Digital Health and Care Wales’ organisational strategy 2024-2030: in focus

Digital Health and Care Wales (DHCW) recently published its organisational strategy for 2024-2030, framed around five key missions: to provide a platform for enabling digital transformation, to deliver high quality digital products and services, to expand the digital health and care record and the use of digital to improve healthcare, to drive better values and outcomes through innovation, and to be a trusted strategic partner and a high quality, inclusive and ambitious organisation.

Planned actions to 2030…

DHCW shares plans to move all data stores and services to the National Data Resource (NDR) platform in order to create a single national clinical data repository; to redesign applications and services to a “clean architecture” which is secure by design and based on open standards; to extend data standards and data components to social care and other partners; to establish an all-Wales framework for data sharing; and to move all live services to the cloud, ultimately closing data centres.

DHCW is reportedly “already making progress towards achieving these aims” and shares a number of anticipating benefits, including a reduction in “technical debt” through decommissioning of legacy systems; reduced cost of infrastructure; reduced dependencies on third party systems; less complexity; and improved cyber security.

On plans to deliver high quality digital products and services, DHCW states that “enabling new models of seamless local health and care is a headline priority”. By 2030, the organisation aims for all prescribing and medicines management in Wales to be digitally enabled; for all digital health systems and major social care systems to flow data to and from the NDR platform; for all core health services to be consolidated into a single all-Wales electronic health record application; and for core social services to also be consolidated into an EHR.

Noting that a ‘best of breed’ approach has previously been adopted by selecting applications for each specialty, DHCW acknowledges that the “environment of differing configurations, logins and user interfaces is complex to manage, and ultimately increases the risk of harm to patients.” The main ambition in this area is to collaborate with delivery partners and suppliers to tackle the “fragmented applications estate”, with expected benefits including improved user experience; “modern fully featured digital applications”; and a more streamlined experience for digital teams.

DHCW adds that a key outcome measure in this space will see the use of internationally recognised assessments to benchmark digital maturity, alongside other standards.

Regarding the mission to expand the digital health and care record and the use of digital to improve health and care, DHCW shares aims to maximise use of the digital health and care record in 2030 “and ensure digital services are being used everywhere”. Objectives in this space include delivering a comprehensive single digital health and care record that is used across all settings throughout Wales, with the strategy emphasising plans for a record “for each person in Wales that will follow that person for their lifetime”, providing a source of truth for a person’s health data “regardless of where it was originally stored or who it was created by.” This record will draw data from a number of sources, including primary care, hospital and community services, patient-recorded information, and wearable devices.

Another objective is for over a million people to be using the NHS Wales App, with DHCW stating that this will support patients by providing “easier access to the right care, resulting in better outcomes”, whilst reducing the need to invest in local solutions for trusts and health boards. With regards to digital inclusion, DHCW pledges to work with the Welsh Government and delivery partners for consideration of non-digital options.

Also by 2030, DHCW aims to achieve a user-reported top-quartile satisfaction rate for DHCW’s products and services. Here, the strategy highlights how planned actions should help staff access relevant information when it is needed without the need to search across multiple sources, and adds that digital tools and artificial intelligence “will be able to use those same records to give personalised recommendations about the treatment of patients”.

Sharing more details around the fourth mission – to drive better value and outcomes through innovation – DHCW states that by 2030, it aims to have an NDR secure data environment in place which provides access for research whilst protecting privacy, and a national information and data insights service which demonstrates net benefit and value. It also aims to deploy AI and automation to deliver year-on-year productivity improvements across NHS Wales.

On the NDR secure data environment, DHCW notes: “The foundational data layer will inform clinical process design, local and national management reporting, innovation and research, and government-level decision making. This will allow us, and our partners, to improve the quality of care, identify trends, and make better decisions about how to allocate resources.”

Objectives around DHCW’s fifth mission – to be the trusted strategic partner and a high quality, inclusive and ambitious organisation – are to take an academy approach to developing people through talent and leadership programmes, and to work with partners and stakeholders to deliver a prioritised pipeline of future programmes and projects. DHCW aims to have a “secure, long-term financially stable position” as an organisation by 2030, with a carbon footprint at least 34 percent lower than at present, “with a clear route to achieving net zero”. The organisation also emphasises the importance of achieving top quartile staff and stakeholder engagement.

On how success will be measured, DHCW plans to examine “how well our products and services are used by health and care organisations and the general public in Wales”, which will see their quality, value to staff and safety levels analysed. It is hoped that this will also help the organisation to pre-empt demand for new digital services and tools.

DHCW also shares hope that staff will be “empowered and motivated to innovate within a culture that rewards delivery”, encouraging creativity to find new ways of working and make effective use of digital tools.

… and principles to guide actions

DHCW goes on to share the five principles that will be used to guide choices as the organisation works towards its strategic objectives: to put people first; to simplify; to design for more data, more digital; to find more value; and to learn from the past and embrace the future.

On supporting people, the strategy highlights that investment is to be made into Centres of Excellence in order to help develop teams and their knowledge. DHCW will also build on its Digital Inclusion Charter Accreditation, and aims for AI and data use “to change drastically in the relatively near future”, with expectations that AI and automation will replace “mundane repetitive work”. An example is provided, with tools to support software coding and development to drive productivity.

Complexity across the system is to be reduced by using standard technologies and processes and eliminating unnecessary steps and processes, with automation and consolidation also aiming to support in this area. The strategy notes that taking an open architecture approach is “central to making our products more simple, resilient and flexible”, along with helping to “innovate faster”.

“Our assurance groups and boards remain critical to validating the work we do, and to be effective within our new ways of working they need to work in a simplified way,” the strategy states. This is to be achieved by establishing clear sets of rules and specifications around what needs to be assured, when and how, with DHCW emphasising that they “should not seek additional layers of assurance when there is no further added value”.

All programmes and projects are to be brought together within a single portfolio management office in order to support the way that projects are run, including use of reporting schedules and tools to support delivery of work.

The strategy emphasises the need to design for more data and more digital for the future, with volume of data expected to grow with the introduction of new ways to capture data electronically. DHCW notes the need to find ways to measure the impact of increased digital and data use, pledging to map digital maturity across partner organisations along with measuring usability and iterating usability assessments over time to highlight where changes are improving user experience.

In order to find more value from digital services and solutions, DHCW will partner closely with local organisations when new products are being implemented, to identify where the organisation’s products and services can be optimised. A “robust” benefit management framework is also to be developed and implemented, to explore the products and services delivered by DHCW, the people using them, and how they are used in “useful and valuable” ways. The importance of proactively demonstrating and communicating benefits is also noted.

On how to measure the value of work, DHCW pledges to focus on the key areas of delivery (ensuring that work is aligned to the right objectives); productivity (ensuring that work is efficient and effective); and value (measuring the outcomes resulting from the benefits realised).

Finally, on how DHCW plans to learn from the past and embrace the future, the strategy sets out a need to find new roadmaps for legacy products “that ultimately steer us towards their decommissioning”. In order to do this, the team “must become change-native, building on our recent work to evolve our product portfolios and develop new, better, effective, efficient, and safer products”. On this note, DHCW stresses that this can only be achieved by having clear direction and expertise in the technologies that the organisation seeks to use. Whilst the NDR will be central to this approach, the organisation also acknowledges the need to invest in and drive value from the Cloud Centre of Excellence; to find innovative ways to deliver increased value, and to be agile to the adoption of new tools.

The strategy can be found in full here.

In other news from DHCW, in the spring we reported details on the planned implementation of a health information system and electronic medical record, as a fully hosted and managed platform across nine health boards, 13 hospitals and 23 laboratories in Wales.

We also explored the organisation’s primary care strategy for 2024-2027, which shares priorities including developing a digital futures team with the intention of shaping technology choices, and enhancing researching and reporting capability.