CareNHS — Campaign for Responsible Leadership in NHS Wales

What We Have Found

Nearly £200 million in identifiable programme costs, no demonstrable return, whistleblowers silenced, and leaders who cannot explain what went wrong. The evidence comes from their own words, in public, on the record.

The evidence we hold — gathered from direct professional experience, Employment Tribunal proceedings, public records, Senedd committee transcripts, Audit Wales reports, Welsh Government intervention letters, and DHCW's own public accountability meetings — paints a picture of an organisation in profound crisis. Not because of lack of funding, not because of inherent complexity, and not because of the hard-working staff who keep things running despite their leaders. The crisis exists because of the people at the top.

They waste public money on a breathtaking scale

In March 2025, the Welsh Government escalated DHCW to Level 3 — Enhanced Monitoring — for "serious concerns about the ability to deliver major programmes." Not one programme. Not two. Nine. Every major project DHCW is responsible for is under scrutiny, simultaneously, under the same leadership.

The numbers, verified from public records, are staggering. Identifiable programme costs alone approach £200 million — and the true total is substantially higher. Over £42 million committed to a social care system (WCCIS) with organisations trying to leave. £47 to £56 million on a radiology contract that hit implementation setbacks within two years. Up to £80 million on a GP systems contract that forced Welsh practices onto one platform, then forced them back to the other. £8.5 million and seven years on an eye care system that has missed two national deadlines and still isn't delivered. £11 million on a patient outcomes platform from an organisation that cannot measure outcomes. Eight years on a laboratory system with one lab partially live and the original supplier contract terminated. And six of the nine Level 3 programmes have never published any expenditure figure at all.

When asked at a public accountability meeting in January 2026 what return the public had received on its investment, CEO Helen Thomas admitted: "We don't have an ROI on all of our investments." The only concrete financial benefit the organisation could cite was £0.5 million in "equivalent savings" — not cash — from a single system. Against hundreds of millions in expenditure.

Alongside those programme costs, FOI data obtained in 2025 reveals that DHCW spent £8.94 million on 49 external consultancy contracts — for strategy, programme design, benefits realisation, and board development — across programme areas that are all now under Level 3 intervention. Three firms alone took over half. DHCW's published accounts disclosed just £757,000 in consultancy. The real figure, even before Kainos spending on the NHS Wales App is included, is substantially larger.

When challenged further, the CEO compared measuring digital investment returns to measuring the value of electricity and water — arguing that accountability is inherently impossible. We disagree.

They endanger patients

In July 2025, the Royal College of Physicians Cymru Wales and RCGP Cymru Wales issued a joint briefing demanding urgent action on digital fragmentation, warning that patients "regularly experience delays that lead to worsening health." DHCW itself acknowledged in its own documentation that the current digital environment "ultimately increases the risk of harm to patients."

The Welsh Patient Administration System (WPAS) — used in almost every hospital in Wales — has been identified by a Health Board as a factor in at least one patient death and is considered their single biggest risk to patient safety. The system connecting GPs to hospital care (WCCG) runs on technology unsupported for eight years, meeting no modern standard for cybersecurity or resilience. A catastrophic outage in the patient identity system mixed up patient records across Wales, with patients receiving wrong health communications and others missing invitations to life-saving treatments.

The Deputy Chief Executive of NHS Wales — not a critic, not a campaigner, but the senior government official responsible for NHS operations — described the national patient app as "mired in delay, non-delivery." The CEO herself admitted in January 2025 that NHS Wales systems were not ready for another pandemic.

These are not hypothetical risks. They are documented failures with real consequences for real people.

They silence those who speak up

In 2018, a Welsh parliamentary committee investigated DHCW's predecessor organisation and delivered a damning verdict: the culture was "the antithesis of open." Staff were "reluctant to be critical on the record." The committee felt it was receiving "pre-prepared lines" rather than honest testimony. They warned that this culture "may be masking wider and deeper problems."

Eight years later, every problem they feared has materialised. And the culture they described has not changed — it has been perfected.

We are aware of at least two senior employees — both holding significant technical leadership roles — who were allegedly dismissed after raising concerns about the very failures that the Welsh Government would later confirm. In one case, the employee's work device was allegedly confiscated. In both cases, the roles were downgraded after their departure.

DHCW adopted the Welsh Government's "Speaking Up Safely" framework, which guarantees protection for staff who raise concerns. In practice, those who speak up are removed. DHCW publishes zero data on how many whistleblowing disclosures it has received, what they concerned, or what happened to the people who made them. Zero disciplinary data. Zero leavers analysis. The policies meant to protect truth-tellers exist on paper and are violated in practice.

When the people raising the alarm are the same people being proven right — and the organisation's response is to remove them — we ask: what would you call that?

They promote friends, not talent

Critical leadership positions are filled with the CEO's proteges and allies — regardless of qualifications, track record, or the recommendations of interview panels. Multiple executive directors and senior managers have no publicly disclosed academic qualifications relevant to the work they oversee. The CEO's own credentials — a BCS fellowship, an honorary professorship, a "Digital CEO of the Year" award from a trade publication's inaugural ceremony — were all accumulated within 18 months, timed precisely to her appointment.

Ifan Evans, who wrote the Welsh Government's national digital health strategy as a civil servant, was subsequently appointed Executive Director of Strategy at DHCW — the role responsible for implementing it. He now marks his own homework. The degree subjects of his three degrees have never been disclosed.

Recruitment at DHCW rewards loyalty. Competence, vision, and the ability to deliver are not merely undervalued — they are actively treated as threats.

They build personal empires at the expense of the mission

Resources are allocated to pet projects and personal domains, not to the greatest need. The CEO's flagship programme — led by Chief Data Officer Rebecca Cook, who has spent approximately 19 years entirely within NWIS and DHCW — consumed tens of millions and dozens of data professionals while critical national systems starved for funding and attention.

DHCW's workforce grew by 78% in four years — from 675 at its predecessor in 2019 to approximately 1,200 by 2023 — roughly thirty times the NHS Wales average of 2.7%. The Senedd's joint committee flagged in July 2023 that it was "not clear to us which skills or departments within DHCW have been prioritised in the staffing increases." Growth continued regardless. When asked in January 2026 whether this expansion was matched by increased patient benefit, the CEO responded: "It would be lovely to sit here and be able to demonstrate the value." Future tense. She cannot point to results. Only a promise that results will come.

The organisation is run not for the benefit of those it serves, but for the benefit of those who run it.

They have built an organisation designed to avoid accountability

This is perhaps the most troubling finding of all. DHCW is not merely failing — it has arranged itself so that failure carries no consequences for those responsible.

Senior directors hold consequential titles — Chief Operating Officer, Chief Commercial Officer, Director of Programmes — while maintaining no public profile whatsoever. No LinkedIn. No web biography. No conference appearances. In at least one case, salary disclosures vanished from published accounts while the individual continued in a director-level role. Try to find the person responsible for programme delivery at an organisation under government intervention for programme delivery failures. You cannot.

At least 23 off-payroll workers earn £245 or more per day — likely £500 to £800 per day for senior interims — collectively costing an estimated £1.5 to £4.5 million per year. Not one is named in any public document. Not one has been called to any Senedd committee. They make operational decisions and spend public money, and no one outside DHCW knows who they are.

The identity of the independent digital expert appointed by the Welsh Government to assess DHCW under Level 3 escalation has never been publicly disclosed. Even the process of holding DHCW accountable is opaque.

And when DHCW itself commissioned an independent assessment — paying Atos Healthcare Consulting £207,100 for a stakeholder review in which only 13.3% of 292 respondents spoke highly of the organisation — it did not publish the findings. The report was marked "for external use." It was obtained only through a private citizen's FOI request. An anonymous account received by CareNHS states that the CEO presented the report internally as a triumph.

When you know your programmes are failing — because your most senior technologist is telling you — and you remove that person rather than listen to them; when you then present optimistic timelines to the Senedd that you know are unreliable; when you publish satisfaction metrics you know are contradicted by the lived experience of staff who've been punished for speaking; when you build an organisational structure where senior decision-makers are invisible, contract values are hidden, and whistleblowing data is suppressed — that is not a failure of judgement. It is a pattern of choices.

The evidence shows an organisation that knew what was wrong, silenced the people who said so, and continued to present a misleading picture to Parliament and the public. We leave you to decide what to call that.

And now they face the biggest decision of all

Wales must decide — within the next few years — how 3.2 million patients' health records will work for a generation. A national Electronic Health Record is the most consequential technology decision in the history of NHS Wales. England has committed £10 billion and reached over 90% EPR coverage. Northern Ireland deployed a unified system across all trusts. The organisation that will shape this decision for Wales has failed at every programme it has attempted, cannot demonstrate a return on any investment, and is led by people who have never delivered technology at scale. Read why this decision cannot be entrusted to the current leadership.

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The case for change: