Delivery is ‘not matching ambition’ in NHS digital transformation, says Audit Wales

Ella Groves, ICNN Senedd Reporter

NHS bodies have “clear digital ambitions” but delivery needs to improve to ensure better services and value for money, according to Audit Wales.

Wales’ Auditor General, Catherine Mealing-Jones, briefed Senedd Members on NHS digital transformation alongside her Audit Wales colleagues on Monday September 28.

Speaking in a Public Accounts Committee meeting, Ms Mealing-Jones said Audit Wales had examined how the 12 health bodies in Wales are using “digital transformation” to improve services.

She said their examinations had looked at NHS digital strategies, leadership, workforce capability and investment planning as well as managing risks associated with digital infrastructure, cyber resilience and the increasing use of AI.

“Clear digital ambitions”

Audit manager Darren Griffiths told the committee that while NHS bodies have “clear digital ambitions”, most have “not yet translated them into costed delivery plans with clear actions, responsibilities and success measures”.

He said not all have assessed their digital maturity, meaning “some bodies do not fully understand their starting point or the scale of change required”.

Mr Griffiths said: “Without clear delivery plans and robust benefit management arrangements, a digital ambition may not deliver better services or value for money.”

Plaid Cymru MS Carrie Harper quizzed the Audit Wales staff on where they believe “responsibility and accountability” sits for the lack of delivery.

The Fflint Wrecsam MS asked if the fault lies with the individual health boards, Digital Health and Care Wales (DHCW), or the Welsh Government.

Noting that all three play a role, audit lead Nathan Couch responded: “At the local level, health boards are responsible for the digital programmes and things that they implement locally.

“At a national level, it’s the Welsh Government and DHCW who are responsible for the rollout and delivery of national digital programmes, in conjunction with the health boards as well”.

He continued: “What came out of the reports that we’ve done is that there is a lack of clarity around the roles and responsibilities of each party in doing that.”

Cyber Risks

Mr Griffiths also stressed cyber security remains a “major risk”, as cyber attacks can disrupt services, expose information, and affect patient care.

He told the committee Audit Wales found boards “discuss cyber risks regularly”, with some having completed self-assessments against national cyber security standards.

However, the audit manager noted “progress in addressing identified gaps has been slow, keeping risks high”.

AI was also deemed to offer “significant opportunities”, with bodies investigating how it could “support daily work, improve services and make better use of resources”.

Noting that boards are “still developing” approaches to ensure AI is used “safely, ethically, and consistently”, Mr Griffiths warned that without getting this right they may “struggle to balance the benefits of AI, with risks to patient safety, data protection and public trust”.

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