Jeremy Hunt HSJ Annual lecture 29 October 2015 - the elephant traps and patient power

Jeremy Hunt HSJ Annual lecture 29 October 2015

Full transcript here: http://www.hsj.co.uk/newsletter/news/hsj-annual-lecture-full-transcript/5091559.article
Video: http://www.hsj.co.uk/newsletter/home/video-health-secretary-announces-ofsted-style-ratings-for-ccgs/5091754.article

Highlights:

• “inescapable, irreversible shift to patient power .. is about to change the face of modern medicine beyond recognition”
• “democratisation of healthcare” is “driven by technology and by our ability to use data differently.”
• “I strongly believe that by running faster towards that destination we are more likely - not less - to be able to cope with the huge pressures doctors and nurses face on the frontline now.”
• Patient power: the future – “In some ways this is just the onward march on modern technology finally taking off in healthcare. But these changes are doing something more: all of them are giving patients much greater control of their own healthcare and responsibility for their health outcomes.”
• Opportunity for doctors – “the move to the ‘quantified self’ in medicine presents a huge opportunity to improve the quality and accuracy of a diagnosis.”

“Today I will therefore talk about this government’s plan to make this happen and the four elephant traps we need to avoid in the process.”

The four elephant traps:

1. The Bureaucracy trap – need to ensure that new IT systems improve rather than reduce clinician productivity
2. The Accountability trap – “by making cross-team and cross-agency working easier, there is also a risk that accountability to the patient is blurred.”
3. The cost trap – “ incremental improvements closely tied to clinician productivity and patient experience are as valuable as big bang changes which carry much greater risk.”
4. The data security trap – “The NHS has not yet won the public’s trust that it is competent in protecting basic personal information… the new guidelines being developed by Dame Fiona Caldicott, our National Data Guardian, as well as the CQC’s review will be vital.”
   “Professor Robert Wachter, … will conduct a review for the NHS on the critical lessons we need to get right as we move to a digital future.” 

Five point patient power plan

1. Plug the transparency gap – work on CCG accountability will go ahead based on Kings Fund report (http://www.kingsfund.org.uk/publications/articles/measuring-performance-local-health-systems).
   NHS England will provide ratings of all CCGs: outstanding, good, requires improvement, inadequate. To be published by June 2016– both as an overall rating, and for cancer, dementia, diabetes, mental health, maternity and learning difficulties.
   Under Ian Dodge, NHS England will be developing a new methodology based on the wider responsibilities CCGs now have for their local health economies.
2. Accountability gap -  Principles outlined by Academy of Medical Royal Colleges on clinical accountability in community settings will be incorporated into planning guidance.  http://www.aomrc.org.uk/doc_download/9850-coordinating-care-in-primary-community-and-outpatient-settings.html
3. Time gap - 4 point NHS England plan to help GPs. 

a.    cutting down time spent payment by allowing everyone access to GPs’ own payments system.

b.    Stop the referrals from hospitals back to GPs when they miss an appointment

c.    Make General Practice truly paperless by 2018

d.    Support GPs to innovate locally across organisational boundaries

4. Continue to explore ways to increase choice in maternity, end of life care and the roll out of personal budgets
5. Continue to tackle the culture gap which still acts as a barrier to putting patients first.