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Value-Based Healthcare for Wales

In Wales, value-based care is underpinned by Prudent Healthcare, first launched as a philosophy and a policy in January 2014. Its key principles of coproduction, equity, intervening gently effectively (and only as much as we need to) and reducing unwarranted variation (including under and over-treatment) are all key to achieving value for our patients and citizens across a whole system of health and social care. Prudent Healthcare has provided a strong foundation for healthcare improvement in Wales and a value-based healthcare approach will help to make the aims of Prudent Healthcare a reality.

In ‘A Healthier Wales’, the Welsh Government outlined their plan for health and social care. It set out the need for health services to change and become fit to meet the challenges that an ageing population presents and how we can all help deliver better health outcomes for ourselves and others. One key component in this plan was to improve value for patients by giving a greater focus to the outcomes that matter to individuals, and considering their relation to the costs of achieving those outcomes.

Michael Porter and Elizabeth Teisberg describe value-based healthcare as being the outcomes that are achieved that matter to patients relative to the costs of delivering those outcomes. The value for the patient relates to the whole cycle of care not just a single intervention. Frequently in healthcare, we do not consider or capture the outcomes that matter to patients and therefore value-based healthcare encourages us to focus on patient-reported outcome measures (PROMs) as well as clinical outcomes.

A National Action Plan for value-based healthcare in Wales was launched in the autumn of 2019, setting out a three year programme to embed the value-based healthcare approach as part of making Prudent Healthcare philosophy a reality. Building on that initial embedment the newly created Welsh Value in Health Centre released an updated strategy in November 2021.

We will continue supporting the implementation and development of outcomes and costing measurement and analysis, using a collaborative approach to sharing and using data to support the improvement of healthcare services and value for patients. This will include measuring the costs of healthcare at a system level and making those visible to clinical teams, allowing them to be stewards of resource by influencing high value care for the populations for which they are caring.

Health and care organisations in Wales are committed to developing their value-based healthcare approaches. This includes better collection and reporting of outcome data for a range of medical conditions, and looking at unwarranted variation in services and outcomes to reveal the under and over-use of different aspects of health care.