Pause six of the nine in-flight DHCW programmes. Focus on three selected by an independent panel using documented criteria. Publish outcomes monthly. Reverses the tragedy-of-the-commons dynamic — concentrates depleted capacity on programmes that can actually finish, instead of producing motion across nine programmes none of which complete. The discipline of refusing to start is the precondition for being able to finish.
Pause six programmes. Focus on three selected by an independent panel including health board clinicians and the external digital expert — not by DHCW leadership, who will prioritise programmes that justify their empire over programmes that deliver clinical value.
For each focused programme, publish a one-page delivery contract: scope, deadline, adoption target, consequences for missing. Signed by the responsible executive. No “revised timelines.” No “lessons learned exercises.” Deliver or be replaced.
Conduct a genuine post-mortem on WCCIS (£42M+) and OpenEyes (£8.5M) with external facilitation. Not to blame, but to structurally understand why they failed. The rebranding escape must be broken.
Selection criteria for the priority three
Programme selection is published, weighted, and externally validated. Three published criteria:
- Patient-safety risk weight. Programmes whose failure is causing or risking patient harm rank highest. WPAS (linked to a patient death), WCCG (8+ years on unsupported technology), and PSBA-class shared infrastructure (the March 2026 cross-NHS-Wales outage) outweigh programmes with administrative impact only.
- Clinical adoption potential. Will clinicians actually use the system if it ships? An adoption forecast from named clinicians at named health boards, not from DHCW programme management.
- Reversibility of harm if delayed. A programme whose delay causes accumulating clinical harm (diagnostic image flow, prescribing safety) ranks above a programme whose delay is operationally inconvenient but clinically tolerable.
Panel composition
The selection panel is at least 50% clinical, drawn from health boards. At least one international peer from Denmark, Estonia, or NHS Digital England participates as a voting member — the comparator jurisdictions that have done what Wales is being asked to do. The Welsh Government observer is non-voting. Panel transcripts are published; selection rationale is published; dissents are recorded, not erased.
Disposition of paused programmes
Paused does not mean cancelled. The six paused programmes retain protected status: staff are retained, vendor contracts are re-stated rather than torn up (with the new conditions of Flip the Model applied to their content), and restart conditions are named in the panel’s published decision. The diagnosis warns specifically against the rebranding escape; this protocol prevents the failure mode where pausing becomes covert cancellation followed by a relaunched “Connecting Care 2.”
Post-mortem methodology
Post-mortems are externally facilitated — by the National Audit Office digital function, the Cabinet Office digital function, or an equivalent independent body. Findings are structural, not individual: the question is “what conditions produced this outcome?”, not “who do we blame?” The list extends beyond WCCIS and OpenEyes:
- LIMS — the four-year-to-two-year compression and the resulting collapse (Sell, PDC February 2025).
- RISP — the global worklist issue threatening cross-Wales image viewing; the legacy supplier forced to provide development for an end-of-life system.
- WICIS — described as “effectively still on pause” with a Welsh Government commissioned independent patient safety review.
- WCCG — eight years on unsupported technology against repeated technical-staff warnings.
Findings are published. The 14-day publication rule under Radical Transparency applies to the post-mortem report itself.
The stop list
Doyle requested in DHCW’s founding year that the board understand “what to stop doing.” It was never implemented. Under this intervention the stop list is a published deliverable from the panel, binding for 24 months: programmes are explicitly stopped, not just deferred. The 14-15 sub-strategies an 800-person organisation cannot operationalise are reduced to a deliverable count, against published criteria, with a stop list of equal weight to the do list.
This intervention dismantles L1: The Hiring Trap and addresses the Tragedy of the Commons by reducing demand on the shared resource pool to a level that allows each surviving programme to succeed. It also operationalises one of the five components of the psychological safety prerequisite for digital delivery: legitimate expectations of staff are only legitimate when staff are properly equipped — which means realistic resourcing, not vacancy savings designed to fail. Reducing the portfolio is the structural mechanism that converts “expect more from the workforce” from cover language into a defensible claim.