Mission 3: Expand the digital and care record and the use of digital to improve health and care

User-centred design (UCD) is the approach of creating products and services with users, rather than for them. This methodology prioritises understanding users' behaviours, preferences, needs, and concerns through direct engagement. It ensures that users are involved throughout every stage of the design and development process—not just at the beginning or the end of delivery.

UCD is critical to the success of all products and services. Products and services that fail to resonate with users deliver no value and achieve no benefits. By fostering partnerships with users, UCD challenges assumptions about their needs, reduces waste and risks, optimises delivery costs, and lowers the need for user support. Moreover, it enhances engagement and drives adoption.

The UCD Working Group that was established in November 2023 has now been repurposed into the UCD Community of Interest, as a mechanism for sharing best practice and showcasing the benefits of UCD with our network of UCD ambassadors. A UCD Community of Practice has also been set up for those who are practitioners in UCD professions. The Community of Practice has established a backlog of activities that includes the creation of a standardised toolkit, learning and career pathways, and the development of a design system. The newly appointed Head of User-Centred Design took up post in March 2025 and has converted the UCD roadmap into an action plan, developed UCD principles for the Technical Design Authority and has been meeting with product and programme leads to discuss their UCD needs.

The NHS Wales Microsoft 365 Centre of Excellence enables all NHS Wales organisations to share a single M365 tenant with more than 125,000 active users, underpinning national collaboration and realising significant cost avoidance. Working collaboratively across organisations, the CoE facilitates weekly changes to M365 to maintain and increase security, as well as functionality enhancements to the familiar Office products such as Teams, Outlook, Word, Excel and many others.

The M365 CoE is a multi-disciplinary capability, working across the full range of M365 technologies, to support organisations to maximise the benefit of the investment in M365 licensing.

Key initiatives and successes include:

• Identity and access management – completion of the discovery phase to understand and document the technical and process landscape
• Development of the Dental Access Portal (as part of a wider project, on behalf of Welsh Government) to establish a nationwide system enabling residents across Wales to register their interest in routine dental treatment
• Development of the Staff Movement Advice app to streamline the submission of payroll changes, terminations, and new starters by line managers across NHS Wales. This is resulting in significant time savings for front-line and back-office staff, and reducing errors, delays and overpayments
• Migration of Viva Engage from the US to EU to enable usage by all NHS Wales organisations, in support of employee engagement and community
• All Wales trial of Copilot for M365, results of which contributed to increasing understanding of the potential opportunities as well as challenges of adoption and support
• Supporting the development by Cardiff and Vale UHB of a cluster services booking application and associated integration with third-party software
• Supporting the creation of a new integrated digital system (Codi) by Health Education and Improvement Wales (HEIW)
• Supporting the implementation of the iCasework application by NHS Wales Shared Services Partnership
• Increasing Power Platform development capabilities across NHS Wales, including working directly with Swansea Bay UHB
• Hosting a Teams Telephony event, together with partners and suppliers, to develop increased awareness of the opportunities and the roadmap towards implementation
• Supporting the movement of resident doctors as they rotate between assignments in different health boards by facilitating bulk M365 account updates

Looking ahead to next year, the CoE is leading a taskforce with stakeholders across multiple DHCW teams and all NHS Wales organisations to prepare for and agree the next M365 Enterprise Agreement (EA). The EA renewal project seeks to ensure the ongoing alignment between the needs of NHS Wales staff, the potential for increased innovation and productivity, and the blend of M365 licences at the lowest achievable cost.

The Welsh Clinical Portal (WCP) has been developed to enable the sharing, delivery, and display of patient information from multiple sources with a single log-on, even when the information crosses health board boundaries. It includes key electronic tasks and supports clinicians with centralised access to information. Future plans involve continuously adding clinical content, expanding electronic test requesting and results notifications, introducing new forms for the Nursing Care Record, and enhancing user-centred design to improve digital maturity. Collaboration with NHS Wales partners through the Microsoft Centre of Excellence remains a priority.

The WCP supports clinicians in delivering effective care by providing more electronic data, reducing time spent waiting for results, and replacing paper-based nursing assessments with digital records. By improving access to diagnostic investigations, the platform helps ensure earlier treatments and reduced duplication of procedures. Additionally, it enables the integration of cancer patient records on modern IT platforms, delivering relevant data for service development and improved patient outcomes.

DHCW is working with key partners to support the Cancer Improvement Plan by developing future funded phases of the Cancer solution. This work includes building functionality for palliative care and improving national cancer data standards. The new Cancer solution replaces the legacy CANISC system with resilient technology, improving access to cancer information, redesigning pathways, and enabling Big Data opportunities through the National Data Resource infrastructure.

Launched in April 2021, the Welsh Nursing Care Record (WNCR) has transformed nursing documentation by digitising forms, standardising processes, and using a single nursing language. Nurses can now complete assessments at the bedside using mobile devices, ensuring efficiency and better patient care. The centralisation of data enables access across health board boundaries, supports auditing, and enhances reporting.

The focus for the year centred around increasing access and functionality of the WCP, further developing digital tools like test requesting and results reporting, and enhancing digital services to support patient referrals and information management.

In the first half of the year radiology test requesting was expanded and, new capabilities were introduced to enhance the Cancer Programme, including palliative care e-Forms. New infrastructure was completed for the Cancer Programme, and a working group was established for improving WRRS and WCRS governance.

Latterly, achievements include the installation of MediScan for cancer screening and colposcopy applications, as well as the integration of WCP with ePMA for medication management. By Quarter 3 WNCR was implemented in 90% of adult wards, with progress towards paediatric integration.