Mission 5: Be the trusted strategic partner and a high quality, inclusive and ambitious organisation

The Well-being of Future Generations Act, established in 2015, requires public bodies in Wales to think about the long-term impact of their decisions, to work better with people, communities and each other, and to prevent persistent problems such as poverty, health inequalities and climate change.

DHCW has been included under the act since June 2024. Once noted under the Act, organisations had until March 2025 to consult on and agree their Wellbeing Statement and Objectives, however, DHCW was keen to undertake this action earlier and published a Statement and Objectives as part of our 2024-25 Integrated Medium Term Plan (IMTP).

Since the establishment of the Act, we have worked to the principles of the Act, specifically the Sustainable Development Principle and associated Five Ways of Working. In March 2024, our Board approved an updated Statement for 2024-25:

“Our activities make a fundamental contribution to the implementation of the Wellbeing of Future Generations (Wales) Act 2015 and the five ways of working. We see this as part of our core purpose, creating the conditions for sustainable access to health and care services.”

Our objectives for 2024-25, which were also approved by our Board in March 2024, are outlined below together.

The Social Partnership and Public Procurement (Wales) Act 2023 Social Partnership and Public Procurement (Wales) Act 2023 (the SPPPA 2023) requires Digital Health and Care Wales (DHCW), as a public body, to produce an annual report to evidence how they have complied with the Social Partnership Duty. The report must be agreed with the public body’s trade union, submitted to the Social Partnership Council (SPC) for scrutiny, and published. The report will be available in the public domain as part of the organisation’s Annual Report.

The SPPPA 2023 provides for a framework to enhance the well-being of the people of Wales by improving public services through social partnership working, promoting fair work, and socially responsible public procurement. It is intended to complement other legislation, including the Socio-economic Duty and the Well-being of Future Generations (Wales) Act 2015 (WFGA 2015).

The Act requires the organisation, in carrying out sustainable development, to seek consensus or compromise with their recognised trade unions when setting their well-being objectives (in line with the Well-being of Future Generations (Wales) Act 2015) and making decisions of a strategic nature about the reasonable steps they intend to take to deliver those objectives. The requirements are intended to ensure that trade unions are fully and properly involved when a public body sets its well-being objectives or makes strategic decisions.

The intended effect of the legislation is to improve the economic, social, cultural, and environmental well-being of people in Wales by strengthening the role of social partnership within strategic decision-making. Involving both employers and workers in key discussions regarding improvements to well-being recognises and values the unique contribution and expertise brought by those directly engaged in public service delivery when addressing shared challenges and seeking innovative solutions. The intended effect of these provisions is to promote cooperation, strengthen policy, and improve outcomes through dialogue between social partners, achieved in social partnership.

At DHCW, we have a strong working partnership relationship. In addition to the formal relationship within DHCW, such as the Local Partnership Forum and the appointment of an Associate Board Member to the Board to represent staff side views, weekly meetings have been ongoing for several years between the Trade Unions and the People and Organisational Development Directorate. These meetings provide an opportunity to discuss any topics on an informal basis and act as a forum to identify any queries or concerns that need to be addressed.

Social Partnership Conference: Representatives from DHCW attended an all-day Social Partnership Conference in Swansea in September 2024. This was well attended by people from Welsh Government, Public and Private Sector, Trade Unions and the Voluntary Sector. Details around the Social Partnership Conference and the implications for DHCW were discussed with our Trade Union colleagues at one of our weekly Trade Union/People and Organisational Development meetings.

Social Partnership Self-Assessment Tool: The Social Partnership Self-Assessment Tool was completed in partnership with our Trade Union colleagues in October 2024. The findings from the tool demonstrated that our partnership is healthy and strong across all areas. There were a few areas that were marked as ‘agree’ and we will explore these further to move these to a ‘strongly agree’ position. A briefing paper on the Social Partnership Duty and results of the self-assessment tool was submitted to our Local Partnership Forum in December 2024. The Forum is chaired alternately by our Chief Executive Officer and the Associate Board Member for Trade Unions.

Social Partnership and Wellbeing Objectives Roundtable event: Representatives from DHCW attended a roundtable event for senior executives in Cardiff in November 2024. This focused on Social Partnership and Wellbeing Objectives.

Wellbeing of Future Generations Statement and Objectives review: Progress against wellbeing objectives is referenced in the previous section of this annual report. A workshop was held at the beginning of December 2024 to review and update our Statement and Objectives for 2025–26. This was led jointly by Executives and Trade Unions to review and develop our new Well-being of Future Generations Statement and Objectives. These were approved by our Board in March 2025.

Actions from the NHS Wales Staff Survey: In recent months, and to support actions and recommendations from the NHS Wales Staff Survey 2023 and the Workforce Race Equality Standards, we have worked in partnership to co-facilitate two Anti-Bullying and Harassment TENTalks in 2024, followed up with drop-in sessions in January and February 2025.

We have raised awareness of the Social Partnership Duty and its implications for the organisation in our organisational newsletter and published a joint case study in DHCW about the importance of social partnership in February 2025.

We are required to produce an annual update highlighting how we have complied with the duty. This update has been produced in partnership, agreed and signed off by Trade Union colleagues.

Our vision is to create a great workplace where our people are fully engaged, high-performing, and exemplify our organisational values and behaviours. The People and Organisational Development (POD) Strategy for 2022–2025 continues to support our strategic ambitions, vision, and focus, ensuring that our newly developed values are integrated throughout the organisation. This strategy will be reviewed and refreshed in 2025.

Our Strategic Equality Plan, developed in partnership and endorsed by the Board in 2023, underscores our commitment to promoting equality and diversity within the organisation. This plan serves as a foundation for fostering an inclusive work environment.

During 2024–2025, we have focused on advancing key people initiatives and action plans introduced in the previous year. The primary developments include:

DHCW Behavioural Framework: We have developed a Behavioural Framework aligned with our organisational values to reinforce expected behaviours across all levels.

Senior Leadership Programme: We continue to build on our leadership development programmes to enhance the skills and capabilities of senior leaders.

Talent Development and Recruitment: We have successfully supported significant recruitment efforts with a strong emphasis on equality, diversity and strategic workforce planning.

Digital Upskilling Programme: As part of our strategic collaboration with the Wales Institute of Digital Information (WIDI), we have partnered with the University of Wales Trinity Saint David (UWTSD) to develop and deliver custom digital e-learning programmes. These programmes support DHCW’s transition to a product-focused operating model by providing employees with essential digital skills. The training covers areas such as Agile Delivery and Scrum (Foundation and Practitioner levels), Artificial Intelligence (AI) and Machine Learning, and Software Development and Testing at various levels. These courses have been successfully implemented and will remain a key part of our workforce development strategy in 2025–26, ensuring our employees continue to drive digital innovation and efficiency.

We remain dedicated to supporting the Welsh Language Scheme by encouraging staff to learn and use the language in the workplace – nearly 99% Welsh Language Awareness compliant and 52% of our staff between level 1 and 5. Additionally, we have focused on targeted recruitment efforts to attract Welsh-speaking employees.

The POD Strategy 2022–2025 will be refreshed, making sure it continues to align with our organisational goals, ensuring that our people are engaged, skilled and embody our values. As we move forward, we will build on our progress and further strengthen our commitment to equality, diversity and workforce development.

As a learning organisation, we continue to provide opportunities to learn, train and develop for all levels in DHCW. At least 60% of our vacancies were filled through internal career moves, compared with 30% in 2023–2024, demonstrating our on-going commitment to supporting staff development and career progression. In addition to in-house training, development opportunities are available through Health Education and Improvement Wales and external providers, including professional memberships, universities and Wales Institute of Digital Information (WIDI), all in line with the Compassionate Leadership Pledge.

Our commitment to developing and supporting our people remains central to our strategic priorities. The initiatives outlined below demonstrate a proactive approach to leadership development, talent management, and succession planning, ensuring DHCW has the right capabilities to meet its current and future ambitions.

After completing the DHCW bespoke Leadership Programme, the DHCW Senior Leadership Team meets on a quarterly basis to discuss key organisational priorities. These meetings provide an opportunity for leaders to collaborate across different functions, drive continuous improvement and ensure alignment with the organisation’s strategy. This approach supports the development of a future-ready organisation that is equipped to respond to evolving challenges and opportunities.

Beyond senior leadership development, we continue to invest in talent pipelines tailored to roles and to address skills gaps identified through Strategic Workforce Planning. In addition, DHCW has also begun identifying critical and pivotal roles to ensure a structured approach to succession planning and future capability building.

Our people have accessed various development opportunities, including 978 employees attending in-house training, nearly 130 taking part in all-Wales (HEIW) initiatives and bespoke programmes and more than 1,000 online learning modules available through 250 licences. Additionally, more than 400 staff members hold professional memberships, such as with the British Computer Society (BCS) and the Federation for Informatics Professionals (FEDIP), and benefit from university partnerships that support both personal and professional growth.

A key focus moving forward is strengthening the integration of professional development into PADRs, ensuring alignment with organisational values and strategic objectives. This comprehensive learning provision ensures our workforce are equipped with the skills and knowledge needed to drive success and adapt to an evolving healthcare landscape. These initiatives also reflect our strategic intent to nurture leadership capability, embed a culture of continuous development and build a strong, future-ready workforce.

We were pleased to take part in the NHS All Wales Staff Survey 2024, achieving a 62.3% response rate, an increase from 60.5% in 2023. This placed us joint third highest in NHS Wales for overall engagement, reflecting the positive contribution of our colleagues across the organisation.

Eight out of ten engagement themes remained strong, and while our overall engagement score reduced slightly to 76%, this remains a positive result given that 10 out of 14 NHS Wales organisations experienced a similar reduction.

We are particularly proud of our strong performance in Flexible Working and Teamwork, both of which exceeded the NHS Wales average. Our Patient Safety sub-theme also improved by 7.6%, reflecting growing staff confidence in our safety measures and ongoing commitment to delivering high-quality care.

Staff feedback has provided valuable insights, and we recognise opportunities to further improve morale and engagement. We are actively enhancing support for colleagues, with a particular focus on managing work pressures and promoting psychological safety to create an even more positive working environment.

A detailed analysis and targeted action plans will be developed to address these findings. Our priority remains creating a workplace where colleagues feel valued, engaged, and supported.

We have continued to strengthen our commitment to equality, diversity, and inclusion (EDI) through a range of impactful initiatives, partnerships, and achievements.

Raising Awareness and Driving Cultural Change: We have delivered dedicated sessions spotlighting topics such as Equality Impact Assessment, Life as a Carer and Anti-Bullying, while also supporting national campaigns like International Women’s Day, Men’s Health Week and Pride. These efforts reflect our ongoing focus on fostering an inclusive and supportive workplace culture.

Strengthening Partnerships and Talent Pipelines: We have continued to build relationships with local community groups, schools, colleges and universities to promote careers in digital health. Collaborations with organisations such as Iungo Solutions and schools like Fitzalan High School have helped raise awareness of opportunities within DHCW. Events such as Eisteddfod 2024 have provided valuable platforms to engage with potential candidates from diverse backgrounds.

We have participated in several career events across Wales, strengthening our employer brand and attracting top talent. These efforts have resulted in the recruitment of apprentices in key growth areas of the organisation. Additionally, we have continued to support intern placements and graduate programmes, including the NHS Wales General Management Graduate Programme, welcoming our third graduate placement since 2021.

Commitment to Excellence and Continuous Improvement: Our efforts were recognised with a Highly Commended Award for EDI at the Healthcare People Management Association (HPMA) National Awards, reflecting our proactive approach to advancing inclusion.

Key achievements include:

• Re-accreditation of ISO 30415 for Diversity and Inclusion, reinforcing our commitment to best practice
• The appointment of a permanent EDI and Wellbeing Lead to provide strategic direction and drive meaningful change
• Strengthening our Equality, Diversity and Inclusion Network, now with more than 32 engaged employees who actively contribute to organisational decisions
• Implementing a robust practice of conducting comprehensive Equality Impact Assessments (EIAs) for relevant policies, frameworks, strategies, projects, and schemes
• Publishing our Gender Pay Gap Report, ensuring transparency and accountability in our approach to pay equity

Further details on our commitment to equality, anti-corruption and the prevention of human trafficking can be found in our Accountability Report.

Through these initiatives, we have strengthened our position as an employer of choice, committed to embedding equality, diversity and inclusion at the heart of our culture and operations.

The Strategic Workforce Planning (SWP) process, launched in April 2024, helped the organisation to identify critical roles, succession planning needs, and workforce sustainability strategies to support its goal to build a more flexible, future-ready workforce.

DHCW is currently undertaking strategic restructuring to align with the organisational Target Operating Model. This will be achieved through the Building Our Future programme. One of the main areas of focus under the programme is to upskill the workforce to ensure they stay current with evolving technologies. The organisation is delivering training in important fields like Agile methodology, AI and Machine Learning and Cloud Software Development at foundation and practitioner levels. Currently more than 380 people have been trained in these areas.

We will continue to support career development and workforce modernisation through Building Our Future, focusing on aligning roles with the Government Digital and Data (GDaD) framework to create clear career pathways and developing a Learning Portal as a platform to help individuals to map career progression and identify skills gaps.

Looking ahead, the organisation will start an annual Strategic Workforce Planning process in May 2025. This will be a time for departments to reassess their training needs, plan for future leaders and think about how to sustain the workforce in the long-term. We will create a consistent and organised approach to workforce planning that will pro-actively support our evolving needs.

In addition to training and transformation, there is a strong focus on recruitment and retention. Since April 2024, 213 new hires have been brought on board, with 87 internal promotions and 127 external hires. Our retention rate is also high at 91.3%, meaning most employees choose to stay.

As part of recruitment efforts, we have also reviewed our resourcing strategy to ensure that it meets current and future workforce needs and supports us in remaining an attractive employer.

Our main objective is financial sustainability. The key financial indicators reflect both statutory (to achieve breakeven in revenue and capital allocations) and administrative targets (to pay 95% of all non-NHS within 30 days). We continue to identify opportunities to automate processes, lead on accounting for digital guidance, benefits management and financial analytics.

The capital funding has enabled investment in key areas such as:

• Laboratory Information Management Solution LIMS(2.0) – to support the programme DHCW procured hardware and software licences to support the solution and completed configuration and testing in readiness to implement across Health Boards in 2025–26.
• Radiology Informatics System Procurement (RISP) – the funding supported activities including licence procurement, system setup, integration, testing and infrastructure commissioning to enable the start of implementation with the remaining health boards and trusts going live in 2025–26.
• Information Communication Technology – key spend related to strengthening of the organisation’s cyber security posture at its datacentres.
• DSPP (NHS App) – the investment in this area is primarily reflective of Priority Patient Pathway Feature delivery, and progress for delivery of the Welsh Identity Verification Service to improve functionality available to citizens across Wales.
• Facilities – the material investment related to the construction of the organisation’s state-of-the-art ‘Digital Futures’ facility at Ty Glan Yr Afon.
• WICIS – investment reflects the ongoing work in Health Boards from clinical leads, nurses and consultants to support system design resolution and readiness.

Alongside the management and achievement of our statutory financial targets we have also delivered the following:

National Leadership – Benefits Realisation
The finance team has worked with stakeholders across Wales to not only agree a refreshed benefits framework and toolkit but also a standardised dataset. An All-Wales Benefits Reporting system has been designed and is in development – this will collate and enable reporting of all benefits from digital programmes. Benefit dashboards will exist for all Wales, each organisation/health board and for each individual programme. This year there was further development of the central benefits repository and reporting dashboard. As a proof of concept, significant progress was made in data population and providing important intelligence on cost, usage and benefits of a number of national digital programmes.

Funding of Service Level Agreements
As part of the 2025–26 IMTP SLA review round, DHCW instigated sessions with senior teams of all organisations and will look to initiate an exercise providing transparency regarding legacy service charging, pressures and constructing a charging model fit for purpose and reflective of new service models and changes in the technological layer (including the shift to cloud).

Control of Cloud Spend (FinOps)
As DHCW’s presence in the cloud grows as part of its strategic aim it is vital that good governance and cost control are embedded into the organisation’s processes. The finance team have established an accredited function to not only ensure processes are followed but spend is incurred in the most cost-efficient way. During the year, the team have published standard operating procedures and constructed cost and consumption monitoring dashboards. Masterclasses have also been held to finance professionals across Wales in order to share knowledge and awareness.

Financial Sustainability
Allied to the SLA charging review exercise, through the Building Our Future programme the IMTP transparently demonstrates DHCW’s approach to maximising resource utilisation through improved productivity and efficiency aligned to the strategic term to 2030. This programme has identified a roadmap within its workstreams to identify gains and any underpinning investment requirement.

We understand that we have an obligation to safeguard the environment and its natural resources. We have an Environmental Strategy in place that integrates the requirements of the ISO14001:2015 Environmental Management System standard within DHCW operations, as well as a Decarbonisation Action Plan (DAP), which has been developed in line with our strategy. This allows us to use a methodical and organised approach to carbon reductions, control the risk of threats, seize all opportunities and to meet the demands and expectations of interested parties. Our Environmental Strategy is the guiding concept to establish, implement, maintain, and continuously improve our performance in managing environmental elements and compliance obligations.

We acknowledge the potential impact that we may have on the environment, and we are fully committed to reducing this impact across the scope of our operations. By increasing environmental awareness, promoting best practice behaviour and through greater engagement with our stakeholders, we have become more environmentally conscious.

We are actively working to improve sustainability by quantifying and lowering our carbon footprint. While there are many activities that can reduce the total quantity of greenhouse gases that we emit as an organisation, we believe they must be undertaken as part of a coordinated and coherent programme to ensure a complete transformation. Crucially, our approach is underpinned with the knowledge that any steps taken must consider not only how to address generated CO2 emissions, but also how we can become carbon efficient (adaptation).

Pollution, rising temperatures, and other environmental factors pose serious health risks. We recognise this as both a climate and health emergency and are committed to tackling these challenges to create a healthier Wales, now and for future generations.

Examples of our progression during the year include:

• Refreshing DHCW’s Decarbonisation Action Plan (DAP)
• Implementing 2024–25 Decarbonisation roadmap actions outlined within our Strategic Delivery Plan, which was established to further DHCW’s contribution to Welsh Government’s Net Zero aims
• Maintaining ISO14001:2015 Environmental Management Systems standard certification
• Actively participating in a number of All Wales Climate Change forums, delivering presentations on a range of subjects
• Continuing to oversee DAP progress through our Decarbonisation Working Group and ensure best practice
• Successfully working with our ICT supplier to reduce unnecessary single use plastic waste packaging
• Analysing the carbon benefits of technology solutions
• Further development of our Environmental Development and Estates Compliance Facilitator
• Data Centre relocation that enables improved PUE (Power Usage Effectiveness) and will result in greater energy efficiency
• Developing and maintaining Sustainable Travel intranet pages to increase staff awareness
• Hybrid working enabling estates rationalisation, which has aided carbon footprint reductions
• Implementing a telematics solution to monitor and improve vehicle usage, which has the potential to lead to lower emissions
• Quantification of our IT estate carbon footprint
• Continuing to monitor utility, waste and paper usage

Emissions Methodology

When reporting our emissions, different methodologies are used in order to calculate these figures. For example, a different methodology will be used in the absence of specific usage data.

As a guide, our approximate methodology breakdown is:

• Tier 1 – 21%
• Tier 2 – 18%
• Tier 3 – 61%

(Tier 1 being the least accurate and Tier 3 being the most accurate).

These methodologies are subject to change and we monitor our usage of these regularly to ensure the most accurate option is being used.

Task Force on Climate-related Financial Disclosure (TCFD)

In accordance with the TCFD-aligned disclosure application guidance, which interprets and modifies the framework for the UK public sector, DHCW has reported on climate-related financial disclosures. DHCW views climate change as a principal risk, therefore it has complied with the TCFD's guidelines and disclosures set out in phase 1 regarding:

• General principles (including scoping)
• Governance recommendation and recommended disclosures (a) and (b)
• Metrics and Targets recommended disclosure (b) – where data is available

DHCW intends to adhere to subsequent TCFD phases in accordance with the timeline for central government implementation.

It is essential that we understand stakeholders’ perceptions and the impact of our work. Operating in a complex and ever-changing ecosystem, challenges and pressures have underscored the importance of strong partnerships and a whole-system approach.

To support this, we have hosted workshops, held one-to-one meetings, and gathered intelligence to deepen our understanding of our stakeholders, fostering more effective partnerships to meet system needs. As part of this commitment, and our mission to be a trusted partner and a listening, learning organisation, we initiated an Independent Stakeholder Review. This complements our internal work by benchmarking progress, establishing a methodology to measure improvements, identifying challenges, and recommending solutions.

The review sought to:

• Capture stakeholder perspectives on working and communicating with DHCW
• Identify concerns, risks, perceived impacts, and opportunities from collaboration with DHCW
• Develop actionable recommendations to improve future collaborative working and stakeholder engagement

The review explored several strategic themes, including stakeholders' understanding of DHCW, their perceptions of its role and effectiveness, and the impact of its work within the system. Additionally, it examined stakeholders' experiences of working with DHCW and considered their outlook on future collaboration and developments.

Recommendations were made for improvement in six areas. These are:

• Promote transparency and effective communication
• Foster collaboration and partnership
• Enhance active listening and responsiveness
• Clearly define roles and responsibilities
• Simplify processes and optimise efficiencies
• Advance interoperability and system integration

In response to these recommendations, DHCW has established an internal Action Plan Delivery Group and an external Stakeholder Advisory Group. The internal group convened for the first time in February 2025, and the external group is set to meet in Quarter 1 of 2025–26. Of the 27 recommendations from the review, 64 actions have been outlined, with 30 already in progress and 10 completed.

As health care’s dependency on digital intensifies, the need to ensure digital equity has become paramount to ensure citizens of Wales are able and supported to utilise the opportunities and improvements generated by emerging technologies.

Helen Thomas, Chief Executive, and Simon Jones, Chair of Digital Health and Care Wales, signed the Digital Inclusion Charter in 2022. The Charter exists to support and champion organisations working in the public, private or third sector in Wales who are willing to promote basic digital skills and help people get online.

To drive forward our commitment and work on digital inclusion, DHCW has set up a working group. The group aims to support digital inclusion within DHCW and more broadly, and to deliver on the pledges set out in the Digital Inclusion Charter for Wales Action Plan.

As a national NHS organisation, it is vital that DHCW delivers strong and proactive communications to raise the profile of its work and build its role as a trusted strategic partner with a reputation as a system leader for digital health and care services.

DHCW’s Communications Strategy, approved by the SHA Board in September 2023, sets out a proactive approach to strengthening communications across five strategic aims:

• Establishing DHCW’s reputation as a trusted strategic partner
• Enhancing internal communications to empower staff and make DHCW a great workplace
• Developing stakeholder communications to foster collaborative relationships
• Growing public communications to improve understanding of DHCW’s role and work
• Enhancing digital communications to reflect DHCW’s ambitions as a digital leader

This strategy aligns with DHCW’s broader missions and strategic objectives, aiming to position the organisation as a trusted system leader in digital health and care. A supporting yearly action plan outlines specific activities to achieve these goals.

During the last year, the Communications Team has fully delivered against the first-year action plan while also managing additional critical demands, including crisis communications, staff awards and support for programme communications.

Strategic Progress Highlights

• Stakeholder mapping and messaging workshops to develop consistent corporate messaging
• Launching a Communications Repository with branded templates and tools
• Establishing proactive media engagement and submitting monthly updates to key stakeholders
• Supporting the Engagement Team to implement stakeholder review recommendations
• Centralising programme communications under the corporate team for alignment
• Developing a strategic approach to events and securing national speaking opportunities
• Producing case studies with partner testimonials to demonstrate impact

Enhancing Internal Communications

• Expanded channels for staff updates with ongoing evaluation
• Revamped staff briefings and executive engagement sessions
• Delivered high-profile staff events like the 2024 staff conference and awards
• Launched campaigns such as #IamDHCW and celebrated diversity via key events
• Supported sensitive topics and major programmes, such as Building Our Future
• Promoted health, wellbeing, and bilingual content in line with organisational values

Developing Stakeholder Communications

• Enhanced the stakeholder newsletter and implemented surveys for feedback
• Improved engagement through a user-centred website redesign
• Built stronger clinical relationships via service visits
• Participated in national communications groups and held a Senedd event
• Improved incident communications in collaboration with Service Management

Growing Public Communications

• Simplified messaging to highlight benefits for clinicians and the public
• Increased presence at events like the Eisteddfod, with record social engagement
• Supported recruitment campaigns and new public services like the Dental Access Portal and NHS Wales App

Enhancing Digital Communications

• Invested in tools and training for in-house digital content production
• Improved SharePoint and website usability using user-centred design principles
• Expanded bilingual content and delivered training on digital comms best practices

Key Indicators of Success

• Record attendance at staff briefings
• Waiting lists for events like TENTalks
• High digital and social engagement – outperforming benchmarks
• Proactive requests from internal teams for communications support
• Strong participation in opinion surveys
• Positive feedback from staff events

Next Steps

In 2025–26, we will focus on delivering the second-year action plan, enhancing our internal and external communications channels, and further strengthening DHCW’s position as a digital system leader.

DHCW has maintained its focus on quality and safety through its commitment to the Duty of Quality and Duty of Candour, introduced through the Health and Social Care (Quality and Engagement) (Wales) Act 2020. DHCW has produced Always On reports and an Annual Quality Report, which demonstrate how DHCW has complied with the Duty of Quality and actively seeks to improve the quality of its services and products.

We have embarked on a programme of activities to further understand and align with the Health and Care Quality Standards 2023. Further information is available in the Annual Quality Report. The aim is to provide DHCW with a framework that interprets the 2023 standards specifically for a digital organisation.

DHCW’s quality framework is supported by an electronic quality management system and an integrated management system. DHCW has maintained several ISO certifications, demonstrating its continued commitment to delivering high-quality services. Multiple groups monitor quality activities, including the Quality and Regulatory Group, the Integrated Management Systems Assurance Group, and the Medical Devices and Alerts Group. These report to the Audit and Assurance Committee, which provides assurance to the Board.

During the year 2024–25, DHCW logged 9 clinical incidents. Four of these incidents were escalated to Welsh Government as Early Warning Notifications due to the assessment of the potential for patient harm during the initial incident review. One other, more complex incident, was reported as a Nationally Reportable Incident by the affected health board.

No patient harm resulting from any act or omission by DHCW has been identified in relation to any of these incidents, nor has there been any requirement to trigger the Duty of Candour.

The Clinical Informatics and Business Change Strategy 2023-26, developed in 2023-24, outlined the creation of a framework and in 2024-25 we have developed and approved our new DHCW Clinical Informatics Framework, aligned to the ‘efficient’ domain of quality.

The framework outlines six clinical informatics practices to guide and ensure that the clinical voice is correctly positioned and included in Digital Health & Care Wales. This includes ensuring clinical safety and quality assurance in the transformation of health and care services using digital technology. It has been developed to reflect and align with professional standards across the UK and will dovetail with the newly forming DHCW target operating model.

The practices are Discovery and Engagement, Benefits and Value, Information and Data Standards, Service Management and Development, Clinical Digital Safety and Assurance and Supporting Professional Development. Each practice has a list of applications, processes and tools to support those processes, to ensure quality and consistency in our clinical informatics and business change provision. The implementation, embedding and evaluation of the framework is included in our Integrated Medium-Term Plan for 2025-26.

This enabler includes the assurance we provide to our Board through risk management, business continuity, performance and planning frameworks.

Planning Approach

Our plan focuses on how digital and data can help manage the pressure on healthcare services and improve patient outcomes. We are committed to transparency and our IMTP clearly outlines our plans, risks and challenges, supporting our commitment to being a trusted strategic partner.

Our annual business plan is an ambitious and comprehensive roadmap, covering a portfolio of change initiatives for the year. To allow DHCW to respond to changing priorities and new requests for additional work during the year, we employ a robust change control process to ensure close management of the plan and deliverables. While some initiatives may be slowed or paused, this approach enables resources to be focused on the highest priority initiatives, delivering the most benefit to NHS Wales. We successfully achieved 90% of our IMTP milestones by carefully managing funding, resource constraints and other complexities within the system.

The plan for Years 2 and 3 is indicative, based on available funding and resources, with delivery timelines colour-coded to reflect certainty and maturity. Any new commitments require additional or reallocated funding and progress through detailed planning and maturity. Capacity across the organisation is forecasted, considering recruitment timelines and absence. The plan has incorporated priorities from key partner organisations, including Welsh Government, health boards, Social Care Wales, and others, gathered from meetings and service requests. Alignment with other plans is managed through ongoing strategic engagement.

Performance Approach

DHCW (Digital Health and Care Wales) adopts a structured, comprehensive approach to performance management, centred on continuous improvement and high performance. This approach ensures that resources are used efficiently to achieve outcomes that meet stakeholder needs, focusing on three key areas:

Performance is managed through a hierarchy of directorates, departments and teams, overseen by the Management Board and assured by the DHCW Board. DHCW’s Performance Management Framework (PMF) sets the system for continuous improvement to achieve strategic priorities and objectives, both in service delivery and supporting mechanisms.

Key Components:

Seven principles underpin the PMF: strategic focus, connectivity of information, materiality, conciseness, reliability and completeness, consistency and comparability, and stakeholder relationships.

KPIs and OKRs are key tools used to measure and improve performance. KPIs are quantifiable measures that reflect DHCW’s critical success factors. OKRs are a goal management framework that follow a structured, hierarchical approach, cascading from organisational objectives, with measurable results to track progress.

DHCW’s Performance Management Framework was reviewed this year and approved by the SHA Board in January. The Framework aims to ensure accountability, with performance metrics and reporting structures aligned to strategic objectives. KPIs are stored in a centralised KPI Register, enhancing visibility, accountability and alignment.

DHCW promotes a culture of continuous improvement, with objectives set at all levels to support strategic goals. Staff are encouraged to share learning, celebrate success and maintain focus on critical priorities.

DHCW’s performance management framework ensures alignment with its strategy, Integrated Medium Term Plan and annual business plan. The approach is cascaded from organisational objectives to team plans, supported by regular reviews, continuous improvement and a culture of accountability.

Our IMTP 2024 – 27 identified our main areas of risk as:

• Cyber: Optimising our protection against cyber-attacks is critical to ensure continued availability and delivery of any of our digital solutions otherwise, optimum, safe, and timely patient care is at risk. DHCW procured the National SIEM for NHS Wales and made other investments to protect NHS Wales from cyber security threats.
• Suppliers: We are reliant on supplier capacity to support key systems over the course of the plan. We need to be confident that delivery timescales are not at risk, and suppliers remain focussed on an NHS Wales roadmap and requirements.
• Digital Inflation: Increased costs from suppliers of digital services will potentially impact on the organisation’s ability to balance finances.
• Sustainable Funding: There are key funding risks: additional funding needed in year 1 and sustainable funding for future years reflective of changing service models and growth. These could impact on delivery of new systems and ongoing operational services. There can be uncertainty about future service level agreement income from other NHS organisations, including the transition of major programmes from Welsh Government digital priority investments into business as usual. This year we completed an initial assessment of service/product costs and accompanying funding. We are working closely with Welsh Government on the future funding model state.
• Resourcing: There is a risk of not filling vacancies in a timely manner. Some digital skills are in short supply and posts are difficult to fill. We set up a Strategic Resourcing Group which enables monitoring of resource requirements at an organisational level to minimise resourcing risks. Additionally, there are risks associated with unfunded positions across the organisation. DHCW are mitigating these by upskilling and reskilling affected staff to mitigate business pressures.
• Legacy Issues: There is still legacy infrastructure which needs upgrading across the estate. Any focus away from this means new systems could sit on sub-optimal infrastructure which could delay roll out and have a reputational impact due to instability. Last year we migrated to a new data centre, recruited 5 of 6 Cloud staff, developed a Cloud economic case, implemented a Cloud PC solution, commenced cloud migration assessment scans and continued to reduce legacy infrastructure.
• Complex Interdependencies: The integrations between digital systems in health and social care are extremely complex and sometimes not well understood. This can result in unexpected delays which may be difficult to mitigate, for example, when systems are provided by third parties. This year we published our API roadmap and delivered 6 priority APIs.
• Use and Dissemination of Citizen Data: During 2024–25 DHCW has been subject to the realisation of a lack of wider NHS Service understanding of its core functions by which the organisation accesses and uses patient data. Gaps in a common understanding and consistent underpinning policy direction have meant that a sound legal basis for the collection, processing and dissemination of Welsh resident data has not been easy to establish. This poses an increasing risk to the organisation and a direct impact on DHCW Strategic Programmes.

Concerns

Although the DHCW Special Health Authority is not recognised as a body under the Putting Things Right (PTR) Regulations, we follow the recommended response and guidance set out under PTR Regulations and take our responsibilities and accountabilities seriously. To this end, we aim to ensure that our responses to concerns raised are cohesive, measured and timely.

We have robust monitoring metrics and systems in place to provide our board with timely escalations and assurances by early identification of emerging themes. We also have a dedicated learning group to ensure proactive measures are in place to address any deviation in delivery of our expected standards.

DHCW Commercial Services plays a unique and vital role, distinct from local trust and central procurement services in Wales. The team oversees a wide range of commercial activities, including the procurement and contract management of complex clinical and digital systems, large-scale technical software and service agreements, and people-based contracts. These robust agreements are essential for delivering effective digital health services across Wales.

The team manages a portfolio of 74 contracts, with a total value of £1.25 billion. Operating within a specialist market is challenging—particularly given the current economic climate and shrinking supplier landscapes. One recent example demonstrating the team's expertise was the successful retention of Audit+ for an additional 12 months into 2026. This solution is integral to general practice auditing, reporting, and supporting wider Welsh Government initiatives.

Over the years, the team has received numerous Welsh awards, recognising innovation and excellence in public procurement. These honours highlight the team's contribution to making the UK a global leader in effective procurement practices. Commitment to ongoing professional development has further strengthened our capabilities and ensures we continue to offer high-quality commercial services.

In line with DHCW’s strategic priorities, the team has delivered a well-defined and prioritised pipeline of future programmes and projects. This has been achieved while maintaining strong levels of staff and stakeholder engagement. Our commitment to best procurement practices, achieving value for money, and supporting the health and well-being of communities across Wales continues to drive our work.

As we reflect on the progress made over the past year, it is clear that digital transformation in health and care is delivering real, positive change. The work of DHCW has shown how data and technology can improve outcomes for people across Wales—making services more accessible, secure and responsive.

Milestones such as over one million items dispensed through the Electronic Prescription Service (EPS) and the continued growth of the NHS Wales App highlight the meaningful impact of our work. These advances empower individuals to take greater control of their health, support professionals to deliver high-quality care, and ensure our systems are more resilient and efficient.

Looking to the year ahead, the ambition set out in our refreshed Integrated Medium Term Plan (IMTP) builds on this progress. We are committed to pushing the boundaries of what digital and data can deliver—through innovation, strong partnerships, and continued investment in our workforce.

Key developments such as the rollout of the national target architecture and enhanced analytics through the National Data Resource will help shift towards proactive, preventative care and a more value-based approach to health delivery.

Our focus remains on expanding digital services that put people at the centre of their care. With a forward-thinking, collaborative approach, we aim to enhance the patient experience, improve population health, and support the long-term sustainability of the health and care system in Wales.

By continuing to innovate and work together, we will drive the improvements needed to ensure everyone in Wales can receive better care, manage their own health, and live healthier lives.