In a significant leap forward for the modernization of healthcare infrastructure in Wales, the Powys Teaching Health Board (PTHB) has officially gone live with its electronic prescribing and medicines administration (ePMA) system, powered by the technology provider Better. The implementation, which commenced at Bronllys Hospital, represents the foundational step in a comprehensive, phased rollout across all community hospitals and inpatient services within the Powys region.
This transition is not merely a localized upgrade; it is a critical component of the national Digital Medicines programme, spearheaded by Digital Health and Care Wales (DHCW). The initiative aims to harmonize and digitize medicines management across the entirety of NHS Wales, replacing legacy paper-based processes with integrated, real-time digital solutions.
The Technological Leap: Better Meds and the Shared Medicines Record
The deployment of the Better Meds system brings with it a pioneering advancement in interoperability. Powys has distinguished itself as the first health board in Wales to successfully implement both "read and write" functionality within the Shared Medicines Record (SMR).
The SMR serves as a centralized, national repository containing vital patient information, including current medication regimens, allergies, and specific intolerances. By integrating this record directly into the ePMA workflow, clinicians at PTHB can access a patient’s comprehensive medical history upon admission. More importantly, they can update these records in real-time as treatment progresses, ensuring that the information remains accurate and accessible at the point of discharge. This seamless data flow is designed to eliminate the information silos that historically plagued patient handovers, thereby significantly reducing the risk of medication errors and enhancing patient safety across diverse care settings.
Chronology of the Digital Medicines Programme
The journey toward this digital milestone has been characterized by strategic planning and collaborative effort between PTHB and its technology partners.
- May 2025: Powys Teaching Health Board formally selects Better as its technology partner to deliver a robust, scalable ePMA system. This decision marked the beginning of a rigorous procurement and integration phase.
- December 2025: The broader Welsh digital health landscape sees a major success as Betsi Cadwaladr University Health Board successfully rolls out the Better Meds system at Wrexham Maelor Hospital, establishing a proven blueprint for the rollout.
- Early 2026: Preparations conclude at Bronllys Hospital, involving staff training, infrastructure upgrades, and system testing.
- Current Phase (2026): The official go-live at Bronllys Hospital initiates the primary phase of the rollout, which will focus on all inpatient wards throughout the remainder of 2026.
- Future Roadmap: Following the stabilization of inpatient services, PTHB has outlined a long-term deployment schedule that includes the integration of the system into outpatient services, surgical theatres, and specialized maternity care units.
Supporting Data and Operational Implications
The transition from paper charts to an electronic interface is a complex undertaking that requires both technical infrastructure and cultural adaptation. For the staff at Bronllys Hospital, the shift represents a fundamental change in daily clinical practice.
Michelle Sweet, a ward manager at PTHB, provides a ground-level perspective on the transition. "The introduction of ePMA has been a big change for the team, and it’s taken a bit of getting used to, particularly in the first few days," Sweet acknowledged. "Any shift away from something familiar is always going to take some adjustment, but overall, it has settled in well."
Sweet highlighted the tangible efficiency gains that the system provides. "One of the biggest differences is simply not having to go looking for drug charts anymore. Everything is there when you need it; it’s clear and readable, and that has made a noticeable difference to how smoothly things run."
Addressing the learning curve, she noted, "The system is user-friendly, and there’s definitely a learning curve, but it’s not as daunting as some initially thought it might be. You can see confidence building day by day as staff get more familiar with it."
Official Perspectives: A Collaborative Achievement
The success of the implementation is viewed by stakeholders as a testament to the strength of the partnership between the health board, Better, and the national DHCW team.
Stefan Siekierski, the delivery director at Better, emphasized the unique challenges of the Powys region. "We’re proud to support Powys Teaching Health Board on this important stage of its digital transformation journey," Siekierski stated. "Delivering ePMA across a health board as geographically dispersed and operationally unique as Powys is a significant achievement and reflects the strength of collaboration between Powys, Better, and partners across NHS Wales."
Siekierski underscored the broader national significance of the project, noting, "This go-live not only marks our second live deployment in Wales, but also another step forward in the wider national ambition to modernise medicines management through connected digital systems."
Implications for Patient Safety and Clinical Efficiency
The primary driver behind the shift to ePMA is the optimization of patient safety. In traditional paper-based environments, errors can occur due to illegible handwriting, misplaced charts, or the omission of information during inter-departmental transfers. By digitizing the prescribing process, PTHB is introducing decision-support tools that alert clinicians to potential drug interactions or dosage discrepancies at the point of entry.
1. Enhanced Medication Safety
The integration with the SMR ensures that clinicians are alerted to patient allergies and intolerances immediately upon prescribing. This "safety net" reduces the likelihood of adverse drug events (ADEs), which remain a significant cause of hospital readmissions and prolonged recovery times.
2. Streamlined Clinical Workflow
The removal of the physical burden of searching for paper records allows nursing and medical staff to spend more time on direct patient care. By digitizing the drug chart, the system enables remote access, meaning that pharmacists and consultants can review a patient’s medication status without needing to be physically present at the bedside.
3. Data-Driven Decision Making
As the system matures, the wealth of data generated by the ePMA platform will provide PTHB with invaluable insights into prescribing patterns. This information can be utilized to audit medication usage, identify areas for cost efficiency, and monitor compliance with national clinical guidelines.
4. Continuity of Care
Perhaps the most significant implication is the ability for the medication record to "travel" with the patient. Whether a patient moves from a community hospital to a specialist unit or is discharged into the care of primary practitioners, the continuity provided by the Shared Medicines Record ensures that the risk of medication reconciliation errors is minimized at every transition of care.
Future Outlook: A Model for Digital Health
The deployment in Powys serves as a vital case study for the remainder of the UK’s National Health Service. The ability to implement such a system across a geographically diverse and sparsely populated region like Powys demonstrates that digital transformation is not limited to large urban teaching hospitals.
As the programme moves into 2026 and beyond, the focus will shift toward scaling the technology to more complex clinical environments. The planned expansion into maternity and surgical services will test the system’s ability to handle high-acuity care, where the precision of medication administration is of paramount importance.
Furthermore, the success of the Better Meds implementation in Powys and at Wrexham Maelor signals a maturing digital ecosystem in Wales. By prioritizing open standards and national integration, NHS Wales is positioning itself at the forefront of digital health maturity, creating a scalable, sustainable, and, most importantly, patient-centered model for the future of medicines management.
In conclusion, the launch of the ePMA system at Bronllys Hospital is more than just a software installation; it is the cornerstone of a safer, more efficient, and more connected healthcare system for the people of Powys and, by extension, the whole of Wales. As staff continue to grow in confidence and the system reaches full maturity, the long-term benefits—ranging from reduced medication errors to optimized clinical productivity—will undoubtedly redefine the standard of care in the region.
