Digital tools are already reshaping how patients interact with NHS Wales, but what will it take to turn this early progress into system‑wide transformation?
The shift from paper to digital is changing how the NHS delivers care in Wales. Patients can now order repeat prescriptions from their phone, see a specialist by video from their living room, or have an AI tool help detect cancer from a chest X-ray.
These changes could deliver significant benefits in a country with a largely rural population, where many patients must travel long distances to access hospital services. Yet the transition is unlikely to be straightforward. Wales must contend with an ageing population and higher rates of digital exclusion than the UK average. There are also ongoing concerns about the ability of Digital Health and Care Wales (DHCW) to deliver major programmes.
The previous Welsh Government’s Digital and Data Strategy for Health and Social Care set the direction for digital transformation. The incoming government will need to determine how best to build on it, what pace is achievable, and where the greatest needs lie.
The NHS Wales App
Perhaps the most visible sign of transformation for patients is the NHS Wales App, which is used by over 650,000 people, around one in five adults in Wales. The app allows users to order repeat prescriptions, track their position on hospital waiting lists, and access health advice and information. Additional features, including access to test results and health records, are planned for the year ahead.
The vision is for the app to become the ‘digital front door’ to health and care services in Wales, and DHCW intends to increase the number of regular users to over 1 million by 2030. Yet the app still offers fewer features than its English equivalent, a gap that was highlighted during scrutiny in the Sixth Senedd.
The end of paper prescriptions?
Prescribing has long relied on paper: signed prescriptions carried to pharmacies and drug charts handwritten at patient bedsides. The Digital Medicines programme aims to digitise these processes across all care settings.
In primary care, the Electronic Prescription Service (EPS) allows GPs to send prescriptions directly to pharmacies, freeing up clinician time, reducing errors, and removing the need for patients to visit a surgery to collect a prescription.
Wales was late to adopt this system. England and Scotland introduced electronic prescribing in 2009, while the first electronic prescription in Wales was issued in November 2023. Since then, however, uptake has increased, with more than 15 million items dispensed by February 2026.
In hospitals, electronic Prescribing and Medicines Administration (ePMA) is replacing paper drug charts with a digital system that includes built-in safety checks. Wrexham Maelor Hospital recently became the first acute site in Wales to use ePMA across all inpatient wards and to feed discharge medicines information into the national Shared Medicines Record. The aim is for this to serve as a single, up-to-date record of every patient’s medicines in Wales.
Building a single patient record
All of this depends on data infrastructure that can connect systems, records, and services. Across Wales, hundreds of separate digital systems mean that patient information which should flow seamlessly between services frequently does not, with potentially serious consequences for patient safety.
DHCW’s long-term ambition is to create a single electronic record spanning health and care for every person in Wales, ensuring that essential information follows patients wherever they are treated.
Progress made towards this includes the Welsh Clinical Portal, which gives NHS professionals access to patients’ digital health records. Wales became the first nation in the UK to share this information across all health board boundaries. A National Data Resource is being developed to underpin the system, and through its Connecting Care programme, DHCW is developing an Integrated Care Record to join up information across the NHS, social care, and the voluntary sector.
The scale of the task, however, should not be underestimated. Similar projects in the UK have encountered difficulties, and DHCW’s delivery capacity has been questioned. In 2023, Senedd Committees identified shortcomings in DHCW’s planning and strategic direction, and the Welsh Government has since placed the organisation in enhanced monitoring over “serious concerns” about its ability to deliver major programmes.
Public confidence and data security
Even if the technical challenges can be overcome, public confidence will need to be earned. While most patients say they would support their health data being shared, concerns about misuse or unauthorised access remain.
Wales has so far carved out a distinctive position through the SAIL Databank, which manages anonymised health data for research and has avoided the GP data-sharing controversies seen in England. Digitisation, however, increases exposure to cyber threats, and the NHS across the UK has faced serious data breaches in recent years. Maintaining public confidence in how data is used, who can access it, and how it is protected, will be essential as the ambition for data sharing grows.
The promise and limits of AI
Artificial intelligence is already in use in NHS Wales, with its most visible benefits emerging in diagnostics. Wales was the first part of the UK to roll out the Brainomix 360 Stroke platform nationally, which uses AI to give clinicians realtime analysis of brain scans and has helped speed up treatment decisions. In cancer pathology, Betsi Cadwaladr University Health Board became the first in the UK to use the Ibex Galen platform to assist with prostate cancer diagnosis, with trials showing a 13% increase in cancer detection. NHS Wales has also piloted the Paige PanCancer Detect platform, which is reported to have reduced the time from initial sample to diagnosis from three months to one to two weeks.
AI is also reducing the administrative burden on clinicians. AI scribe tools such as Magic Notes, which is being used by social care teams in Powys, can listen to clinical conversations and automatically convert them into structured medical documentation, freeing up staff time for direct care.
Across all these developments, however, a consistent principle applies: that AI should support, not replace, clinical judgement. This caution is well-founded. While AI performs strongly in structured, well-defined tasks, its reliability drops significantly when dealing with uncertainty or open-ended reasoning.
ChatGPT Health, which launched in January 2026 but is not currently available in the UK, illustrates the risk of applying general-purpose AI to clinical settings. A recent study found that it missed over half of serious medical emergencies.
Better access for some, new barriers for others
Digital transformation risks leaving behind the people who stand to benefit most. An estimated 4% of adults in Wales do not use the internet at all, and digital exclusion disproportionately affects older people, rural communities, and those on low incomes.
Yet the absence of digital services can itself be exclusionary. In Powys, which has no district general hospital, virtual clinics allow patients to see specialists by video rather than travelling to hospitals outside the county. Virtual wards are taking this further, enabling patients to recover at home with wearable devices tracking vital signs and alerting clinical teams to early signs of deterioration.
But these benefits depend on patients being able to access them. For those without reliable internet, affordable devices, or the confidence to use them, the risk is that digital transformation widens the gap it is meant to close.
Can delivery match the ambition?
The Seventh Senedd will need to scrutinise how the Welsh Government navigates the risks and opportunities of digital transformation, and some difficult questions lie ahead.
Is there sufficient investment to deliver transformation at the scale and pace required? How can digital innovation reduce, rather than widen, existing health inequalities? And how can patients be given confidence that their health data is safe, secure, and used in their interests?
Article by John Hitchcock, Senedd Research, Welsh Parliament
