EUROHEALTH

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Enhancing the health workforce
The community approach helps address
social isolation and loneliness, which is
frequently experienced by patients with
leg ulcers and has proven to shorten
recovery time. It has also been identified
as a more cost efficient use of community
nurse resources. 14
Conclusion
Prudent healthcare in Wales is in its
early stages, but it has already caught the
imagination of those focused on improving
the delivery of public services. Its success
is predicated on strong leadership, not
only at the top of organizations, but
also at the clinical professional level. It
provides an opportunity to reshape and
base clinical care pathways on evidence
and allows for a greater emphasis on
primary and community services which
are located closer to the individual. At its
core, Prudent healthcare calls for new
relationships between service providers,
professionals and the public that centre on
sharing power and challenging traditional
practices and roles. People need to be
equal partners in securing their health and
well-being and must take responsibility
for their own health. To do this they
need information and support from
knowledgeable health workers.
Mark Drakeford, Welsh Minister for
Health and Social Services, sums up the
urgency and need for reform by saying:
“Our health services are under pressure;
the people who work in the health service
feel that pressure absolutely every day…
So today in the challenges we face,
I believe that the Prudent healthcare
movement gives us an opportunity to
recreate, reinvent and reimagine that most
important of all our public services for
the future…” 14
References
1
Welsh Government. Prudent healthcare web site,
2016. Available at: http://gov.wales/topics/health/
nhswales/prudent-healthcare/?lang=en
2
National Assembly for Wales. Well-being of Future
Generations Act, 2015. Available at: http://www.
legislation.gov.uk/anaw/2015/2/contents/enacted
3
ABIM Foundation ‘Choose Wisely’ campaign.
Available at: http://www.choosingwisely.org/aboutus/
4
British Medical Journal ‘Too Much Medicine’
campaign. Available at: http://www.bmj.com/toomuch-medicine
5
Vincent C. Adverse events in British hospitals:
preliminary retrospective record review. BMJ
2001;322:517.
6
MacArthur H, Phillips C, Simpson H.
Improving Quality Reduces Costs. Cardiff: 1000
Lives Improvement, 2012. Available at: http://
www.1000livesplus.wales.nhs.uk/quality-and-cost/
7
Bevan Commission website. Available at: http://
www.bevancommission.org/home
8
Dineen R. Co-producing Prudent healthcare:
putting people in the picture, 2015. Available at:
http://www.prudenthealthcare.org.uk/coproduction/
9
Good Practice Wales website. Available at: http://
www.goodpractice.wales/
10
WHO Regional Office for Europe. Nurses and
midwives: a vital resource for health. European
compendium of good practices in nursing and
midwifery towards Health 2020 goals, 2015.
Available at: http://www.euro.who.int/en/healthtopics/Health-systems/nursing-and-midwifery/
publications/2015/nurses-and-midwives-a-vitalresource-for-health.-european-compendium-ofgood-practices-in-nursing-and-midwifery-towardshealth-2020-goals
11
National Leadership & Innovation Agency for
Healthcare (Wales) Framework for Advanced Nursing,
Midwifery and Allied Health Professional Practice in
Wales, 2010. Available at: http://www.weds.wales.
nhs.uk/resources-workforce-modernisation
12
National Leadership & Innovation Agency for
Healthcare(Wales) All Wales guidance on delegation,
2010. Available at: http://www.weds.wales.nhs.uk/
resources-workforce-modernisation
13
Powys Teaching Health Board leg clubs. Available
at: http://www.powysthb.wales.nhs.uk/leg-clubs
14
Welsh Government. Prudent healthcare –
securing health and well-being of future generations.
Action plan, 2016:22. Available at: http://www.
prudenthealthcare.org.uk/securing-health-andwellbeing-for-future-generations/
Economic Crisis, Health
Systems and Health in Europe:
Impact and implications for policy
By: S Thomson, J Figueras, T Evetovits, M Jowett,
P Mladovsky, A Maresso, J Cylus, M Karanikolos and H Kluge
Copenhagen: Open University Press, 2015
Freely available for download at: http://www.euro.who.int/
en/health-topics/Health-systems/public-health-services/
publications/2015/the-case-for-investing-in-public-health
Economic shocks pose a threat to health and health system
performance by increasing people’s need for health care and
making access to care more difficult – a situation compounded
by cuts in public spending on health and other social services.
But these negative effects can be avoided by timely public
policy action. While important public policy levers lie outside
the health sector, in the hands of those responsible for fiscal
policy and social protection, the health system response is
critical. This book looks at how health systems in Europe
reacted to pressure created by the financial and economic
crisis that began in 2008. Drawing on the experience of
over 45 countries, the authors:
• analyse health system responses to the crisis in three policy
areas: public funding for the health system; health coverage;
and health service planning, purchasing and delivery
• assess the impact of these responses on health systems and
population health
• identify policies most likely to sustain the performance of
health systems facing financial pressure
• explore the political economy of implementing reforms
in a crisis.
The book is essential reading for anyone who wants to
understand the choices available to policy-makers – and the
implications of failing to protect population health or sustain
health system performance – in the face of economic and other
forms of shock.
Eurohealth — Vol.22 | No.2 | 2016