Casestudy: Digital Health and Care Wales

Clinical context 

The threat to eye health from blinding disease is a common and growing issue. 

Currently, 100,000 people in Wales are living with sight loss, a figure predicted to double by 2050. As the incidence and prevalence of eye health problems is set to increase dramatically in the next couple of decades, it is important to balance capacity and demand.  This will involve transfer of care from hospital to the primary care setting where clinically appropriate, as documented in Together for Health: Eye Health Care, Delivery Plan for Wales 2013-20. 

Digital Health and Care Wales is a new Special Health Authority, creating the digital solutions needed to improve health and care for over 3.1 million people in Wales. Digital Health and Care Wales was previously known as NHS Wales Informatics Service (NWIS).  The National Eyecare Programme has been running since January 2020 and to date has implemented OpenEyes at Cardiff and Vale University Health Board and more recently for Glaucoma at Cwm Taff Morgannwg University Health Board. 

On 1 June 2023, the accountability and responsibility for the National Eyecare Programme was transferred to DHCW and they have been working on submitting a re-baselined plan to the Welsh Government. DHCW recognised that they needed help with testing and so asked Acutest to review their current testing and provide recommendations and actions for improvement.

Full assurance review objectives 

Acutest worked closely with the client to define the objectives of the project following these phases:

• To review and document the ‘AS IS’ processes relating to Development and Testing 
• To review the environment structure and identify if any have a dual purpose, what organisations have access and by whom 
• To identify, review and if necessary, document the test strategy, approaches, scripts and controls 
• To review the basis upon which test scripts are developed 
• Review of test reports and documentation 
• Document the review approach, methodology, interviewees and documents reviewed 
• Document findings with examples where applicable 
• Document recommendations 

“It’s a relief to have had the assurance review with recommendations, as it now gives us something to work with going forward. Jessica Winfield, Acutest Senior Assurance Consultant was easy to work with, well received by all that she engaged with, is a professional and efficient self-starter and I appreciated the short daily updates at the end of each day which enabled me to quickly keep track of her progress. The report and presentation slides are easy to read and understand.”

Alison Paul, National Programme Lead Digital, Eyecare Programme

The solution

The Test Improvement Plan review is an approach to achieving cost and time improvement and enhanced quality through better governance. The following activities were undertaken: 

• Discovery sessions with key stakeholders in the project 
• Evidence gathering 
• Assessing the evidence through applying a score based on the capability of the behaviour of the delivery streams and their output 
• Providing findings and recommendations 

Outcomes

DHCW now has a clear objective insight into the current state of testing for the National Eyecare Programme. They have a list of recommendations which clearly define the impact, time to implement and the benefits to implementing the recommendations enabling them to move forward with the implementation of OpenEyes and Open ERS to the remaining Welsh Health Boards.