The Scale of Failure

In March 2025, the Welsh Government escalated DHCW to Level 3 — the highest tier of intervention — for "serious concerns about the organisation's ability to effectively deliver a number of major programmes." Nine programme areas were placed under formal scrutiny. This section examines each one.

1. Enterprise Architecture / National Target Architecture (NTA)

DHCW appointed Channel 3 Consulting — a private-equity-backed consultancy (£10m MBO funded by WestBridge Capital, Cardiff registered) — and Aire Logic (Leeds-based, employee-owned) to develop the National Target Architecture.

After nine months of Phase 1, only two reports had been delivered: a Current State report and an Initial Target State report. 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 producing strategy documents, not deploying systems. That it required Level 3 escalation to initiate is itself an indictment of DHCW's strategic capability.

2. NHS Wales App / DSPP

The NHS Wales App was conceived in 2021-2022 as a national patient-facing platform — the "digital front door" for every patient in Wales. As of early 2025, it was still in beta with approximately 1,000 users at ten GP practices — a negligible footprint.

By late 2025, DHCW claimed 345,000 registered users. No total programme budget or spend has been disclosed. At the January 2026 accountability meeting, the Deputy Chief Executive of NHS Wales, Nick Wood, delivered a devastating verdict:

"You could argue that the NHS app, from a patient perspective, is probably the most important digital development that we're likely to see... But it's been mired in delay, non-delivery."

He noted that the app only showed waiting time data for patients referred from December onwards — excluding the 653,000 people already on the waiting list. "People are clearly not adopting it, because it's not there for what they want it to be there for."

Sam Hall, Director for Primary Community Mental Health Digital Services, was unable to provide a timeline for when the app would reach critical mass. The Cabinet Secretary responded: "I'm not getting a great deal of confidence that we know what the critical path is for the app."

The CEO herself admitted: "I think that's a bit of a gap at the moment."

3. Connecting Care (replacing WCCIS) — £42M+

The single most financially damaging programme. The Welsh Community Care Information System (WCCIS), launched in 2015 as a 12-year programme, had consumed over £30 million by March 2022 with a further £12 million planned. By that point, only 15 organisations were live (13 local authorities, 2 health boards), with 6 yet to commit.

Audit Wales concluded the ambition 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.

An independent strategic review in early 2022 triggered a full programme reset and rebrand to "Connecting Care" in 2024. The business case for the replacement scope remains pending under Level 3 scrutiny.

Over £42 million committed with no prospect of full national adoption. The senior responsible officer was simultaneously serving as interim Chief Executive of another health board — a governance arrangement that divided accountability.

4. Data Architecture / National Data Resource (NDR)

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. The Programme Chair position was flagged as needing reassignment. Target date remains 2030 — effectively a decade-long delivery timeline from inception. No published budget or total expenditure figure has been found in public documents.

Chief Data Officer Rebecca Cook — who has spent approximately 19 years entirely within NWIS and DHCW — leads this programme. It is one of the programmes under Level 3 scrutiny. No formal academic qualifications are publicly disclosed for the person leading a programme intended to transform how Wales manages health data.

5. Radiology (RISP) — £47-56M

Contract awarded 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 by 2026.

Multiple health boards signed Local Deployment Orders. However, "setbacks were encountered due to changes in the supplier's implementation plan" and negotiations are ongoing. The supplier is not named in accessible public sources.

A £47-56 million contract encountering implementation setbacks within two years of award — before systems are deployed — is a significant risk to public money.

6. Laboratory Information (LINC/LIMS) — 8 years, one lab partially live

LINC 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 system was extended through June 2030 — thirteen years beyond initial deployment.

A revised approach deploys by discipline rather than by health board. 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 — Hywel Dda, for example, faces approximately £176,000 in extra costs for 2025/26.

Eight years of programme activity. One laboratory partially live. The original supplier contract terminated. No published total expenditure.

7. Primary Care — The Double Migration

This programme embodies wasted investment through directional reversal.

In 2018, EMIS lost preferred vendor status after a procurement evaluation, forcing roughly half of Welsh GP practices to switch to VISION. The migration generated significant GP complaints and RCGP 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 one system, then forced back to the other.

The total cost of both migrations combined has never been published. The waste is structural and considerable — not just the direct migration costs, but the disruption to clinical workflows, the retraining burden on GP practices, and the loss of confidence in DHCW's strategic direction.

The GP IT systems contract overall is valued at up to £80 million over 5 years (awarded 2022).

8. Digital Medicines / Electronic Prescription Service (EPS)

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. One million items dispensed by early 2025. Full rollout targeted November 2026.

Helen Thomas revealed in January 2025 that only 7% of GP practices were using e-prescriptions.

For context: England completed EPS implementation over a decade ago.

This is DHCW's strongest-performing escalated programme — and Wales remains a decade behind England on the same capability. When your best programme is a decade behind a direct comparator, the scale of failure across the portfolio comes into sharp focus.

9. Secondary Care / OpenEyes — £8.5M, seven years

The Welsh Clinical Portal (WCP) is an established system with incremental enhancements. However, the linked OpenEyes eye care digitisation programme demonstrates the pattern of failure at its purest.

• £8.5 million allocated from January 2020
• National rollout target of March 2021 — missed
• Revised deadline of March 2023 — also missed
• Full rollout now projected for early 2027 — seven years after funding commenced

CEO Helen Thomas was summoned to the Senedd Health Committee in May 2025 specifically on OpenEyes. DHCW executives conceded "there was a period where things didn't progress as they should." Thomas acknowledged that engagement with health boards "could have worked a lot better" — a significant understatement for a programme seven years behind its original timeline.

The cumulative picture

Nine programmes. All under Level 3 intervention. All under the same leadership.

When Thomas was asked at the January 2026 public accountability meeting what return the public had received on these investments, she replied: "We don't have an ROI on all of our investments." The only concrete benefit she could cite was £0.5 million in "equivalent savings" — not cash — from a single system.

Against several hundred million pounds in total expenditure.

Thomas then compared measuring digital ROI to measuring the value of electricity — arguing that accountability for outcomes is inherently impossible.

We disagree. And so, it seems, does the Welsh Government — which is why DHCW is under the highest tier of intervention.

All figures verified from Senedd proceedings, Audit Wales reports, Welsh Government written statements, DHCW annual accounts, and DHCW's own public accountability meeting of 29 January 2026. Sources cited on individual evidence pages.