Mission 2: Deliver high quality digital products and services

Good progress has been made in advancing the National Immunisation Framework (NIF) from discovery into Alpha. The indicative roadmap, submitted to the Welsh Government in August, outlines a programme of iterative development, led by the Welsh Immunisation System (WIS) with contributions from associated products and services.

Despite resource constraints, notable strides have been made in expanding the functionality and reach of WIS in support of the NIF’s strategic objectives. In July 2024, the deployment of the WIS Core Web App marked the commencement of a transition to a microservice architecture. This modernisation enhances the system’s ability to scale, supports agile development cycles, and underpins improved delivery of vaccination programmes across Wales.

Crucially, these technical developments have yielded tangible benefits for patients. By August 2024, WIS was fully configured to support the new Respiratory Syncytial Virus (RSV) vaccination programme, as well as the COVID-19 autumn booster campaign. This readiness enabled Wales to begin RSV vaccinations at the earliest feasible opportunity, reducing the risk of severe respiratory illness, particularly among infants and pregnant women.

As of June 10th, almost 100,000 people have been vaccinated with nearly 10,000 interventions in pregnancy — directly contributing to the prevention of RSV-related hospital admissions in vulnerable populations.

To facilitate prompt and sustainable delivery, a new automated primary care payment feature and post-payment verification process were introduced in September 2024. Designed to scale for future campaigns such as flu, this functionality ensures timely reimbursement for providers, supporting continuity of care and reducing administrative burdens across primary care settings.

The system’s ability to respond rapidly to unplanned requirements — such as those for RSV — alongside wider transformation and business-as-usual demands, reflects sustained investment in modern product development and DevOps practices. Test automation coverage exceeding 80% of the WIS codebase supported 14 successful releases in Q3 alone, enabling timely updates for RSV and COVID booster delivery. We are now entering a space where rapid and continuous delivery will help us support new policy in a timely manner and open new opportunities.

We have made numerous iterative releases to support the rollout of RSV and flu vaccine messaging to GP systems; Spring Campaign enhancements; and the implementation of new User-Centred Design (UCD) elements for central flu vaccine procurement. These releases represent a step towards a Single Vaccination Record, improving patient safety by reducing duplication and supporting informed clinical decision-making. The onboarding of Hywel Dda UHB to a centralised communications platform for letters, emails and SMS enhances patient engagement and ensures consistent, timely information delivery.

Simultaneously, efforts to consolidate childhood immunisation data have continued at pace. The integration of this data into the National Data Warehouse allows health professionals to access a comprehensive and secure source of immunisation records. This capability supports improved clinical care, strengthens national surveillance (e.g. for MMR2 uptake at age 16), and enhances the ability of Public Health Wales to provide timely, reliable uptake data — directly supporting efforts to prevent disease outbreaks and promote equitable access to vaccination.

These data-sharing improvements underpin a more responsive, preventive healthcare system. By facilitating accurate modelling, forecasting, and uptake monitoring, the enhanced system mitigates risks associated with viral spread, reduces unnecessary hospitalisations, and ultimately contributes to better health outcomes for patients across Wales.

The Connecting Care Programme, which succeeded the WCCIS Programme, is a national programme that manages the delivery of the CareDirector product, which enables the safe sharing of information between health and social care to deliver improved services and support for people in Wales. A single integrated health and social care record system was introduced to help social services (adults and children) and a range of community health services (including mental health, therapies and community nursing) to ensure that care and support for individuals, families and communities are more effectively planned, co-ordinated and delivered.

Since 2016, 16 local authorities and 5 health boards now utilise the CareDirector system. While the system may not have fully met the needs of all service users, it set a precedent for integrating information across health and social care services. The scope has since broadened to include initiatives aimed at creating national digital standards, promoting unified digital processes that can be applied across different systems. A programme is now underway to procure "best of breed" solutions for Mental Health, Community Health, and Social Care, so replacing CareDirector v5.

The programme faced challenges in establishing effective collaborative governance across this broad scope of services. It was agreed to devolve responsibility for social care delivery back to the local authorities and an exercise was run to design a new governance model for the programme’s work. This led to a separation of the business cases for Health and Social Care with initial versions being submitted to the Welsh Government in October 2024. Changes were requested to the Health Business Case after review in January, with the subsequent Business Case resubmitted in April.

The delay in the approval of the business case has led to significant budget constraints in financial year 2024–25 and moving forward in 2025–26. The challenges of creating a collaborative plan have led to delays in moving forward with procurement, so it was agreed that Betsi Cadwaladr University Health Board would progress with procurement as a pathfinder for other health boards for a mental health solution. DHCW has worked with all health boards to create a single set of national requirements for mental health and community applications. Betsi Cadwaladr University Health Board based their procurement on this national set.

Further progress has been made in the replacement of the CareDirector system in mental health, community health, and social care, as well as the development of digital and data standards across community and mental health. Working with service leads across Wales, national digital and data designs have been developed for mental health services and the specialist perinatal service. The designs follow the citizens’ pathway for a person accessing these services and they identify the data items to be collected at each point of the citizens’ journey.

The data is assured through the Welsh Information Standards Board (WISB) and the data requirements have been included in the national set of functional requirements as part of the replacement Mental Health system in Wales.

Key achievements include multiple updates to the existing CareDirector platform, agreement of a national set of functional requirements across community and mental health, the commencement of social care procurement across 18 local authorities, and the submission of an initial Outline Business Case for the future programme of work.

The WICIS is intended to collect real-time information from monitoring devices, pumps and respiratory equipment used in patient care. To provide frontline staff with easy access to vital data and insights, offering a quick and clear overview of patient and device statuses across the ward; and to replace all paper charts and hand-written observations of vital signs. With over 10,000 patients admitted to critical care in Wales every year, this digital system will help reduce the burden on frontline staff and will be integrated into NHS Wales digital systems, ensuring information is available when and where it is needed.

The planned go live at the Grange Hospital was delayed following testing locally. Subsequently, an independent review was commissioned by Welsh Government which found that changes were required to improve the system and programme governance before it could go live.

Following the review, a scope workshop took place, attended by all health boards to discuss potential ways forward. A high-level plan has been drafted to improve the system, introduce new governance arrangements and move the system from development into test and implementation. DHCW is working with Welsh Government and NHS Executive to agree the next steps.

Diagnostic services in Wales are facing challenges due to increasing demand, changes in clinical care, a lack of standardisation and scarce expertise. NHS Wales aims to improve service efficiency and effectiveness by reconfiguring services and providing diagnosis closer to the patient. Digital technology is being used to enhance service delivery, patient safety, communication, error rates, costs and data usage.

We are working to integrate new laboratory and radiology informatics solutions, expand electronic requesting functionality, and enhance the national availability of diagnostic results and reports. This means better access to test results, improving patient care and clinical safety. Better information sharing across boundaries and improved storage and distribution of imaging are also key goals.

Modern diagnostic imaging is essential for diagnosis and treatment in modern patient care. Radiology services are being provided in a wide range of healthcare settings across all health boards and trusts in Wales. In future, regional diagnostic hubs will expand the range of services provided outside of typical hospital environments.

The Radiology Informatics System Procurement (RISP) programme aims to procure and implement a new system that integrates picture archive and communication, patient dose management and radiology information management functionality. The integrated system will be rolled out across Wales by 2026. The Laboratory Information Management System (LIMS2.0) Programme supports delivery of a modern, sustainable and safe pathology service as part of the Pathology Statement of Intent. Both programmes transferred to DHCW from the NHS Wales Health Collaborative in January 2023.

The RISP programme is progressing, with all Health Boards and Trusts agreeing go-live dates. Due to a number of issues affecting the programme, the original timescales were unable to be met. We are working closely with the suppliers and the health boards to ensure the programme is delivered to the contractual deadlines. System integration testing began in October and data migration is progressing with most Health Boards approving the Penetration Test Report.

Public Health Wales went live in February, with further planning meetings taking place across health boards to ensure ongoing progress.

The WLIMS is the current laboratory system which will be replaced through the LIMS2.0 programme. It is a clinical IT system used by pathology staff across Wales to store, record and exchange information such as blood test results. The system also links to the machines that perform texts and analyse the samples.

WLIMS links to the Welsh Clinical Portal, allowing health professionals to see all previous tests conducted for a patient, and request new ones, no matter where they are in Wales.

This year, the Blood Transfusion part of the service went live in Swansea Bay University Health Board. This means blood transfusion data is now available across Wales for both laboratory and clinical staff, enabling a more joined up approach.

The LIMS2.0 programme is progressing and has made remarkable progress, however some milestones have slipped and as a result a mitigation plan has been developed to ensure deployment is complete by the end of November.

Digital Medicines combines programmes and projects that will deliver the benefits of a fully digital prescribing approach in all care settings in Wales. Responding to an Independent review, in September 2021 the Minister for Health and Social Services set out an ambition for a comprehensive digital medicines plan for Wales and asked Digital Health and Care Wales to establish the programme. The programme has four interconnected areas of work:

• Primary Care Electronic Prescription Service (EPS) Programme
• Secondary Care electronic Prescribing and Medicines Administration (ePMA) Programme
• Shared Medicines Record (SMR) Project
• Patient Access Project (NHS Wales App)

The Electronic Prescription Service (EPS) replaces paper prescription forms and enables GP practices to electronically send a prescription to a patient’s nominated community pharmacy/dispenser.

EPS is currently in use across all health boards and in 44 GPs practices, 281 Community Pharmacies and 3 Dispensing Appliance Contractors (DACs).

Similarly, another significant milestone was achieved in January 2025, where all Community Pharmacy Patient Medication Record (PMR) systems, with a footprint in Wales, completed assurance activities to start receiving digital prescriptions from GP practices.

Through the Patient Access Project and working in collaboration with the Digital Services for Patients and Public (DSPP) programme, “prescription ready” notifications have started to be sent to the NHS Wales App, informing patients when their medicines are ready from their community pharmacy. Software development is also nearing completion on a feature that enables patients to “nominate” a community pharmacy, via the NHS Wales App, to receive a prescription from a GP practice digitally using EPS.

It has been an important year too for the Secondary Care ePMA Programme, with six health board contracts now signed with their chosen ePMA supplier and each are now planning their hospital implementations. To support these plans, there was a well-attended national ePMA Collaborative Learning Network event in November 2024, where all health boards, Velindre University NHS Trust, DHCW, Welsh Government and ePMA suppliers came together to collaboratively work through challenges and to learn from other successful ePMA implementations. Readiness work is also continuing to integrate ePMAs with the national architecture, with the first go live planned for May 2025.

The Shared Medicines Record (SMR) project has delivered the platform for a comprehensive and consolidated medicines, allergies and intolerances record for every patient in Wales. Its Application Programming Interface (API) with GP Medicines, GP Allergies and Discharge Medicines capabilities, has been developed and made available for ePMA suppliers; allowing them to start testing the ability to read and reuse digitally recorded medicines, allergies and intolerances information without the need to transcribe from one system to another.

Overall, significant progress has been made in advancing electronic prescription and medication management initiatives. These efforts demonstrate an ongoing commitment to overcoming challenges and ensuring successful implementation for the benefit of patients and healthcare providers across Wales.

Choose Pharmacy helps community pharmacies provide services for patients and the public, freeing up GP appointments for people with more complex needs. It supports pharmacists in clinical decision-making and improves patient safety by offering:

• Accessible advice and support at a time and place convenient to local communities
• Digital templates which help to guide pharmacists through a patient consultation

The Choose Pharmacy Application has provided and supported the ability for community pharmacies across Wales to deliver 460,705 Common Ailments Consultations, which includes 53,158 Sore Throat Test and Treat Consultations and 12,321 Urinary Tract Infection Consultations.

Digital and technology solutions are at the heart of primary care and general practice service delivery. We provide primary care with a growing range of digital tools to help GPs and primary care contractors run their services – from appointment management to repeat prescriptions, chronic disease management, access to electronic referrals and laboratory testing, as well as access to patient records.

Since December 2023, DHCW primary care teams have been working closely with practices using Vision, to undertake a large-scale migration to the alternative supplier. This work has, to date, been taking place at a steady rate which prioritises clinical safety and minimises disruption to practices and patient services.

The parent company of INPS (suppliers of the Vision Clinical System used by 154 GP Practices in Wales as of December 2024) placed INPS in voluntary administration in December of last year. There was no warning that this action was imminent.

The impact of losing core GP systems to Primary Care and the wider healthcare system cannot be underestimated – this was registered as a corporate risk, shared with Health Boards. DHCW set up an Incident Management group with four work streams: Commercial and Legal, Communications, Operational and Technical. These groups worked with Administrators, colleagues across the other three NHS nations and a range of contingency options were prepared.

A new buyer was sought with a preferred buyer selected by the Administrator at the end of January 2025. DHCW teams have been working closely with all parties to ensure a smooth sales process, continuity of service and no disruption to practices or patients.

The Dental Access Portal provides a central platform for health boards to allocate places for routine dental treatment at NHS dental practices across Wales. DHCW designed and built the service which provides the Welsh Government, NHS Wales and partner organisations with a clear picture of the scale of demand for NHS dental services. The software has been delivered using the agile methodology, with a user-centred focus throughout the development.

Following a pilot in the summer of 2024 and staggered implementation, the DAP service is now available in all Health Board areas. Patients living in every area of Wales can use this service to request an NHS dentist for routine dental treatment.

The provision of Microsoft 365 to community optometrists and support staff aims to deliver a safe platform to meet business needs which can be exploited by future projects such as Electronic Referral Service and Electronic Patient Record.

Other benefits include:

• Access to NHS Wales Global Address List and potential reduction of any risks associated with the use of personal e-mail accounts (information governance)
• Access to Teams for chat and meetings (communication)
• Less delay when comparing to paper mail (efficiencies)
• Less chance of information being lost/not acted upon and easier to track (information governance/efficiencies)
• Having digital copies saves time converting paper to digital (efficiencies)
• Less paper usage (environment)

The rollout project has concluded, and user/site targets set by Welsh Government and achievement rate are detailed in the table below: