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AFTER I launched my third annual report as Chief Medical Officer for Wales last week, I realised there are lots of reasons to be optimistic about Wales' healthy future.

Younger people in Wales are living healthier lifestyles, and as the population ages we are reorganising care for older people to better meet their needs and help them to live independently for longer.

Making good health decisions that benefit you throughout your life is a prudent healthcare approach - an approach we are trying to take across NHS Wales.

My annual report focuses on the whole journey, from a healthy start in life, through a healthy pregnancy to making the right choices to maintain a healthy lifestyle and ageing well in Wales.

Prudent healthcare means using the finite resources available to the NHS wisely; and taking the approach of doing "everything appropriate" rather than "everything possible".

At its heart is true partnership between healthcare professionals and people, with patients playing a key role in designing services that meet their needs but also playing their part.

This partnership involves all of us taking more responsibility for our own health and wellbeing.

We know that many chronic conditions can be avoided completely by healthier lifestyles.

We are living longer, and it's vital that we age well and in good health - this is a prudent approach to healthcare.

When we do need care it is becoming clear that a hospital ward is not automatically the best place for frail older people when they become ill, which is why it is vital to rethink the care we provide.

A prudent healthcare approach is one where hospital stays are kept to a minimum and where the care that is provided is focused on the individual, rather than the individual fitting into the rigid health service structure. We are seeing more locally based multidisciplinary teams developing across Wales to better meet the needs of older people in the place they live.

In Llanelli, the care delivered to older people has been redesigned by a community resource team involving a range of different organisations.

Their first priority is to support people to solve their own health and wellbeing issues in an informed way, which reduces demand on the service.

The guiding principle of the team is "to only do what matters to the individual, rather than what matters to us". The team encourages individuals to participate in the community, be it a choir, chapel, playing dominoes in the pub or joining a local history group. Integrating into communities and building relationships helps to improve quality of life. This approach, which is focused on the individual, has improved the average time for inquiry resolution, the percentage of people returning to the service within a year, the number of new residential care placements needed, the number of complaints and the number of people needing meals on wheels services.

More people are retaining their independence and are happier with their care.

This is a more prudent healthcare approach in action - effective and tailored to the individual giving better results all round.

The team behind the Powys Virtual Ward has already received wide praise, and an NHS Wales Award, for their work supporting frail older people who are at risk of emergency hospitalisation, to remain in their homes.

It's a collaborative approach involving their GP, district nurse, social services, third sector organisations and specialist nurses. The GP, district nurse and social worker have a daily 'ward round' where they assess the patients.

The most appropriate professional attends to the patient's specific needs and co-ordinates with the wider team.

It has created an alternative to automatically hospitalising older people and helps people to maintain their independence. As a result, it is being rolled out across the whole county.

I am encouraged by the new investment in primary care services and to see health and social care services in Wales collaborating and working with older people to improve and individualise the care they provide - this is the future for sustainable health care in Wales for our current and future generations.

Dr Ruth Hussey is the Chief Medical Officer for Wales
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Publication:Western Mail (Cardiff, Wales)
Date:Oct 19, 2015
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