February 2024

Eight separate databases for the Welsh Nursing Care Record (WNCR) have been replaced with a single national instance.

The upgrade went live in November 2023 and replaces multiple instances at each of Wales’ seven health boards and Velindre Trust with a single national database. It will bring additional economies of scale and efficiencies, with the WNCR support team now only having to manage one database.

Previously, if a problem was identified by a health board, the fix would have to be applied eight times across each database. Now a single national database means the fix only has to be applied once at an all-Wales level. The upgrade lays the groundwork to further improve access to information more widely across NHS Wales. The project involved the collaboration of hundreds of NHS colleagues from across Wales.

Fran Beadle, Chief Nursing Information Officer at DHCW, said: “WNCR has transformed nursing in Wales by standardising documents and providing a digital solution in practice, to enhance patient safety and experience.

“Collaboration, engagement has been the true success of this project, this has been evidenced once again in supporting the availability of information for healthcare professionals across Wales.”

The Welsh Nursing Care Record launched in April 2021, replacing paper nursing notes on adult inpatient wards with a digital system, bringing improvements to efficiency, safety and the patient experience. Over 83% of eligible wards across Wales are now using the WNCR and over 10.3million inpatient nursing notes have been captured to date.

Work is currently underway to expand the WNCR to capture children’s inpatient assessments, following £1.7m of funding from the Welsh Government’s Digital Priorities Investment Fund.

The Welsh Nursing Care Record (WNCR) has completed its rollout at Nevill Hall Hospital – one week ahead of time.

Here, Lucy Flatman, Clinical Nurse Specialist at Aneurin Bevan University Health Board (ABUHB), discusses the rollout.

"All of the Nevill Hall Hospital staff were amazing, so helpful, receptive and accommodating.

"Implementation of WNCR was complete on December 8th – one week ahead of time – allowing for an additional week of onsite support until December 15th 2023.

"The ABUHB digital training team were absolutely brilliant, speaking with ward managers daily, checking their rosters for staff who needed training that week, doubling back to live areas, providing out-of-hours support to night staff and ensuring that of the ward staff available from start of training – November 6th until December 15th – 100% were trained.

"In total, more than 424 staff were trained across the Nevill Hall Hospital site, including students, bank and agency staff, Allied Health Professions and medics. During which time, our brilliant digital training team also continued to support training of new staff and staff rotating into areas already live with WNCR via booked face-to-face training and on-the-day training via Teams."

Events exploring the integration of digital technology within the nursing and midwifery sectors in Wales were described as "motivational" and "inspiring" by those who attended.

The conferences – Empowering and Embracing Digital Transformation: Nursing and Midwifery in Wales – took place in Cardiff and Llandudno in December.

Nursing and midwifery professionals heard first-hand from colleagues who have led digital projects, revolutionising patient care and healthcare practices in NHS Wales.

Speakers included DHCW's Chief Nursing Information Officer Fran Beadle, DHCW's Clinical Informaticist for the Welsh Nursing Care Record (WNCR) Bev Havard, and Hywel Dda University Health Board's Head of Nursing for Professional Standards and Digital, Dr Lesley Jones.

Organised by Health Education and Improvement Wales (HEIW), in association with Digital Health and Care Wales (DHCW), those attending were also given the chance to find out ways to develop digital skills, connect with like-minded professionals and have hands-on experiences with cutting-edge digital tools and technologies transforming healthcare delivery.

Sue Tranka, Chief Nursing Officer for NHS Wales, said she was "blown away" by the work of the clinical informatics team on a recent visit to DHCW in Cardiff.

Clinical informaticists bridge the gap between clinicians and technical experts to create a shared understanding for development of digital products and services.

Following the meeting where the latest digital initiatives were discussed, Sue Tranka said: “It has been an absolute pleasure to have met the wide-ranging team and explore how we can support one another. 

"I have been blown away by the skill in the room, by the clinical expertise and the passion for digital transformation for Wales. 

"I am incredibly proud of the team I’ve met and I look forward to working closely with them in the future to support their journey through digital transformation."

Anne Watkins, National Maternity Clinical Informatics Lead said: “The Digital Maternity Cymru (DMC) team are thrilled to welcome on board the Health Board Maternity Clinical Informatics Leads. 

“These clinical leaders' local knowledge, experience, and expertise are invaluable to the digital transformation of maternity services in Wales.

“We look forward to being on this journey together.”

Over the coming issues of our newsletter, we aim to bring you a series of blogs from our Florence Nightingale Scholars in Wales to demonstrate their journey and why you should apply. In this edition, we hear from Emma McGowan who works in Powys Teaching Health Board.

It was suggested by my line manager to apply for the Florence Nightingale Digital Scholarship in December 2020. I completed the application form and, in all honesty, didn’t expect to hear any more. 

However, fast-forward a few months and I had delivered a successful quality improvement initiative to the panel and was staring my scholarship.

Throughout the year of my scholarship I was fortunate to attend several courses that had a really positive impact on me both personally and professionally. These included the Personal Presence and Influence training with the Royal Academy of Dramatic Arts (RADA). This was eye-opening and an opportunity I wish everyone could undertake.

Alongside this I attended a Women's Leadership Retreat at the Eden Centre. This was something completely out of my comfort zone but perhaps was the most impactful few days I have encountered. I also undertook a healthcare leadership programme and had the amazing experience of flying a British Airways flight simulator at Heathrow Airport!

I was matched with a very knowledgeable and experienced mentor in England which was incredibly beneficial to understand the digital landscape in healthcare outside of Wales. Alongside this, the network of colleagues I have gained from the scholarship is immense and the sharing and willingness to help each other as nurses from different countries, backgrounds and sectors is amazing.  

The scholarship resulted in me presenting a Situation, Background, Assessment, Recommendation (SBAR) to define the nursing evaluation and approve a high-level set of standards and principles for use across Wales to the executive directors of nursing. This was endorsed and approved and will continue to improve the nursing process as we move form paper to digital.

This is the last digital nursing and midwifery newsletter from Digital Health and Care Wales, but you'll find all this and more in DHCW's main newsletter: