How are digital and data services delivered in the NHS in Wales?

What are digital and data services in the NHS?

Digital health and social care is about adopting and developing digital technologies to improve care workflows so that people can be treated faster, safer and as close to home as possible. Digital and data technologies are key to transforming health and care services. For example, by enabling earlier and more accurate detection and treatment, encouraging a shift towards prevention and self-management, moving services from hospital into the community and home, and enabling the whole system to organise itself seamlessly around the needs of each individual. Good digital tools drive improvements in how health and care services are delivered and how people manage their own health and wellbeing.

As with other health policy areas, the Welsh Government is responsible for setting the policy around digital and data in the NHS in Wales. The two key strategies that define the approach are A Healthier Wales and the Digital and Data Strategy for Health and Social Care in Wales.  

What is the role of Digital Health and Care Wales (DHCW)?

Digital Health and Care Wales (DHCW) is an NHS Wales Special Health Authority (SHA), established in 2021. DHCW works in partnership with the Welsh Government, health and care organisations and citizens to provide national digital and data services that support the delivery of health and social care. NHS Wales organisations have their own digital teams that run local digital services within their own organisations.

Modern health and care services depend on good digital tools, data and information. DHCW runs or supports the delivery of more than 100 services and delivers major national digital transformation programmes to support this.  

The organisation gives frontline health and care staff digital tools that help them provide safer and more efficient care. For example, DHCW’s digital applications enable health and care staff to access the information needed to make decisions, and to record the actions they have taken. DHCW also operates and manages major national digital infrastructure, including cyber security and two data centres.  

DHCW’s aim is to put people at the heart of what it does, working to the highest standards to deliver quality and making digital a force for good within health and care. The organisation develops and delivers digital tools for patients and the public to empower people to live healthier lives.  

How is DHCW funded?

As stated in our explainer about how the NHS in Wales is funded, DHCW receives revenue funding from the Welsh Government, local health boards (LHBs) and NHS trusts to deliver services in line with the duties outlined within its Standing Orders. DHCW submits an annual business plan to the Welsh Government, setting out how the organisation will meet the requirements of the Cabinet Secretary’s Remit Letter. An annual budget is submitted alongside the annual plan, which needs to be compliant with statutory financial duties and meets the requirements of probity and value for money. Funding from the Welsh Government is allocated for programmes and agreed through funding letter awards, while funding for specific services provided to LHBs and trusts is defined and agreed within Service Level Agreements on an annual basis. DHCW may also receive income from third parties in relation to services delivered. 

Why is digital and data important in health?

The NHS in Wales is at a turning point, with the challenges complex and ever-changing. Improving health and reducing inequalities against a backdrop of unprecedented demand, the ongoing impacts of the COVID-19 pandemic and limited resources all bring major challenges, but the opportunities to transform health and care are also significant.

The need for a digital and data revolution in the delivery of health and care has never been clearer. This was illustrated by the COVID-19 pandemic, when the use of digital and data supported the development of the Test, Trace, Protect Programme as well as the successful and swift rollout of the COVID-19 vaccine programme.  

Digital and data are key enablers to improving outcomes in safe, responsive and prudent health and care services. They are the foundations for innovating to develop services that empower patients and health and care professionals and are essential for embedding and sustaining health and social care integration and supporting people to interact seamlessly across health and care services, regardless of their location or who is providing their care.  

What recent progress has been made in digital health in NHS Wales?

In recent years, the development of major new digital services has helped to enhance outcomes, strengthen resilience, remove backlogs and support access to services. These national digital clinical systems ensure key information is shared and visible to all health care professionals (with the appropriate safeguards in place) regardless of geography, allowing for more informed decision making and safer care.

This includes: 

To improve health and care in Wales, DHCW is establishing a modern, open digital architecture that enables secure access to common core services. This architecture will facilitate secure and seamless data exchange between diverse systems, fostering interoperability and innovation.  

DHCW is defining a national target architecture with a clear roadmap for implementation with the aim of driving efficient information flow and supporting the development of innovative digital solutions across health and care. However, there is still much more to do, and work continues to drive digital transformation across NHS Wales to benefit its staff and patients.  

What next for digital health?

Digital and data technologies are the key to transforming health and care services, as set out in Welsh Government’s ‘A Healthier Wales’ strategy. Technologies can enable earlier and more accurate detection and treatment, encourage a shift towards prevention and self-management, move services from hospital into the community and home and enable the whole system to organise itself seamlessly around the needs of everyone.

There is constant growth in data and in digital. Data comes from ever more diverse sources, including remote monitoring and wearables. Digital apps and services are multiplying too, driven by wider digital adoption and new technologies like Artificial Intelligence (AI).  

There are concerns about how AI will develop; health and care data is sensitive, and privacy is paramount. Therefore, safeguarding and appropriate use of data is key if the NHS in Wales is to realise the full potential that wider availability of data can bring.  

Not everyone wants to, or is able to, use digital, but it is essential we use it to complement the human aspects of health and care. Protecting digital investment and supporting people who are digitally excluded to upskill and develop their digital confidence and protecting investment in digital are essential, even in the current challenging financial circumstances.

What will support digital transformation?

• Digital maturity: The levels of digital maturity across NHS Wales varies and this will need to be improved to make the best use of the opportunities digital present.  
• Integration: Digital and technology are essential for embedding and sustaining health and social care integration. They will support people to interact seamlessly across health and care services, regardless of their location or who is providing their care. Work in this area is underway but there are more opportunities to support this much needed integration in Wales.
• Driving technology adoption on the frontline: There is a need to make sure the infrastructure, skills and confidence are sufficient to enable digital to be adopted by those delivering care on the frontline.  
• Digital inclusion and equitable access: Digital transformation should not leave anyone behind. Those who are digitally excluded need to be given access to support and skills development to allow them to make the most of the opportunities that digital can provide.  
• Sustainable funding models and including digital in future service planning: Sustainable funding for digital will make a significant difference in the planning and delivery of systems and services. Digital will need to be put at the heart of future service planning if there is to be a transformation in health and care.
• Recruiting, retaining and retraining talent: Career paths need to be varied and there is a need to ensure the right continuous professional development offers are in place. While the growth of digital and data will mean we have more systems and services, skills will also continue to change, and we need to make sure people are able to respond to this. Through investment in digital education, infrastructure and industry, Wales can ensure that digital skills are at the forefront of achieving a sustainable, equitable, and thriving future for all its citizens.