £11 million platform for measuring outcomes, commissioned by an organisation whose CEO admits she cannot demonstrate a return on investment.

RISP — £47-56 million. The supplier has never been publicly named. For a contract of this scale in Welsh public services, this is extraordinary.

Cisco HIMSS INFRAM assessment — value undisclosed. No published contract value or procurement notice identified.

Atos stakeholder engagement review — £207,100. The review found only 13.3% of stakeholders spoke highly of DHCW. Descriptors: "Slow," "Inconsistent," "Confused." The report was marked "for external use" but never published. It was obtained only through FOI. Audit Wales noted DHCW had only begun implementing the recommendations.

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.

The broader pattern is captured in FOI-046, which requests a complete list of all single tender actions and direct awards exceeding £100,000 since 2019. When non-competitive procurement is routine rather than exceptional, it indicates a procurement function that is not delivering value for money.

4. The ROI Admission

The inability to demonstrate value did not emerge in 2026. It was first flagged by the Senedd in 2023. When DHCW was asked in oral evidence in October 2022 whether £30 million spent on WCCIS represented value for money, the answer was: "that's quite a tricky question to answer in terms of the quantification of the benefits" (Joint Committee Report, July 2023, para 27). The committees cautioned against "over-optimism and a focus on celebrating successes at the expense of realistically assessing both what needs to be achieved and how the work agenda needs to be prioritised" (para 18). Three years passed. Nothing changed.

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.

Claire Osmundsen-Little, 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, 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."

5. Consultancy Classification

DHCW's 2023/24 annual accounts disclose only £0.757 million as "external consultancy" expenditure. A Freedom of Information request has now revealed 49 consultancy contracts totalling £8,943,015 with contract dates spanning 2019 to 2026 — substantially more than the single-year disclosed figure. Three firms alone — Gartner (£2.07M), Channel 3 Consulting (£1.53M), and KPMG (£1.28M) — account for £4.87M, more than half the total. Additional millions were spent on Kainos for the NHS Wales App, not captured even in the FOI data.

Part of the gap is explained by multi-year vs. single-year comparison and by accounting classification boundaries between "consultancy" and "programme expenditure." However, DHCW's own information governance team categorised all 49 contracts as consultancy in the FOI response. The public had no visibility of the true scale before this disclosure, which was itself admitted by DHCW to have been incomplete in its first iteration. See £8.94 Million on Consultants. Nine Programmes Still Failing. for the full analysis.

6. Executive and Senior Leadership Pay

DHCW's published annual accounts individually disclose remuneration for only a handful of board-level directors. The full cost of DHCW's leadership team is significantly larger than the accounts reveal.

Board-level directors (disclosed in annual accounts)

Senior leaders below the disclosure threshold

Several individuals hold director-level or "Chief" titles but are not board members, meaning their salaries are not individually disclosed in the annual accounts. This structuring has the effect — whether intentional or not — of hiding the pay of senior leaders from public scrutiny:

• Rebecca Cook, Chief Data Officer — holds a "Chief" title but is not board-level. Salary undisclosed. Has spent approximately 19 years within NWIS/DHCW. Described in tribunal documents as the CEO's protege.
• Chris Collis, Digital Transformation Lead — not a board member, no DHCW web profile, no Senedd appearances. Salary undisclosed.
• Sam Hall, Director of Primary, Community & Mental Health Digital Services — salary undisclosed. Unable to provide a timeline for the NHS Wales App at the January 2026 accountability meeting.
• Michelle Sell, Director of Programmes and Engagement — salary was individually disclosed at £90,000-£95,000 in the 2021/22 accounts, then vanished from subsequent years despite continued employment. Three different director-level job titles in four years.

Workforce growth without demonstrated benefit

Total revenue pay costs across the organisation reached £66.1 million in 2023/24. The full workforce trajectory: 675 staff in 2019 → 969 by March 2022 → approximately 1,200 by 2023 — a 78% increase over four years, roughly thirty times the NHS Wales average of 2.7%. The Senedd's July 2023 joint committee noted: "It was not clear to us which skills or departments within DHCW have been prioritised in the staffing increases" (para 59). Growth continued regardless.

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 responded: "That's obviously unsustainable. So, what's the organisation going to do to address that?" The CEO agreed: "Oh, yes."

Thomas's total remuneration of up to £215,000 (including pension contributions) has been 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 Level 3 (Enhanced Monitoring), and the only quantified benefit the organisation can cite is £0.5 million in non-cash time savings.

No DHCW director has faced any publicly visible consequence for the failure of any programme at any point.

7. Off-Payroll and Shadow Workforce

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.

Only one has been publicly identified: Stuart Davies, engaged through Hafod Interim Limited. The other 22 remain unnamed.

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 Level 3 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.

The Bottom Line

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.

What You Can Do

This evidence exists because someone looked. You can help make sure it leads to change:

• Write to your MS — ask what they will do about DHCW's failures
• Share this page — the more people who see this evidence, the harder it is to ignore
• Submit what you know — if you have evidence of waste, misconduct, or the suppression of concerns
• Support the FOI campaign — 54 Freedom of Information requests targeting DHCW's hidden data

Related pages:

• Nine Programmes, Zero Delivery — in-depth article on every failed programme
• What They Admitted — the CEO's own words on ROI and spending
• What They Don't Publish — the data DHCW keeps hidden
• The Shadow Workforce — 23 off-payroll workers costing millions
• Programme Delivery Reform — how to fix programme delivery
• Patient Safety — the human cost of these failures