Are you listening?


Two days, 8,000 health and care professionals, 400 exhibitors, 300 speakers; this week’s Health+Care – incorporating the Commissioning Show – was as impressive as the statistics suggest.

Anyone who has visited an event at ExCel will understand the difficulty in trying to summarise one. With so many enthused and erudite speakers, picking even a handful from this conference would do the rest an injustice. So, then, perhaps it makes sense to focus on the one speech that had the potential to affect everyone there: Jeremy Hunt’s keynote address on the second day.

The BMA had set the scene, using the national media this week to hammer home the messages we have been reading in the specialist press for months. At this stage in the election cycle, with a winter to pass through before votes are cast, the doctors are on a pre-election push, happy in the knowledge that the NHS will be a key political battleground and that their requests are more likely than ever to be met.

Speaking to an audience of commissioners and providers, however, Mr Hunt addressed different concerns. Beginning with compliments, he positioned himself as the clinical commissioners’ friend, acknowledging their innovations and praising their advances; yet, he also asked them to do more.

Central to his vision is accountability. CCGs were challenged to become ‘accountable care organisations’, working with long-term contracts based on capitated grants, answerable for almost all the care delivered to their populations. He used the renowned health system of Valencia as an example and identified four critical success factors:

  • the ability to track, in real time, health and social care costs at an individual level;
  • the need to share electronic health records across the whole NHS;
  • the full involvement of the acute sector in reshaping local service delivery, especially when moving care out of hospitals and into primary care; and
  • local leadership that does not look for top-down direction.

Perhaps more interesting than all of this, however, were his brief comments on standards. Though admitting the response to the Francis report had been ‘magnificent’, it was time, he said, for standards and quality to be upheld and improved by commissioners – change must be led by cleverly utilised data rather than targets, inspections and bailouts.

Some notable commentators will likely be pleased with this direction of travel, although they will probably also reflect with some scepticism; it is safe to assume, for example, that the BMA is expecting emergency funding before the end of the year and we are still waiting for the launch of

So, though few will disagree with the Secretary of State’s objectives, many might question the ability to deliver them on the ground any time soon with conditions as they are. Mr Hunt opened his speech by paraphrasing Bill Clinton: politics is like running a cemetery – you’ve got a lot of people underneath you but you can’t be sure they’re all listening. Let’s hope he’s not deaf to the concerns of the interred.