Plans for change

The Welsh Government has committed, through its Mental health and wellbeing strategy (2025-2035), to developing a mental health core dataset for Wales.

The planned dataset will follow the patients through their whole care journey and aims to link data from different services, including referrals, therapies and treatment, across both primary and secondary care and community settings. If implemented, this dataset will provide much greater insights by linking datapoints that currently exist in isolation and by introducing new data. Both the statisticians and users, however, felt that progress on the new dataset has been slow.

The organisation tasked with developing this core dataset is Digital Health and Care Wales (DHCW). While we were carrying out the research for this review, a pilot of the dataset was underway with one local health board.

We heard about several barriers that are currently preventing the roll out of the dataset across the whole of Wales.

A significant barrier is the lack of the necessary IT infrastructure. The health boards in Wales currently have different systems for capturing mental health data. All the health boards must agree to adopt the new dataset and the appropriate software, but not all have done so yet.

There is no legal mandate for health boards to adopt the new system. As health boards are legal bodies in their own right, DHCW cannot force them to participate.

Another barrier to implementing the new dataset relates to issues around funding and resourcing. Obtaining and implementing standardised IT systems may prove difficult due to financial constraints. The current shortage of suitably skilled personnel also means that it will not be possible to simply implement new systems without appropriate individuals being identified to enter data, and extensive training being given to these individuals. Again, this could be challenging due to time and funding constraints.

Further challenges exist in the delivery of mental health care itself, as provision can be different across the health boards. Mental health is a complex topic, and Wales is a diverse country. Reflecting the importance of delivering services that are appropriate for specific populations, there are different models and service offerings across the seven health boards. This makes the collection of consistent data on mental health more challenging.

Given these barriers, the statisticians were concerned that although an all-Wales system would be preferable, the outcome may end up being a collection of disparate systems, as is currently the case. If this happens, there will also be the additional challenge of ensuring that data definitions are consistent, so that items are collected in a consistent manner. The statisticians expressed doubts that this consistency could be achieved.

Users we spoke to were generally very aware of the planned dataset and expressed hope that it will improve data collection and reporting. They felt that the core dataset will be key to addressing existing gaps, and that patient-level detail will provide vital information on who needs support and that this, in turn, will genuinely inform planning.

However, users were also largely aware that the dataset has been promised for several years and remains undelivered. They spoke of the challenges of rolling out such a system in Wales, and of the difficulties in securing agreement from all seven health boards. They also noted that to enable data to be fully joined up, organisations such as the Ambulance Service and Public Health Wales would also need to contribute data, which introduces additional challenges.

Some users were optimistic that the core dataset would finally be delivered in the near future, while others remained sceptical due to the ongoing barriers.