How can regulation support a preventative approach to healthcare in Wales?

Setting the scene

On Friday 27 March 2026, the Professional Standards Authority and the Welsh Government held a joint online seminar exploring how regulation can support a more preventative approach to healthcare in Wales.

I had the opportunity to Chair the seminar, which brought together speakers and attendees from across health and social care to consider an important question: how can regulation help systems identify risks earlier, support professionals more effectively, and contribute to safer, higher-quality care before harm occurs?

A strong theme running throughout the seminar was that prevention should not be seen as an additional responsibility sitting outside regulation. Instead, speakers reflected on how preventative thinking can be embedded into the way regulation is designed, delivered and evaluated, from professional standards and education to the use of data, public voice, workforce development and emerging technologies.

Opening the seminar, I reflected on Wales’s ambition for a more integrated, community-focused and preventative health system. Regulation can play a key role in supporting this ambition, particularly when it is used as an enabler of improvement rather than simply a mechanism for responding when things go wrong. With this, it  is also important to draw attention to the PSA’s recently published Standards for regulators and Accredited Registers. Regulatory approaches are crucial in helping identify risks earlier, and making better use of insight and supporting positive change across the system.

Keynote: Prevention by design

The keynote address was delivered by Rhiannon Jones (Workforce and Education Nursing Officer, Office for the Chief Nursing Officer, Welsh Government) who spoke on Prevention by Design: How Regulation Should Strengthen A Healthier Wales. Rhiannon argued that prevention needs to be built into the everyday operation of health and care systems, not treated as a separate policy aspiration. Linking her remarks to the ambitions of A Healthier Wales, she reflected on the importance of helping people stay healthy and independent for longer, shifting care closer to home, and creating the conditions for earlier intervention.

Rhiannon’s contribution also challenged attendees to think about how regulation can help “hardwire” prevention and equity into education, training, organisational standards and continuing professional development. She pointed to practical opportunities for regulators and system partners, including strengthening prevention-related competencies, learning from Fitness to Practise insights, and recognising the value of community-based learning environments such as pharmacies, local authorities and the third sector. Her message was clear: if prevention is to become a core feature of health and care, it must be visible in the expectations placed on professionals, organisations and systems.

Public voice and early warning signs

The importance of listening to people and communities was explored in the panel session featuring Lauranne Cullen (Regional Director for Cardiff and the Vale, Llais), and Donna O’Boyle (Acting Executive Director of Professional Practice, Nursing and Midwifery Council).

Lauranne focused on the role of people’s experiences as a vital source of intelligence. She encouraged attendees to think differently about feedback from patients, service users and communities, not simply as comments on what has already happened, but as early warning signs that can help identify where risks may be emerging. Experiences of delays, confusion, poor communication or difficulty accessing services can point to deeper issues in the system. Lauranne’s contribution underlined the need for regulation to be closer to communities, more responsive to lived experience, and better able to draw on qualitative insight alongside other forms of evidence.

Donna reflected on the NMC’s role in supporting upstream regulation and prevention. Emphasising that professional regulation should not only intervene when serious concerns arise, but should also support professionals earlier through standards, guidance and learning. Her reflections highlighted the value of using Fitness to Practise insight proactively, drawing on wider system data, and ensuring that the voices of patients, service users and marginalised groups inform future regulatory approaches. Donna also spoke about the NMC’s work to review its Code and approach to revalidation, ensuring they continue to reflect contemporary practice and issues such as equity, digital change, AI, staff wellbeing and public health.

Using data to tackle inequalities

Another key theme was the role of data in moving from description to action. Professor Anton Emmanuel (Director of Equality, Diversity and Inclusion, NHS Wales), spoke about how data can help tackle inequalities when it is used with purpose and with the intention of driving accountability. His contribution highlighted that data is only meaningful if it leads to action and in turn to improve workforce and patient experience. He shared examples of how workforce and equality data can be used to identify disparities in progression, referrals and representation, and then support targeted interventions.

Professor Emmanuel also emphasised the importance of combining quantitative evidence with people’s experiences. Data can help make inequalities visible, but it needs to be interpreted alongside lived experience and used to drive clear commitments, measurable targets and sustained change. His remarks reinforced a wider message from the seminar: insight is most powerful when it is used not only to understand problems, but to disrupt systems to prevent them from continuing to produce unequal outcomes.

Artificial Intelligence, innovation and human oversight

The seminar also considered how emerging technologies may support prevention, while recognising the need for careful governance and human oversight. Janet Monkman (Chief Executive, Academy for Healthcare Science) reflected on how artificial intelligence (AI) could support areas such as registration, revalidation, Fitness to Practise analysis, public engagement and organisational learning. She was clear, however, that AI should support and not replace human judgement. Her contribution highlighted the importance of transparency, fairness, governance, auditability and human oversight if AI is to be used responsibly within regulation.

Dr Alex Aubrey (Clinical Lead for Artificial Intelligence, Health Education and Improvement Wales) closed of our final panel presentation by focusing on AI’s potential to support earlier detection, better targeting of care and faster intervention. Drawing on examples from stroke imaging, endoscopy and digital pathology in Wales, he explored how AI can help identify issues sooner and support more effective decision-making. At the same time, he cautioned that the benefits of AI are not automatic. Tools that appear accurate can still lead to poorer decisions if they are not properly evaluated or understood. Dr Aubrey stressed that safe and effective use of AI depends on workforce capability, strong governance and the confidence to question and interpret AI outputs critically.

Conclusions

Taken together, the discussions pointed to a broad and shared understanding of prevention as something that must be built into systems, relationships and ways of working. Regulation has an important role to play in this - not only by setting expectations and responding to concerns, but by helping to identify risks earlier, make better use of intelligence, support learning, and keeping people and communities at the centre of decision-making.

The seminar also highlighted that a preventative approach cannot be delivered by regulators alone. It depends on collaboration across policy, regulation, education, professional practice, data, technology and public voice. Speakers returned throughout the event to the importance of working across boundaries: between organisations, between professions, and between the system and the people it serves.

The seminar provided a valuable opportunity to reflect on how regulation can support Wales’s ambitions for a more preventative, inclusive and person-centred health and care system. It reinforced the idea that regulation, when designed and used well, can be a powerful enabler of earlier action, better insight and continuous improvement. Regulation can help to protect the public not only by responding to harm, but by supporting the conditions that prevent it from happening in the first place.