The paper investigates the challenges of implementing Business Intelligence (BI) in NHS Wales. The study is informed by extant literature, a modified Delphi approach that draws on the knowledge of ten expert panelists from the NHS/Welsh public sector, and from the extensive industry experience of one of the authors of this study. Our adapted Delphi methodology lends itself to supporting the nature of this research since it not only structures a group communication process to explore and seek consensus on specific aspects of BI implementation in NHS Wales, but it also identifies the mean priority accorded by our expert panel to approximately eighty BI-related questions. The specific findings are presented under the following six headings – tools, resources, data, business drivers, business process needs and business service needs. The findings, in general, highlight that the existing BI services in NHS Wales are not presently supporting the delivery of evidence-based business decisions.