The purpose of the paper is to consider the potential definitions of early intervention and assess their consistency with the principles of prudent healthcare. To help achieve this we explore the interpretation of
early intervention, drawing from its application within a prudent approach to health.

There is a long-standing ambition by Welsh Ministers of creating world-class health and social services in Wales, ‘services best suited to Wales but comparable with the best anywhere’ (Welsh Government 2011). To achieve this against the backdrop of increasing demand and austerity will require a very different approach and culture than is evident to date. This paper outlines a series of recommendations to redraw the relationship between citizen and state.

It is clear that to achieve sustainable prudent health and healthcare in Wales, immediate change is urgently needed. The problem lies in making this happen. Similar messages have been made before (Wanless 2003) and many of the barriers identified in this paper have been long recognised and articulated. These are not new, yet NHS Wales continues to perpetuate largely the same practices, roles and responsibilities, making minor modifications, sometimes with the things known not to work or which shouldn’t be in place.