When I joined DHCW as the Chief DevOps Officer (at the top of Band 9), it was not a career move. It was a decision to serve. But NHS Wales and DHCW are organised to resist change, and focus on many things — stated mission and delivery not being amongst them, or at least not anywhere near the top of their priorities.
What follows are my observations and opinions, grounded in lived experience inside DHCW — offered as honest analysis. I believe them to be accurate and true, and I share them in the public interest.
What I saw
Directors had a dramatically low understanding of technology and system complexity. Hence they constantly commissioned expensive analyses from consulting firms. When the findings pointed to structural problems rather than simple fixes — or reflected difficult truths back at them — they were rejected. Reports were buried. Anything that questioned competence was suppressed.
The longer I stayed, the clearer the pattern became. Many of the systemic problems were not merely tolerated.
They were maintained on purpose. The goal was never catching the rabbit. It was chasing it. Focusing on real work would have exposed the lack of capability to deliver.
The systemic problems served as an excuse for poor delivery and enabled a perpetual performance theatre of new initiatives, re-starts, new strategies, and new programmes.
The performance theatre had a daily texture, and my own calendar was its clearest symptom. Three or four meetings ran in parallel at almost every hour, most recurring every week with the same agenda, the same discussion, and nothing actioned between one and the next — an institutional Groundhog Day. I started most mornings not by planning the work but by deciding which meetings I could safely miss in order to do any real work at all. The organisation had come to mistake the meetings for the work: motion was the deliverable, and activity stood in for delivery.
I left because I could not fix this from the inside. What I have learned since leaving is worse. Every improvement initiative I had built — programmes to save money, fix dangerous systems, recruit competent technical experts, or improve delivery capability — was actively undermined: quietly deprioritised, defunded, or handed to people who lacked the skills to continue it. That was not neglect. It was their chosen strategy.
That is the plainest reason this blueprint exists. What one person could not fix from the inside, no internal review can fix either: every mechanism that should correct the course is absorbed by the culture that produced it. The problem is structural, not individual — and a structural problem has to be solved from outside the system that created it.
What no internal review could surface
DHCW is not an organisation that is failing despite honest efforts. It is a system configured not to succeed.
1. DHCW is a thinly-repainted NWIS
NWIS — the NHS Wales Informatics Service — was a nationally discredited organisation. The ambition it existed to deliver was not new: an electronic patient record for Wales had sat at the heart of the Informing Healthcare strategy since 2003; two decades on, it is still undelivered. By 2018 the Senedd’s Public Accounts Committee found the body dysfunctional, with broken governance and what it called “a culture of self-censorship and denial.” BBC Wales reported the failures publicly: 21 IT outages in the first half of 2018 alone — one every nine days — systems so outdated that clinicians were forced back onto paper records, and a cross-party inquiry that raised “serious question marks” over the service’s “competence, capability and capacity” to deliver. The political response was to wind NWIS up.
What followed was a rebrand, not a reform. DHCW was stood up to replace NWIS, adopting a new name, a new logo, a new statutory footing — and substantially the same organisation beneath it, including all the existing workforce and leadership, operating the same monopoly delivery model, an antipattern every comparator country had examined and rejected. Helen Thomas, who had held senior executive roles in NWIS through its decline, became DHCW’s Chief Executive. Rhidian Hurle, drawn from the same cohort, became DHCW’s Medical Director.
The diagnostic significance is structural, not biographical: every reform mechanism that had failed against NWIS — internal challenge, audit, oversight, programme intervention — was facing the same people, in the same roles, with the same incentives, the day DHCW was founded. The label changed. The system did not. What did change is the organisation’s fluency with the system around it: the underlying delivery problems remained unsolved, while the rituals that stand in for delivery — performance reporting, assurance, governance — grew steadily more polished.
2. No technical leadership
DHCW is a national-scale technology delivery body, operating what is probably the most complex technology ecosystem in Wales. Its executive directors are career NHS administrators. None has any documented or observed experience successfully delivering complex technology systems, or leading a high-performing technical delivery organisation. Their backgrounds are in NHS management and administration — not in building or shipping software at scale, leading an engineering function, recruiting technical staff against external criteria, or being held accountable to delivery rather than to process.
What the organisation is fluent in is the machinery of NHS administration — the strategy paper, the committee, the board report, the Senedd appearance — and in the suppression of concerns. What it has not been fluent in is delivery. So what it produces is performance theatre — new strategies, rebrands, recruitment drives, presentations, pledges, endless meetings, pilot programmes, awards — every artefact of an organisation that is busy, none of the substance of an organisation that delivers.
The operational signature is measurable. The DHCW data centre suffered near-identical cooling-failover failures in July 2024 and June 2025 — twelve months apart, 32 services offline each time, the CEO’s “never event” characterisation of the recurrence erased from the published minutes. In March 2026 the PSBA network failed across all NHS Wales for hours. Three consecutive years; no corrective action visible between them. This is what “no technical leadership” looks like at the infrastructure layer.
3. The confusing hypocrisy
They declare one thing, then do the opposite. To an outsider who does not know how to play the game, it is bewildering. Take the Compassionate Leadership Pledge: approved at a board meeting in under fifteen seconds, with no member asking what was in it. The reality underneath it was the opposite of compassion.
Posts were left deliberately unfilled to meet annual financial targets — year after year. The Chair warned about it from year two: “you just heap misery on misery every year when you do that.” Audit Wales warned against it. The pattern continued through years three, four, and five.
The consequences were predictable and measurable. By 2024, the staff survey recorded a 65% burnout rate — a finding stripped from the published minutes. In 2024 alone, the organisation lost five senior leaders — four senior technical leaders during my own time inside the building, and the director responsible for people and workforce. Annual-leave buyback schemes were introduced because remaining staff could not take the leave they were owed. Long-term sickness rose 59% across three years, against headcount growth of 30%; the leading cause recorded in the Annual Report was stress and anxiety. By July 2025 the burnout figure had risen to 68.9%, with the year-on-year increase itself stripped from the published minutes. The cumulative effect was to hollow out the organisation’s technical delivery capability from the top: in my short tenure alone we lost those senior leaders to burnout and disillusionment, and the capability left with them.
The Compassionate Leadership Pledge was a label, not a policy. The behaviour underneath it produced the burnout, the resignations, and ultimately the delivery failure that escalated DHCW to Level 4. The structural reading — what successful digital delivery requires, and how DHCW’s culture inverts it — sits at Psychological Safety.
4. Lack of trust and respect
Underneath the hypocrisy and the opacity of the rules ran something more corrosive: a prevalent, and to me shocking, lack of respect for individuals, and a deep mistrust of technical experts by the people leading them — reciprocated, in time, in the other direction. Leaders did not believe their own technical staff knew how to do their jobs. So they commissioned the expensive external analyses described above — sometimes from former employees who had since become consultants, as if leaving the building and returning with an invoice was what finally made a person worth listening to.
The same mistrust shaped how the work was run. Leaders could not delegate. They would hand the same task to several subordinates at once without telling any of them, then micromanage whatever came back, and routinely override sound technical decisions from above — usually to catastrophic effect. The consequence was predictable: capable people, given no authority over their own domains and no confidence from those above them, disengaged. Job satisfaction collapsed, and with it the organisation’s ability to keep the technical talent it depended on.
5. Suppression of concerns
The same gap between word and deed runs through the organisation’s approach to raising concerns. Safety and transparency are stated values; in my experience, raising problems was not safe. During my time there I saw people who spoke up about delivery or capability find themselves managed through performance routes rather than heard. The pattern, as I experienced it, was unmistakable: candour carried a cost.
The mechanisms that should have surfaced this failure from inside were closed one by one. People who raised concerns about technical capability, programme realism, or the integrity of the published record were managed out.
In 2018 the Senedd’s Public Accounts Committee found “a culture of self-censorship and denial” at the predecessor body, NWIS, and reported that evidence from the NHS read like “a pre-prepared line.” Eight years on, with dissent met by managed exits, the same culture is operating. Anonymous Glassdoor reviews describe “a horrendous culture of bullying with management sweeping any issues under the carpet.” By 2026, DHCW publishes zero whistleblowing statistics, zero disciplinary data, and zero staff-leavers analysis.
And there is no structural safety valve. Wales has no independent speak-up guardian: the NHS Wales Speaking up Safely framework (2023) routes concerns through an internal executive lead and a board-level champion — people inside the very hierarchy a concern might be about. That is weaker even than England’s Freedom to Speak Up Guardian model, which is itself criticised for sitting within the organisations it is meant to hold to account. When a culture penalises candour and the only channels report to the people a concern is about, suppression is not a risk in the system — it is built into it.
6. The manufactured narrative
A counter-narrative fills the silence the diagnosis would otherwise produce. DHCW reported 80% staff satisfaction in the same 2024 survey that recorded 65% burnout, later climbing to 68.9% — the headline it carried into a Level 3, and then Level 4, escalation. When a stakeholder survey returned only 13% of respondents speaking highly of DHCW, the meeting that received the result was celebratory — pats on the back, congratulations, no acknowledgement that thirteen per cent positive external sentiment is not a finding to celebrate.
The published board minutes are the engine of the narrative. Entire reports — CEO reports, finance reports, performance reports, Board Assurance Framework presentations, risk-register discussions — are deleted wholesale from them. The Campaign for Responsible Leadership in NHS Wales has documented 107 sanitisation instances and 237 hiding-intent passages across DHCW’s published record; in one transcript the curation ratio fell to 8.6% — fewer than one word in eleven, with fifteen of nineteen speakers entirely absent.
The sanitisation is not random. It removes admissions of failure by executives, structural financial warnings, independent member challenges, and any context that would reveal a pattern of deterioration.
The trajectory was clear
Almost every element of the March 2025 escalation of DHCW by the Welsh Government was visible years earlier and named by people inside the room. The vacancy-savings death spiral was warned about from 2022. Funding instability was flagged from founding. Programme overload was identified at month seven. Technical debt was named as a structural problem in 2023. Cross-programme resource risk was raised repeatedly by the sharpest governance voice on the board, who departed in March 2026 having identified “the lack of governance and assurance mechanisms across the organisational gaps” as the biggest impediment to progress.
None of this was hidden. It was visible to anyone with technical experience who was tuned to the operational reality on the ground rather than locked in a leadership ivory tower. I found these problems by walking the floor and talking to staff who told me they had never seen a director before. That took curiosity, the willingness to hear bad news, and technical judgement — the kind of leadership that, in my experience, was not being practised at the top. Add to this a shocking poverty of decision-making, and little real understanding of what was actually going on.
All governance deficit patterns observed at the escalation, almost four years later, were already operational at the dawn of DHCW.
Why pro bono
For the last year I have been working pro bono on the creation of this blueprint. I have done this as a volunteer, on my own time, because I joined DHCW to make a difference and I intend to make that difference whether the organisation cooperates or not.
The work applies the systems-dynamics framework developed at MIT and articulated for institutional analysis by Donella Meadows — stocks, flows, feedback loops, delays — to map exactly why DHCW fails, how the failure is structurally protected, and what would fix it. The methodology is published in full. The analysis specifies the conditions under which its core thesis would be falsified.
Wales gave Britain the NHS. It can build the digital foundation NHS Wales now needs.
This blueprint is offered freely for political, NHS, and public use, with attribution — licensed under Creative Commons CC BY 4.0. It belongs to the people of Wales, not to the leadership that created the problems it describes.