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NHS digital delivery not matching ambition in Wales, finds auditor

Key Points

• On 17 September 2026, Audit Wales issued a report indicating that digital delivery in NHS Wales is not commensurate with the level of ambition.
• 11 out of 12 NHS bodies had annual expenditure averaging around £216 million for digital technologies and services, mainly on maintenance of legacy systems, during 2023-24 and 2024-25.
• DHCW was spending an average of around £191 million annually, charging the NHS bodies an average annual amount of £66 million for national products and services.
• The auditor revealed that most of the NHS bodies have been unable to translate their digital ambitions into realistic costed digital delivery plans with actionable outcomes and indicators.
• Around 2% of the workforce in NHS Wales had completed a national digital skills self-assessment tool, which reveals the lack of clarity regarding the skill set of the workforce.
• Risk to cyber security continued because of the presence of outdated technology, inadequate training, and evolving threat landscape, along with problems in attracting and retaining digital experts.
• A spokesperson of the Welsh Government stated that digital and data transformation are one of the key priorities and that the Welsh Government would consider the findings of the report in connection with the development of the NHS

Wales (Wales Times) September 18, 2026 – Audit Wales has concluded that digital delivery across NHS Wales is falling short of stated ambitions, with funding pressures, ageing systems and workforce gaps constraining progress. The findings, set out in a report published on 17 September 2026, point to heavy reliance on legacy technology, unclear delivery planning and limited insight into staff digital skills as key obstacles to modernisation.

What did Audit Wales find about NHS Wales’ digital progress?

As reported by Lee Peart of Healthcare Management, Audit Wales stated that “NHS digital delivery in Wales is not matching the scale of ambition with funding pressures, ageing systems and workforce gaps holding progress back.” The auditor’s assessment covered the seven health boards, three NHS trusts and Health Education and Improvement Wales, alongside Digital Health and Care Wales (DHCW), which leads national digital work for the health service.

The report found that while NHS bodies had digital ambitions broadly aligned with the national strategy, most had not translated these into clear, costed delivery plans with defined actions, responsibilities and success measures. Audit Wales also noted that although some digital projects considered digital inclusion – including in mental health and maternity services – NHS bodies would need better ways of demonstrating that digital change is improving access for those most at risk of exclusion.

How much is NHS Wales spending on digital technology and services?

Audit Wales analysed digital spend across 2023–24 and 2024–25, finding that 11 of the 12 NHS bodies reported a combined average of around £216m a year on their own digital technology and services. Most of that expenditure went on maintaining existing digital services and systems rather than investing in digital change, indicating that day-to-day operational costs are crowding out transformation.

DHCW spent an average of around £191m a year over the same period, within which it recharged NHS bodies around £66m a year for national products and services. The auditor concluded that, while some funding had been made available specifically for digital investment, it was not sufficient to meet demand across NHS Wales.

Why are cyber security and workforce skills flagged as concerns?

Cyber security remained a persistent concern due to old technology, training gaps and evolving threats, according to the Audit Wales report. NHS bodies also struggled to recruit and retain specialist staff in areas such as cyber security, data analysis and digital project delivery, particularly where the private sector offered more attractive roles.

On workforce capabilities, the auditor found that NHS bodies did not generally know enough about the digital skills of their staff and recorded very low take-up of a national self-assessment tool. Only around 2% of the NHS Wales workforce had completed the tool, limiting the ability of leaders to target training and support effectively.

What does the report say about Digital Health and Care Wales’ own transformation?

A separate Audit Wales publication on DHCW’s digital transformation highlighted weaknesses in internal governance and planning. The auditor noted that DHCW’s Organisational Strategy gives less attention to its own internal digital needs, and while its Integrated Medium Term Plan offers more detail on internal improvements, it does not clearly explain expected benefits or outcomes.

The Board receives regular reports, but these mostly cover national programmes, meaning oversight of internal digital transformation is weaker and the Board cannot track progress, costs and benefits closely. Financial uncertainty further complicates internal transformation, as most funding is short term and focused on national systems, reducing flexibility for internal investment and limiting transparency in financial reporting.

How has the Welsh Government responded to the auditor’s findings?

A Welsh Government spokesperson said:

“Digital and data transformation to modernise our health and care system is a key priority for this new Government.”

The spokesperson added that, as part of the First 100 Days plan, foundations had been laid for an ambitious agenda that would be built upon as the programme for Government is implemented.

The government stated it is committed to strengthening national digital services, improving consistency and interoperability of data sources, enhancing cyber resilience, expanding digital tools for patients and staff, and embracing innovation such as the responsible use of AI in healthcare. It said it would consider the report’s findings and recommendations alongside work to refresh the NHS Wales Digital and Data Strategy, adding that digital services must work for everyone and that patients who cannot or choose not to use digital channels will continue to have alternative routes to access care.

Background to the development

The Audit Wales report builds on earlier scrutiny of DHCW’s performance and governance. In August 2026, the Auditor General published Digital Health and Care Wales: Digital Transformation, which found that DHCW “does not have its own digital transformation strategy” and that board oversight of internal transformation was weaker than for national programmes. That report listed six formal recommendations covering measures and milestones, a costed infrastructure plan, funding clarity, post-closure accountability, skills and value-for-money evaluation.

Coroners in Wales have previously cited absent, delayed and partly delivered digital systems among circumstances contributing to deaths since 2018, issuing multiple Prevention of Future Deaths reports that reference delays and fragmentation in national digital rollouts. In April 2026, the Welsh Government escalated DHCW to Level 4, Targeted Intervention, citing delivery, accountability and leadership concerns. Against this backdrop, the latest Audit Wales findings reinforce long-standing concerns about the pace and coherence of digital change in NHS Wales.

Prediction: how this development can affect patients, staff and health boards

If the gaps identified by Audit Wales are not addressed, patients in Wales are likely to continue experiencing slower diagnosis, fragmented handovers between clinicians and limited access to up-to-date digital tools, which can prolong waiting times and increase the risk of errors. For clinical and administrative staff, persistent reliance on legacy systems and unclear delivery plans may sustain high workloads, reduce confidence in digital tools and hinder efforts to adopt innovations such as electronic prescribing and shared records at scale.

For health boards and DHCW, the combination of funding pressures, skills shortages and cyber security risks could delay major programmes, increase costs and expose organisations to greater regulatory and reputational risk if incidents occur. Conversely, if the Welsh Government’s stated commitments translate into costed, milestone-driven plans with clearer accountability and stronger workforce development, the health service could improve interoperability, reduce duplication and deliver more consistent digital services for patients and staff.