Digital and data across Wales: strategy, projects and insights

Digital and data across Wales

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Here we focus on digital and data across Wales, taking a closer look at the strategic direction, insights, recent developments, and more around digital healthcare. With insight from key stakeholders including Digital Health and Care Wales (DHCW), InterSystems, the Welsh Ambulance Services University NHS Trust, and Betsi Cadwaladr University Health Board; we unearth key priorities and outlooks from across the Welsh health system.

Strategic direction

A key story covered by HTN this year was the organisational strategy published by Digital Health and Care Wales, framing DHCW’s planned activities until 2030 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 include moving 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 also shares a number of ambitions, looking ahead to 2030. It hopes that 2030 will see 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.

Earlier in the year HTN also shared DHCW’s primary care strategy, spanning 2024-2027; this shares priorities including the development of a digital futures team intended to help shape technology choices and enhance researching and reporting capability.

This strategy sees DHCW commit to priorities including consistently developing and improving the positive impact of digitally-enabled change; addressing shortfalls in consistency and quality across the whole digital portfolio; collaborating with others to ensure that policy is developed “against the richest and most comprehensive data” available; and developing, agreeing and standardising a framework detailing data management and interoperability standards, to be adopted across primary care in Wales.

We can also gain insight into the strategic direction of Wales in future months and years by taking a look at some of the procurement opportunities that have recently arisen, such as NHS Wales Shared Services Partnership Procurement Services seeking expressions of interest from industry partners to help shape a “comprehensive” commercialisation strategy and delivery model for Wales, aiming to help realise commercial value from NHS innovation activities. Other opportunities have included DHCW sharing intent to procure an all-Wales general practice data extraction and reporting solution; and issuing a contract notice for a network as a service solution designed to enable the department to “strategically interconnect its physical datacenter estate, public cloud platforms, and consumer base using a resilient underlay/transit network”.

Strategic direction
Insight from InterSystems
Digital Health and Care Wales
Welsh Ambulance Services University NHS Trust
Betsi Cadwaladr University Health Board
The latest news from Welsh health boards

Insight from InterSystems...

As part of our deep dive into digital healthcare in Wales, we spoke with Colin Henderson of InterSystems about the organisation’s work in this space, the benefits that can be seen as a result, and ambitions for the future.

Firstly providing some context into the key projects and programmes for InterSystems in Wales, Colin shared how InterSystems supports the deployment of the LIMS 2.0 project, aiming to upgrade all health boards from the legacy TrakCare Lab solution to the web-enabled and responsive design TrakCare Lab Enterprise by the end of 2025, moving to a fully hosted and managed solution by InterSystems.

“This is a national instance of the LIMS supporting 21 laboratories across six health boards,” Colin explained, “and the programme will put Wales onto a future-proofed platform to enable the pathology service to innovate and evolve over the next decade. It will also support Wales in its ambition to have 95 percent of laboratory requests from primary and secondary care delivered electronically.”

Reflecting on outcomes or metrics from InterSystems’ work in Wales, as well as how staff and citizens can benefit from the LIMS 2.0 project, Colin considered: “Diagnostic testing is critical as the results inform next steps and plans, so efficient processing of laboratory information is key to improving flow in the health system. There are multiple benefits from this project, which is a fully hosted and managed service – for example, it gives a single rich clinical pathology record that is available across the country that supports the seamless movement of work across any laboratory site. It also provides a standardised solution for functionality, test repertoire and workflows across all laboratory sites, and enables efficiencies in working practices and distribution of work across sites.”

The other advantage Colin raised is around the enablement of consistent working practices at each laboratory. “Where necessary, the workforce can move to support demand in services,” he noted. “In addition, it gives a means of national business intelligence and insights into the pathology services for Wales.”

Are there any particular areas of potential in the Welsh landscape when it comes to digital healthcare, in Colin’s view? “Wales’ digital ambitions are consistent with what we are seeing across many health and care systems regionally and internationally, with a data services platform and suite of key digital capabilities at the heart of the strategy,” he said. “Delivery of national projects is readily achievable in Wales, evidenced by the national LIMS solution and the successful national shared care record – this could also be further developed and expanded, enabled by an enhanced digital platform, to support patient and citizen engagement and to deliver more population health or disease centric views and capabilities.”

Colin commented on the “bustling research community in Wales”, elaborating that the existence of several national solutions already in place “makes it much easier to unleash that wider potential of the data that is being collected, to support the research and innovation ambitions”.

As for what the future holds in this space, Colins said: “Wales is a key territory for InterSystems, and we are discussing what else we could explore as a strategic partner to the nation. Our priority and focus at present is the successful delivery of the national LIMS solution, but we have offered the opportunity to share learnings and experiences with other regions across the UK and Ireland. Once live, we are excited to explore a next wave of innovations that could sit around the LIMS deployment such as the use of AI to support test prioritisation, where we expect a positive lab result, or the use of our supply chain management capabilities to focus in on the supply side of lab operations.”

In all InterSystems’ active territories, the regions are “wrestling with similar challenges”, Colin reflected. “Whilst our focus is on diagnostics in Wales presently, other regions are using the same TrakCare suite of InterSystems technology to deliver a standardised PAS and EPR system, supporting information flows not just in acute, but in wider community and mental health services within a single database structure. Our IRIS technology is also already used in Wales and could be enhanced to deliver more of the data platform services that Wales requires to deliver on its digital ambitions. Whether Wales opts to pursue InterSystems options or not, to be an effective partner to Wales, we want to surface the learnings and experiences from other regions to help explore the art of the possible.”

...from Digital Health and Care Wales...

We also heard from Sam Hall, director of primary, community and mental health digital services at DHCW, as she shared insight into some of the key projects she has been involved in over the past year.

“This has been a huge year for projects,” she reflected. “We have worked on eye care projects to identify new tools for primary care community optoms; digital mental health; shared care records between health and social care; creating a dental access portal to help people access dental services in Wales; and the continuation of our vaccine services in Wales.”

In terms of priorities for the future, Sam noted that Wales is “only at the beginning of the shared care record journey, so that is a huge priority, as is leveraging more from digital mental health. Also, we’re working on enhancements to our Choose Pharmacy product to deliver more common ailment support closer to home. We’ve got a lot on our books!”

Are there any areas or opportunities Sam thinks should receive more focus, or any challenges she would like to tackle if possible? “Digital mental health can’t have enough focus,” she considered. “The services are under incredible pressure and sustainability can only happen if we change our methods of offering the service. There’s also Care Closer to Home – that’s a huge project for our ageing population. And I would like to see focus on supporting our GP practices, who are under increasing pressure.”

As for what excites Sam in this space, she said: “The ethical use of AI, not for the big things, but for making the little things easier – trying to use digital tools to create time, essentially. Our frontline staff aren’t asking for funky new systems, they are asking for more time to do their job well. I think AI could be part of the answer to that.”

...from Welsh Ambulance Services University NHS Trust...

To gain insight into what has been happening with regards to digital at the Welsh Ambulance Services University NHS Trust (WAST) we spoke with Dr Mike Brady, consultant paramedic and assistant director for remote clinical care.

Firstly, Mike explained how WAST provides a range of services, from non-emergency patient transport to NHS 111 Wales and 999 services, and outlined the main uses of digital clinical tech. “The range of technology across these services is vast, from electronic patient care record systems and computer-aided dispatch systems to robotic automation technology to perform time-consuming administrative tasks to free up staff to focus on tasks that add the most value,” he said.

“My area of clinical practice, however, is remote clinical care – any interaction that clinical and non-clinical staff have with patients over video, remote monitoring, telephone, or online that is not face-to-face directly with the patients. One such technology is the new NHS 111 Wales Call Prioritisation Streaming System (CPSS), used by our amazing health advisors.”

How is the recent implementation of the CPSS making a difference? “Combining clinical evidence, modern technology and opportunities for interoperability, CPSS aims to ensure that patients are getting the right care from the right person the first time,” Mike said. “It ensures that WAST works effectively within the wider integrated urgent care sector in Wales. Health advisors ask symptom-specific questions in a structured, evidence based and auditable way that allows them to effectively prioritise and stream the patients to where they need to be or to speak to the person they need to speak to. This might mean getting a call-back from one of our nurses or paramedics, being advised to contact a general practitioner pharmacist, visiting a minor injury unit, or managing symptoms at home with help from our NHS 111 Wales website.”

The service has recently undertaken an “appropriateness of CPSS outcomes study”, Mike added, and looks forward to publishing “positive results” early next year.

As for what is happening around remote monitoring for the Welsh Ambulance/111 service, Mike explained how WAST has been working with Health Boards and the Small Business Research Initiative (SBRI) Centre of Excellence to pilot remote monitoring technology to assess how it can help care for patients by the right people first time. “The technology being used captures a patient’s vital signs, including heart rate and blood oxygen levels, and data is sent in real-time to clinical control rooms, where remote care clinicians determine the appropriate next steps for the patient,” he continued. “Thinking differently about how we respond to our patients is key to ensuring that we can transform care for more patients in their own homes where it is possible to do so, in turn safely reducing the number of patients we take to the emergency department and ensuring ambulances are available for those who need them most. Whilst this is very early work, I am very excited to see how we can learn fast and adapt quickly to the use of this technology to deliver high-quality patient care.”

Looking to the future, Mike considered where digital priorities should lie. WAST has recently published its Digital Plan 2024-2029, he noted, which aims to enhance the quality of patient care through use of technology and data-driven innovation. “We are aiming to improve healthcare outcomes, patient experiences, and operational efficiency by investing in advanced digital tools and fostering a culture of continuous digital improvement with inclusivity and equality at its centre,” he said. “These innovations include implementing advanced dispatch systems, telehealth services, and real-time communication tools – we want to ensure faster response times when needed, better care coordination, and more personalised patient experiences.”

Specifically focusing on remote consultation, Mike concluded: “I would like to see more research into using a broad range of technologies in the remote clinical setting, their effectiveness, novel applications, and how we can integrate them into more services. I want to prioritise how we can safely and morally use large-scale data to benefit the population as a whole and specifically further the use of machine-led learning, artificial intelligence, and mathematical modelling to augment real-time clinical and operational decision making, empowering and equipping our fantastic people to respond better to a range of everyday scenarios.”

...And from Betsi Cadwaladr University Health Board...

An update from Betsi Cadwaladr offered an insight into achievements from the last 12 months, saying: “Over the past year, we have laid the groundwork for several transformative digital programmes aimed at improving patient care and operational efficiency.” One such digital programme has been preparing for the implementation of an Electronic Prescribing and Medicines Administration (ePMA) system, the board highlights, which is hoped to “digitise medication management and reduce errors, streamline workflows and enhance patient safety”. Part of the preparation, the update shares, has been in working closely with clinical teams to ensure “the necessary infrastructure is in place”.

The board also shared that it has “made strides” in the mental health space, identifying the “key elements” of a digital mental health record, and successfully securing the appropriate funding. It states that “whilst these initiatives are in their early stages, they aim to improve access to care and support timely interventions for patients”.

Betsi Cadwaladr also notes that, “the securing of funds and establishment of an Electronic Health Care Record Transformation Programme (EHR) will allow us to move from significant unwarranted variation to simplify and standardise practice, workflows and information to enable us to deliver great care, made easy, every time.”

In terms of the next 12 months, the board outlines two “key imperatives” as areas of focus: the implementation of a new radiology system, and a new LIMS. It states that “the criticality of these programmes cannot be underestimated, as any failures could impact the ongoing operation of any healthcare providers”. It also shares plans to rollout its ePMA system “across BCU’s acute and community sites”, with aims for a “smooth transition for clinical teams and patients” meaning a focus on “a robust training and engagement programme to maximise the system’s benefits”.

The update goes on to say: “Clarity around the future target state architecturally from a business capability perspective will be key so that the Health Board have a clear target to work to for all its projects and programmes. The first area of focus is Mental Health Services where the procurement process has begun. This will be the biggest and most significant transformation to happen in Wales where Digital and Data is the enabler.”

The EHR will also “remain a central priority”, according to Betsi Cadwaladr, with a focus on ensuring system interoperability, engaging stakeholders, and “testing prototypes to deliver a seamless and user-friendly experience”. The update finishes with the following sentiment:

“Building a strong digital culture is essential to our success. We’re committed to upskilling our workforce, upgrading digital infrastructure and supporting collaboration to realise the full potential of these innovations. We are excited about the progress we are making and look forward to seeing these initiatives come to life, bringing significant benefits to our patients and communities.”

The latest news from Welsh health boards

Let’s take a closer look at some of the latest developments around digital and data from each of NHS Wales’ health boards.

Aneurin Bevan University Health Board

Earlier this year, Aneurin Bevan shared the news that a surgical robot had “successfully completed” its first procedure at the Royal Gwent Hospital’s urology department, following “weeks of extensive training for urology staff” and the addition of machines to meet the Da Vinci robot’s sanitisation needs.

Another announcement highlighted the expansion of Aneurin Bevan and Cardiff and Vale’s QuicDNA project to other health boards, promoting the collection of real-world evidence on the impact of liquid biopsy testing in cancer treatment pathways, and ensuring “patients across Wales can benefit from this pioneering technology”.

The health board also celebrated that some of its patients have begun to benefit from the Electronic Prescription Service (EPS), meaning that prescriptions can be sent electronically from a GP to a pharmacy without the need for a paper form, and that patients “no longer need to visit their surgery to pick up a repeat prescription form”.

On social media, staff from Aneurin Bevan have created their own version of John Lewis Christmas advert, using a dedicated TikTok filter. The board also shared an update on LinkedIn detailing the arrival of new linear accelerator radiotherapy machines, used to deliver high-energy x-rays or electrons to the region of the patient’s tumour”. The machines will form part of the Satellite Radiotherapy Centre, which is “expecting patients in Spring 2025”.

Betsi Cadwaladr University Health Board

Betsi Cadwaladr University Health Board has shared updates on its robotic surgery capabilities, including Ysbyty Gwynedd hospital’s official recognition as “the first NHS robotic training centre in Wales to train other surgeons in robotic knee surgery”.

The board also highlighted the hospital’s milestone of performing “more than 140 robotically assisted surgeries”, following the rollout of robotic surgery across gynaecology and general surgery. The Surgical Versius Robot was first introduced in 2022 at Betsi Cadwaladr as part of the National Robotic Assisted Surgery Programme, which aims to offer patients a less-invasive option for surgery.

Cardiff and Vale University Health Board

News shared from Cardiff and Vale over the last six months includes the launch of a new Dental Access Portal to help patients register for NHS dental services in the region. Launched by DHCW, the portal went live at the end of October, and is expected to be rolled out nationally by the end of the 2024.

The board also highlighted its signing of a Memorandum of Understanding as a “formalised pledge to work with science technology company Illumina” around the development of preventative care genomics in Wales, helping to support the development of new technologies, treatments, and services to support preventative care.

The introduction of electronic prescribing in Cardiff and Vale as part of the wider rollout of the Electronic Prescription Service across Wales has also seen patients getting greater control over how they access their prescriptions, and allowing staff to monitor “at all times” where a prescription is, “eliminating the risk of a piece of paper being lost”.

And the board recently celebrated “10 years of robotic-assisted surgery” at the University Hospital of Wales, with the da Vinci Xi surgical system allowing patients to benefit from “smaller surgical incisions and reduced complications, leading to faster recovery and fewer days in hospital”. Across the health board, there are “five trained surgeons across Urology and ENT, who have operated on more than 2,700 patients from across Wales since September 2014”.

Cwm Taf Morgannwg University Health Board

Cwm Taf Morgannwg University Health Board shared progress around robotic surgery, highlighting its successful use in treating a bowel cancer patient, and outlining that “all suitable patients” diagnosed with this form of cancer are offered robotic surgery as an option in their care.

The health board also announced the launch of a new Digital Health Assessment Platform designed to improve patient outcomes and experiences, initially focusing on heart failure and lymphoedema patients. It shared how staff are being actively encouraged to get involved and explore how Patient Reported Outcome Measures (PROMs) “could be integrated into their services in the future”.

Partnering with Nervecentre to deliver a new ePMA is hoped to help “reduce the risk of medication errors, help ensure information is accurate, up-to-date and readily available to support clinical decision making, and ultimately improve patient care” across Cwm Taf Morgannwg. The health board also notes the potential for the solution to offer clinicians “more time to deliver safer and more effective care to patients”.

And a new online CBT service is offering a new perinatal referral pathway with the perinatal team at Cwm Taf Morgannwg, with patient progress being monitored to allow “more serious cases” to be identified for further help. The service is available for anyone in Wales aged over 16, with no need for patients to see their GP or join a waiting list.

Hywel Dda University Health Board

Earlier this year, Hywel Dda University Health Board published a tender worth an estimated £75 million for a digital transformation strategic partner to support them in planning, accessing and managing digital ambitions by leveraging the capacity and expertise of both the health board and the partner.

It is hoped that the long-term partnership will “significantly” accelerate the pace of the health board’s digital response and priorities, with specifications including that the partner be flexible in nature; that they will provide “stable and sustainable” solutions; and that they will work in an integrated way with the health board’s internal teams.

The health board also offers patients the ability to manage their health appointments through the Hywel Dda Post portal, to view their medical information online using the Patients Know Best (PKB) portal, and to access a library of digital health apps reviewed against criteria on data and privacy, usability and accessibility, and clinical and professional assurance.

Powys Teaching Health Board

Powys Teaching Health Board recently shared its new investment of £1.7 million in digital X-ray equipment, funded by the Welsh government to offer “faster, clearer images” and help “improve diagnostics for the people of Powys”. The new equipment is also hoped to help the health board tackle waiting lists for X-rays and “improve access to treatment”. With the first phase underway at Ystradgynlais, Llandrindod Wells and Welshpool, the second phase is set to begin in January.

A new digital service designed to provide a central platform for Welsh Health Boards to allocate places for routine NHS dental treatment has been piloted at Powys Teaching Health Board. The Dental Access Portal aims to tackle “significant variation” between Health Board allocation of NHS dentist places, which reportedly brings challenges in measuring the “true level of demand” on a local and national level. The portal has been designed and built by Digital Health and Care Wales, ahead of a national roll-out later in the year.

Swansea Bay University Health Board

Swansea Bay University Health Board has highlighted the work of its prehabilitation team in educating and supporting patients waiting for surgery, helping patients stay in shape by offering exercise classes and weight management advice, which they can choose to take in-person or virtually.

The Health Board also shared how a new phone app enabling dental staff to access expert advice had “helped eight out of 10 patients avoid a trip to hospital”, with Swansea Bay thought to be the first region in the UK to implement the Consultant Connect app within dental specialities. With functionality supporting internal messaging and sharing of images to help with getting a second opinion, the Board noted how it had the potential to “reduce the need for face-to-face appointments in the hospital in some cases”.

Taking to social media for International Women’s Day earlier this year, Swansea Bay celebrated its female-led digital transformation team, pointing to their roles as “leading players in four pivotal digital systems” and in “developing and delivering healthcare digital systems which are benefiting patients not only in Swansea Bay, but across NHS Wales”.

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