What is EPMA? It is the national NHS Wales Electronic Prescribing and Medicines Administration programme — the clinical IT layer for prescribing and medicines management. EPMA is the clearest example of the accountability gap that DHCW's executive named in 2024: DHCW is measured against EPMA milestones, but the accountable delivery body is the seven health boards, not DHCW. EPMA was also one of four national systems taken offline by the March 2026 PSBA-class infrastructure outage.
What EPMA does
EPMA is the national NHS Wales programme for Electronic Prescribing and Medicines Administration — the clinical IT layer for prescribing, dispensing, and medicines management. It is one of the highest-clinical-impact digital programmes in NHS Wales: incorrect prescribing or missed administration produces direct patient harm.
Status
In rollout. Local organisations (the seven health boards) are the accountable delivery body; DHCW provides the platform.
The accountability paradox
EPMA is the clearest example of the accountability gap the Blueprint diagnoses. Ifan Evans named it in November 2024:
“This persistent ambiguity, let’s call it, which we usually phrase as ‘we need to clarify roles and responsibilities’… PDC is an oversight and assurance function, not a programme management function.”
DHCW is being measured against EPMA programme milestones, but the accountable delivery body is the health boards. DHCW has no mechanism to hold the health boards to account; the health boards have no contractual relationship that gives DHCW that authority. The result is a programme where every party can attribute slippage to a different party, and no party owns the recovery plan.
Documented issues
- The accountability gap was named at the Performance and Delivery Committee 46 months after DHCW’s founding and was never closed.
- In March 2026, EPMA was one of four national systems taken offline simultaneously by a single PSBA-class infrastructure failure (alongside O365, RISP, and radiology).
- EPMA delivery slippage is regularly cited in DHCW board papers without a corresponding accountability conversation about who is supposed to deliver what.
Where this is discussed in the diagnosis
- L11: Captured Governance — Evans’s quote about the EPMA accountability gap appears here.
- Policy Resistance — EPMA is the canonical example of multiple actors pulling in incompatible directions.
- Intervention 4: Flip the Model — embedded delivery teams in health boards close the accountability gap by design.