Making prudent healthcare happen

Prudent healthcare – setting out the prudent principles

At the Welsh NHS confederation conference in January 2015, the Minister for Health and Social Services endorsed the prudent healthcare principles proposed by the independent Bevan Commission, following a year of vigorous discussion and debate.

Below are the final four principles set out by The Bevan Commission:


  • Achieve health and wellbeing with the public, patients and professionals as equal partners through co-production;

  • Care for those with the greatest health need first, making the most effective use of all skills and resources;

  • Do only what is needed, no more, no less; and do no harm.

  • Reduce inappropriate variation using evidence based practices consistently and transparently.


However, the prudent healthcare concept of ‘only do what only you can do’ remains a powerful one, especially for a prudent health and social care workforce for the future. It will therefore be important to maintain the concept that no professional should routinely be providing a service, which does not require their level of clinical ability or expertise – only do what only you can do – as Wales continues its prudent healthcare journey.

Making prudent healthcare happen – the journey so far

In 2013 the Bevan Commission published  Simply Prudent Healthcare, which considered how Wales could make the most effective use of available resources to ensure high quality and consistent care across Wales. Following this paper,  the Minister for Health and Social Services outlined his vision for Prudent Healthcare at the Welsh NHS Confederation Conference in January 2014, including a draft set of prudent healthcare principles.

Service testing workshops in four health boards and treatment areas were developed between the health boards and Public Health Wales to test the application of the draft principles. The workshops were co-ordinated in March and April 2014 by 1000 Lives Improvement. ‘Achieving prudent healthcare in NHS Wales’ summarised the learning from the workshops.

In June 2014 the Minister for Health and Social Services presented a paper to Welsh Government cabinet on prudent healthcare and issued a written statement Delivering Prudent Healthcare.

During the summer that same year the Institute of Welsh Affairs (IWA) held a debate with the Minister and public service leaders, entitled Can the NHS be saved by a Prudent Approach? , and ran a series of four blogs.

Making prudent healthcare happen captures some of the perspectives of those working in or using health and social care services in Wales about what prudent healthcare means to them and its potential for Wales. The online resource was officially launched by Professor Mark Drakeford AM, Minister for Health and Social Services at the fourth Welsh Public Health Conference on 6 October 2014 Making Prudent Healthcare Happen. In December Welsh Government issued a Welsh Health Circular, Making Prudent Healthcare Happen – an update.

In January 2015 the Bevan Commission provided further advice after a year of conversation and debate around the principles and the Minister for Health and Social Services endorsed the final set of four principles at the Welsh NHS Confederation Conference, prudent healthcare one year on. He also outlined his priorities for prudent healthcare in 2015 and additional contributions were added to the online resource and launched at the conference. A copy of the Minister’s speech is available here.

You can view more prudent healthcare resources and case studies on the resources page and view all articles on this resource, here.
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