Embedding Value Based Healthcare in Wales and inspiring change across the world
Sarah Puntoni, Programme Manager, NHS Wales Executive
Introduction
Welsh Government policy emphasises the need to involve patients in care decisions with prudent health care principles and Value-Based Healthcare (VBHC) forming the basis of planning and delivering these services. Implementing Value-Based healthcare required significant cultural and transformational change to support Prudent Healthcare delivery.
This approach underpins the National Clinical Framework, focusing on co-production, equity, effective intervention (when needed), and reducing unwarranted variation. Prudent Healthcare can provide a strong foundation for healthcare improvement in Wales and a nationally aligned and driven Value-Based healthcare approach will support making Prudent Healthcare a reality.
Methods
Dr. Sally Lewis initiated Value-Based Healthcare in Aneurin Bevan University Health Board (ABUHB) in 2014, leading to national support and the creation of the Welsh Value in Health Centre (WViHC).
A National Action Plan for VBHC was launched in 2019, engaging all NHS Wales trusts and health boards. The WViHC is developing best practice and resources including Patient Reported Outcome Measures [PROMs] Standard Operating Model (PSOM), outcome data collection, providing skills and capacity in key areas and reducing unwarranted variation in services.
It also facilitates evidence-based decision-making through Welsh Health Circulars and promotes data-informed decisions at all system levels. Methods used included QI, PDSA cycles, and Evaluation and Benefits Realisation Frameworks.
Outcomes / Learnings
- Initial work at ABUHB tested VBHC methodologies on staff, systems, and patients, focusing on a whole-system approach.
- Wales is the first country to design and describe the methodology on ‘How’ to evidence a value approach.
- The PSOM (first of its kind) allows consistent collection, analysis, and use of PROMs.
- Dr. Lewis has guided colleagues towards partnership working and data-informed decision-making.
- Digital tools developed to highlight variations in outcomes, processes, and costs, generating pathway improvements.
- WViHC enables use of previously unavailable outcome data, promoting a data-informed, person-centred care system.
- Wales is now a global leader in VBHC under Dr. Lewis’ vision.
What next?
- WViHC team now integrated with Digital, Data, and Analytics in NHS Wales Executive, enhancing connectivity and broader application.
- Closer alignment with NHS Wales Executive functions aims to transform the system towards person-centred, outcome-focused care.
- Partnerships with academia, industry, and public bodies support universal application of the approach.
- Wales' international reputation is fostering opportunities for collaborative learning.
- Next phase will focus on maintaining momentum and building on existing achievements.
