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What is Essencial

Essencial "Adding value to clinical practice" is an initiative which identifies low-value clinical practices and promotes recommendations on how to avoid them.

Better quality, better healthcare

Results from the health care system of Catalonia place it at the forefront among European counterparts making it one of the systems of reference. It is highly valued by users and an important driving force for the country’s economy. In order to maintain and improve the quality of this healthcare provision, Catalan health care system requires coordinated action.

The quality of health care is directly related to the effectiveness and efficiency of health care services provided to achieve the maximum possible value for the available resources.

Nowadays there is enough evidence to show that, alongside clinical practices which have been proven effective, there are other low-value practices as well as some, which the evidence tells us, add no value whatsoever.

Avoiding clinical practices which do not add value can help improve healthcare quality, innovation and sustainability of the health system, insomuch as it frees up resources which may then be allocated to processes that do add value to clinical practice. For this reason, the development method for this project is explicit and transparent, and involves participation of health professionals from every stage throughout the process.

The project is based on close and ongoing collaboration between Catalan scientific societies, health professionals, patients and the Agency for Health Quality and Assessment of Catalonia (AQuAS as per the Catalan synonym).

General objectives

Main objective

  • Promoting clinical practices aimed at avoiding practices classified as adding low or no value for the general public. This in turn will contribute to improving healthcare quality.

Specific objectives

  • To inform the professional community and the general public of procedures which, according to the scientific evidence and expert opinion, fail to provide benefits to patients’ health.
  • To encourage health professionals to contribute to identifying practices which are of little value.
  • To assess the impact of the recommendations on the health system, both from the point of view of the process as well as the end result.

Project phases

Identifying practices of low value
During the initial phase of the project, clinical practices that contribute little value are identified by analysing multiple sources of information. The Agency for Health Quality and Assessment of Catalonia (AQuAS) coordinates this process in collaboration with scientific societies, the Department of Health master plans and the professional community.

Prioritizing recommendations
Recommendations are introduced into the database available on this website as part of an ongoing stage in the prioritization process in accordance with the following criteria:

  • prevalence and significance of the condition or disease;
  • frequency of use;
  • adverse risk/benefit;
  • impact on organization and patient preferences, bearing in mind that these should be in line with the Health Plan, the master plans and scientific societies.

Active communication
A specific communication strategy is designed for each prioritized recommendation which is tailored to the particular stakeholders involved using the most suitable communication and distribution channels in each case (social media communication tools, press releases, scientific communication, etc.).

Assessing the impact
In this final stage, and whenever possible, an impact assessment study is carried out by measuring the degree of knowledge of prioritized recommendations and their adoption by medical professionals, as well as any changes in healthcare provision attributable to the implementation of the recommendation.


The Agency for Health Quality and Assessment of Catalonia (AQuAS) operates a work plan in coordination with professional and scientific societies even though comments and suggestions are always welcome from any sector of the community.

You can contact us via e-mail at the following address: essencial.salut@gencat.cat  

Update:  04.03.2013