On 16th January 2014 the Health Minister introduced the principles of ‘Prudent healthcare’ which would shape future development of services in NHS Wales:

  • Do no harm
  • Undertake the minimum appropriate intervention
  • Work in co-production with the patient, to consider “what can we do together to address the difficulties that you are experiencing”
  • Deliver healthcare that fits the needs and circumstances of patients, and actively avoids wasteful care that is not to the patient’s benefit
  • Deliver healthcare on the basis of equity, with clinical need and nothing else determining treatment by the NHS.

He explained that this would require a change of attitude:

“the traditional way that people think of health services is as an escalator in which we are always pushing people up the levels of intervention and somehow the higher up the intervention levels you go the more prestigious it becomes and the more you feel you’ve got something good out of the health service. Prudent medicine is about saying the more we can do at a citizen level, the more we can do at a population level, the more we can do at a primary care level then the better the service we provide to patients.”

In hospitals secondary care needs to pay more attention to the list of interventions that are not normally undertaken, the INNU document (Interventions that are not normally undertaken), and NICE’s 867 ‘do not do’ clinical guidelines

4 groups will be convened to apply the prudent healthcare principles to Orthopaedics, Prescribing, ENT services and Pain management services.

The ME/CFS Task & Finish Group is due to hold its 2nd meeting on 21st February and has been instructed to work within these principles.

Summary of Health Minister’s address   Press release in Welsh

Sir Mansel Aylward on prudent healthcare

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