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Auditor highlights problems with Welsh care information system


Wales is still a long way from realising the full benefits of the Welsh Community Care Information System (WCCIS), according to the country’s central auditor.

Audit Wales has published a report on the progress with the system, the contract for which was signed with CareWorks in 2015, saying the prospects for full take-up remain uncertain, and that important issues need to be resolved including around how the system functions.

WCCIS was developed as a shared electronic record for health and social care staff, with the intention that all seven health boards and 22 local authorities would implement it by the end of 2018. But by the end of August this year only 15 – two health boards and 13 councils – had gone live, four had signed deployment orders, four were in active negotiation and six were yet to commit.

Among the report’s findings is that there are differences in how organisations are using the system – often utilising only certain functions – which is limiting opportunities for integrated working and undermines the value for money.

The development of key functions such as for the Welsh language and mobile interfaces has been delayed, with a current estimate for completion at the end of 2021. There have also been issues around the performance of the system.

Cost increase

Costs have been higher than expected, with the Welsh Government and NHS Wales Informatics Service having spent or committed over £30 million to March 2002 with more funding from health boards and local authorities. The auditor says it has not been possible to provide a reliable overall estimate but it is clear that these run into several millions of pounds.

One key element which requires further development is a set of national data standards to ensure organisations input data in a consistent way. This work is at different stages across different service areas, and the Covid-19 response has highlighted the importance of this work and showed that this is possible given enough focus.

Meanwhile, work is still ongoing to develop a suitable framework for reporting on the benefits of WCCIS implementation.

Need to take stock

Among the report’s recommendations for the overall management of the system is a need to take stock of expectations and further roll out, and pull together a clear national picture of feedback from users on its performance. Also, there is a need to consider how relevant lessons can be applied to any successor contracting arrangements and wider public procurement.

Auditor General Adrian Compton commented: “The potential benefits of a shared electronic record across health and social care are clear to see; even more so given some of the challenges presented by the Covid-19 pandemic.

“However, the Welsh Government’s ambitious vision for WCCIS is still a long way from being realised. It now needs to work with the various organisations involved to take stock of expectations for the remainder of the contract term and the resources and wider commitment needed to support progress.”

In response to the report, the WCCIS programme director Dave Street said it is already acting upon the recommendations.

Complex and unprecedented

He said: “The scale of implementing a shared electronic record across 29 organisations is unique, complex and unprecedented in Wales, the UK and internationally.

“This level of innovation means we are continually adapting, improving and responding to ensure the system provides the support health and social care professionals need to deliver care closer to people’s homes and we know it’s already making a difference.

“More than 12,000 frontline staff are already using WCCIS every day, many moving away from a paper record for the first time. The system has been particularly impactful during the Covid-19 pandemic where it has been used to identify people in need of support and direct staff and resources to the right areas.

“WCCIS is a long term programme and it’s encouraging that 15 local authorities and health boards have already gone live with the system and are seeing the benefits. A further seven organisations are also working with us to join the system as soon as possible.

“Given the ambition in Wales of achieving an integrated system, there has been significant investment and the national programme spending is in line with predicted costs.

“We remain committed to the vision of rolling out the system across Wales and are actively working in partnership with organisations to make this happen.

 “We will continue to support and encourage working across the system to ensure that Wales becomes the first country in the UK to have a single integrated community health and social care record for its citizens.”

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