Hunt sets his seven day NHS in motion
Edmund Stubbs, 16 July 2015
Today I heard Jeremy Hunt give a 40 minute speech at The King’s Fund concerning his vision for the NHS, the direction it should take and the reforms it should introduce over the next 25 years. It was certainly encouraging to hear a current politician talk in terms of a long term strategy, and indeed, there was much to be welcomed in what he said.
Mr Hunt expressed his intention to introduce a ‘buddying’ programme, at first for five struggling hospitals in this country, which will involve them in being mentored by the Virginia Mason hospital in Seattle, one of the safest in the world. Virginia Mason employs slightly less staff than in similar institutions in England but has established procedures to enable clinicians to spend 80% of their time with patients and thereby improve clinical outcome. This commitment to patient contact and safety from the minister was encouraging to hear.
Mr Hunt went on to confirm his commitment to a shift from episodic to holistic care combined with moving healthcare more into the community, avoiding hospital admissions wherever possible. He further emphasised the importance of installing patient centred care regimes, with patients not only having information on their conditions readily available but also, importantly, given knowledge as to how best to act themselves to improve or eradicate their maladies.
A strong emphasis must however be placed on the advisory role that clinicians and other health workers might play in supporting a patient through an illness. It is obvious that very human qualities would have to be encouraged in health care professionals, perhaps through adequate relevant training, to ensure that patients do not take a disproportionate amount of responsibly and autonomy in regard to their own treatment.
Another principal theme in Mr Hunt’s speech was the ‘deal’ he intends to strike with NHS providers where they will have less ‘targets’ to achieve in return for heightened transparency. Such ‘intelligent transparency’ he holds, will provide a system that is not only honest about its failures but will have the confidence to put them right. The minister drew a parallel with the the successful culture of openness in the airline industry which he believes could be mirrored by the NHS.
However, it could reasonably be asked how such transparency is to be achieved? In order to provide the necessary data for each institution, performance, a complex, all embracing concept, must be measured. It is hard to envisage how information of such broad ranging complexity could be reduced to a form easily tackled by the ‘reduced regulation’ that the health secretary referred to. Transparency may give patients improved choice amongst providers and hence encourage creative competition between NHS institutions, but hospitals, for example, will surely still have to meet the same kind of targets, how else could their performance be measured?
Mr Hunt made the point that greater transparency will make the devolution of central control to more local levels easier to achieve. According to him, transparency will mean that areas of the country can be carefully monitored during any potential devolution process and allow central governing bodies to intervene if necessary to maintain or improve standards in the regions.
The final major development to be outlined in Mr Hunt’s speech today, evident in the media headlines, is that newly qualified doctors will henceforth be given seven day NHS contracts. The secretary of state became somewhat heated when he talked of the foreseen opposition to this move from the BMA. He claimed that he had been in negotiations with the BMA on this issue since 2012, and that he had ‘yet to meet a doctor who did not think that a seven day NHS was a good idea’. If this is true, it it is likely that the BMA (and many other stakeholders) do not question the benefits of seven day healthcare but have major concerns as to how such an augmentation of the existing service is to be funded.
Edmund Stubbs is Healthcare Researcher at Civitas, @edmundstubbs1