‘Silly Rules’ campaign identifies everyday procedures which may inadvertently impact health and care

Hundreds of frontline staff and patients in Wales have highlighted the everyday rules and procedures which may inadvertently impact the efficient delivery of health and care.

They have also suggested improvements, from reducing unnecessary paperwork to changing outdated booking processes.

A new report called ‘Silly Rules’, by the Bevan Commission, an independent health and care think tank in Wales, and Llais, the citizen voice body for health and social care, highlights how minor tweaks to delivery could streamline services to improve the experience of patients and staff.

Almost 800 responses were gathered, showing the opportunities to make health and care more efficient and effective.

Bevan Commission Director Dr Helen Howson said: “At a time when health and care professionals and leaders are already under intense pressure, we want to identify practical ways to relieve that pressure and make everyday care better.

“This work is about understanding the barriers people face when delivering and accessing care and recognising that rules introduced for the right reasons can become outdated or have unintended consequences.

“The response to our ‘Silly Rules’ campaign was striking and culminated in almost 800 examples of rules, habits and routines that get in the way of delivering or receiving good care.

“Together, they demonstrate a shared appetite for change; to simplify, streamline and strengthen the system so that time and energy are focused on effective and efficient care.”

Llais Chief Executive Alyson Thomas said: “The responses to the Silly Rules campaign highlight something we hear every day: people want health and care systems that work with them, not against them.

“These examples reveal opportunities for simple, sensible improvements that could make a real difference to staff and patients.

“By working with the Bevan Commission and partners across Wales, we’re ensuring that people’s voices drive the changes needed to remove barriers, reduce wasted effort and build a system that delivers care in the way people expect and deserve.”

According to estimates, around 20-30% of all resources invested into health and care systems are lost to waste.

This led the Bevan Commission and Llais to ask one simple question: “If you could break or change any rule(s) to provide a better care experience for patients, families or staff in Wales, what would it be?”

The majority of the ‘rules’ submitted came from the workforce and about a quarter from members of the public.

Frustrations included a ward manager completing ‘six hours of paperwork’ following a minor fall, and a patient being told they would need to phone to make an appointment – even though they were standing in front of the receptionist.

The Silly Rules initiative was inspired by the Institute for Healthcare Improvement’s (IHI) Breaking the Rules for Better Care campaign, which originally explored the barriers experienced by people working in and using health services in the United States.

Building on this work, the Bevan Commission partnered with Llais to ask the simple question about how to make things better here in Wales.

Responses were categorised into 10 themes, with almost half (48%) falling under Operations and Service Delivery. Other notable categories were Clinical Services, Communications, and Digital and Information.

The Bevan Commission and Llais will continue to work closely with health and social care organisations in Wales, following the principles of prudent health care and ensuring that resources are used to their best effect.

The Commission has developed a toolkit, which will be shared with health and care organisations in Wales to help them review their own rules, identify unnecessary barriers and implement evidence-based change.