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Author: Bevan Commission


This paper is the second in the series called ‘Exploiting the Welsh Health Legacy’ which calls for a joined up, prudent and social model of health and care – moving away from the more traditional medical model of care.

A New Way of Planning: Working Towards a Prudent Model of Health and Care” sets out the planning, thinking and approach required to implement this new, social more Prudent model of Health and Care in Wales. In our first paper, we set out the case for change and described the new model – a model which best suits the needs of people in Wales. A model which prevents ill health and preserves and supports all aspects of wellbeing, in which everyone has a responsibility.

We have looked at how this could be achieved by looking at health and care through a different lens – a prudent lens. This proposed new model is based on the Bevan Commission’s concept of Prudent Healthcare and the application of its principles in practice. It recognises the shared responsibility of society starting with the individual.

A Prudent Model of Health and Care will:

Actively encourage everyone to take collective action and responsibility to help us all live the healthiest lives for as long as possible;

Call upon all agencies to act together and assume joint responsibility in whatever way they can best do this to ensure we make the most of the resources we have to meet individual and population health needs;

Develop a strong, robust and prudent integrated health and care system to support both our health and care needs;

Make the most effective use of all skills and resources available including local people, patients and the third sector;

Ensure that those with the greatest needs are prioritised and the hard to reach groups are included.

A Prudent Health and Care System is one:

  • In which we all share responsibility for maintaining our health and that of others and that we have high quality, effective and efficient services which meet the needs of people, as and when needed;
  • Where the focus is on the joint ownership of the NHS by all in Wales, through the co-operative concept of ‘Our Welsh Health and Care Service’, ensuring that this is;
  • A shared responsibility belonging to the people of Wales, who use it and pay for it;
  • Focused on preserving and protecting health and wellbeing, not just treatment and ill health;
  • High quality, integrated prudent health and care services, equally available for all, working with everyone to ensure the most prudent and right care is provided.

Moving forward and next steps

This paper represents the first stage in a process of essential and fundamental change and the rebalancing of the NHS in Wales. Further ongoing engagement and consultation are needed to expand upon and test out whether the ideas in this paper fully represents the feedback and views received to date and in determining the next steps.

This model is designed around the needs of people in Wales, not the systems the processes or the professionals. It embraces the principles set out by Aneurin Bevan for a National Health Service, namely; comprehensive, free at the point of delivery and accessible by all, alongside the fundamental 4 Prudent Healthcare Principles. It builds upon its origins whereby communities, people, professionals, patients and local employers all played a key part and responsibility in maintaining health and in caring for its communities and the people within it with great pride.

The Bevan Commission proposes to ensure that the people of Wales recognise both their rights and responsibilities and are able to respond by getting involved and finding solutions to the challenges that the NHS faces. It will seek to ensure that our NHS in Wales is co-owned by them, similar to members of a ‘unique NHS club’ in which we all have our individual club numbers and clear ‘rules’ by which it operates in response to services and support received.