Code Blue to Green:
 A Test Manager’s approach in NHS Wales

First of all; let me introduce myself; my name is Jess and in my professional life I’m a Senior Assurance Consultant (otherwise known as a Test Manager) working for Acutest (Part of Trustmarque). I’ve over a decade of expertise in software testing and quality assurance and really love my job – who wouldn’t love getting paid to break things!

In this series of articles, I want to share with you a truly unique opportunity that I stumbled upon when my personal life clashed unexpectedly with my professional life and to share some truly insightful ideas and discoveries with you.

In article 1 ‘Blinking into reality – How my journey began’ I shared some tips on carrying out an assurance review following a piece of work that I had completed with Digital Health and Care Wales (DHCW). In this article; I share how an unplanned hospital stay led me to some interesting knowledge.

Code Name: Defect Detective – Undercover In The NHS

The 06 February 2024 started out like most days until my phone rang ‘You need to go to A&E; we think you might have sepsis’.

We’ve all heard the tales—the epic sagas of A&E waits stretching into eternity. The ticking clock, the uncomfortable chairs, the shared glances of fellow patients—all part of the waiting game, but I was pleasantly surprised with how quickly I was triaged and taken to a ward. Perhaps TripAdvisor should add a “Healthcare” category.

I’ve been in hospitals regularly throughout my adult life and it’s always struck me the onerous process of being admitted to hospital, however; today something was different! As I waited in my hospital room a nurse entered holding an iPad and told me she was going to get me admitted before her shift ended. I commented on the presence of the iPad as we went through the usual admission questions and the nurse explained that they were now using the iPad as part of the Welsh Nursing Care Record (WNCR). This allows staff to record, share and access patient information electronically across wards, hospital sites and Health Board areas. With my technical background and with a genuine interest in Healthcare I asked her how she was finding using the iPad and the nurse seemed keen to engage with me and gave the following feedback:

1. Login Difficulties: It seems she regularly encountered challenges logging in to the iPad using valid credentials
2. Admission questionnaire was not intuitive
3. Slow data loading which was frustrating

Now, with my software testing hat on the feedback piqued my curiosity with the obvious questions ‘who tested the software and how thoroughly?’. Those of you that know me; know that I don’t sit still and lying in a hospital bed watching tv just wasn’t going to cut it so whilst my fellow inmates binged on daytime TV dramas, I feasted on the real drama—the evolution of healthcare tech. The information I received I made a note of with the intention of doing something with it; although at that point I wasn’t sure what…

A month later; fully recovered and back at work I still had my undercover notes (as I was calling them) but who could I tell my story to and would anyone be interested? Then it dawned on me –why not tap into my LinkedIn healthcare network as someone would know who I should talk to. So like a digital detective, I aimed high and reached out to Professor Hamish Laing – previously a Medical and Digital Director in NHS Wales. It was like dialling the VIP hotline of healthcare insights as he provided me with the following information:

• The WNCR has digitised and standardised a lot of processes previously conducted on paper but may not have made the most of the opportunities for digitalisation.
• Some parts of the NHS estate have poor wifi and systems can be slow to authenticate. Health Boards are receiving funding for additional hardware and wifi upgrades through the Electronic Prescribing and Medicines Administration Programme (ePMA)
• No Health Board in Wales has an Electronic Patient Record (EPR) and nearly everything remains on paper in secondary care however there are plans for a review to be conducted by Welsh Government to look at the approach to hospital record digitalisation although EPR’s are expensive and funding in Wales is tight.

The information that Hamish so readily shared with me gave me great insight into the trials and tribulations of digital transformation within NHS Wales. There appears to be definite appetite and awareness for the change but funding is lacking which makes the improvements hard to deliver. However; the message I took from our communication was that there are people within NHS Wales who are striving to make a difference; and these are the people I hoped to meet.

In my next article Breaking Barriers – Forging New Connections I delve into the intricate web of healthcare networks with a keen eye on understanding the barriers to change. I explore how my NHS Wales connections are paving the way for transformative shifts and seeking actionable solutions to improve patient health across NHS Wales.

About the Author

I started my testing career in 2013 as a Test Analyst working for a large multinational bank.

Since then I have worked and trained hard, moving up in the testing assurance path in various industries such as banking, HR and automotive and have been working as a Test Manager since 2022.

I joined Acutest (part of Trustmarque) in January 2023 as a Senior Assurance Consultant and have been supporting our clients in media, social housing and healthcare.