Prudent healthcare principles

The principles of prudent healthcare is the concept underpinning the work of the Bevan Commission

Watch International Bevan Commissioner Professor Don Berwick introduce the Prudent Principles and discuss how the principles of Prudent Healthcare can help NHS Wales recover from and reset after the coronavirus pandemic.

The four principles

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

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

3. Do only what is needed – no more, no less – and do no harm.

4. Reduce inappropriate variation using evidence-based practices consistently and transparently.

The origins of the concept

In December 2013, the Commission introduced the concept of Prudent Healthcare with the publication of Simply Prudent Healthcare, which included a set of provisional principles that underpins the concept’s aims and objectives. This landmark publication was followed by Prudent health: one year on, a qualitative assessment of the concept’s effectiveness in policy and practice to date.

Throughout 2014, the Commission reached out and encouraged a wide-ranging conversation on what Prudent Healthcare should be. Following a series of workshops, debates and the launch of a dedicated website, the Commission launched the finalised Prudent Principles in January 2015. These were endorsed by the Minister for Health and Social Services and now underpin Welsh healthcare policy.

At the heart of policy

Prudent healthcare is at the heart of A Healthier Wales, Welsh Government’s long-term plan for health and care, and informs much of today’s health and care policy and discussion in Wales. The Bevan Commission’s Exploiting the Welsh Health Legacy series (below) explores the concept in detail and how it can inspire A New Way of Thinking, A New Way of Planning and A New Way of Doing.

Translating it into action

Prudent healthcare principles are also being applied in action by the Bevan Innovators (Bevan Exemplars,  Bevan Advocates & Bevan Fellows). Bevan Exemplars are health and care professionals who trial and test out their innovative ideas to deliver prudent healthcare on the front line of the NHS. Bevan Advocates are members of the public who share their experiences, develop person-centred solutions and inspire others to make different health and care choices to support prudent healthcare. Bevan Fellows are health and care professionals developing prudent practice at a national level leading innovations, developing research and training others.

A ten-minute taster: The prudent principles

Professor Don Berwick, President Emeritus of the Institute for Healthcare Improvement, and International Bevan Commissioner.