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The Prudent Health Care Blogs Prudent principle three: Do only what is needed and do no harm I have a feeling that the illustrious French philosopher Voltaire was not particularly impressed with doctors when he gave us the following pearls of wisdom: 'Doctors pour drugs of which they know little to cure disease of which they know less, into humans of whom they know nothing' , and, 'The art of medicine consists in amusing the patient whilst nature cures the disease' . Perhaps he had been on the receiving end of some adverse effect of a preferred remedy of the day or he had been attacked by a quack bearing a jar of leeches. I don't know. However, I do think he made a point which still holds true today, even with the advances we have made in our knowledge and understanding of disease and the development of evidence-based modern medicine. When the Prudent Healthcare principles were first described some of my colleagues felt a little i...

The Prudent Healthcare Blogs     Principle Two 'Care for those with the greatest health need first' At first glance the second principle seems obvious and straightforward to adopt. After all, who would deny that we should prioritise those in greatest need of care? However, as we consider this more carefully, we start to see that this is not at all as easy as it first appears. Do we really focus our resource and attention on those with greatest need? How do we define need? When treatment is immediately life saving we can reassure ourselves that we are certainly prioritising those in greatest need and the NHS excels in this function, but what about when the situation is less acute? For example, in a healthcare system where resources will always be finite, how do we prioritise between the all of the needs of a population with, say, cancer and a population with neurodegenerative disease? In an ideal world of course we would be able to cater for the needs (an...

The Prudent Healthcare Blogs     Principle One Public and professionals are equal partners through coproduction Coproduction, like any word which is adopted into policy or management processes, can often feel like a rather hackneyed term and is not universally popular. However, the concept which it describes is extremely important to the delivery of modern healthcare services and for improving the experience and outcomes of the people using those services. Here is a definition of coproduction from the Social Care Institute for Excellence: ‘A way of working whereby citizens and decision makers, or people who use services, family carers and service providers work together to create a decision or service which works for them all .’ For this principle we need to be applied in the context of Prudent Healthcare we must consider to what extent people are (and feel) involved in caring for their health at both a micro and a macro level. At a micr...