#ImInWorkJeremy– What do Hunt’s reforms proposed mean for the NHS?

We have all seen the barrage of abuse on social media Jeremy Hunt has come under this week following a career defining speech at The King’s Fund, where he laid bare his 25 year vision to change how the NHS is run.  In particular, how NHS contracts for newly qualified consultants should be changed to prevent them from opting out of weekend work, a move he feels will help reduce death rates of patients who are treated on weekend. The last major reforms to consultants’ contracts were made under Labour in 2003, with some critics suggesting this package was “overly generous.”

The move has been condemned widely by the BMA and NHS staff as “a wholesale attack on doctors” who are furious at the suggestion that NHS staff are not working weekends, prompting the hashtag #ImInWorkJeremy to trend on Twitter and Facebook, with NHS workers taking selfies of themselves at work in hospitals.

This has since escalated with a petition established calling on David Cameron to remove Hunt from his post as Secretary of State for Health gaining nearly 100, 000 supports and a further petition on the official Parliament website calling for to debate a vote of no confidence in Hunt.

But has the resultant Twitter storm distracted from the very real and open debate that has to happen regarding the NHS?  Have NHS staff been unreasonable by allowing their emotional attachment to their job cloud the real concerns raised by Hunt on how to reform the NHS so it functions better for patients?

Hunt replied to the barrage of tweets with a cringe worthy text speak acknowledgement of the hard work being put in by NHS staff.

So, what is the offer?

Hunt’s proposals is centred around saving lives.   Research suggests patients get a poor standard of care and are therefore  more at risk of death if treated on the weekend. Research conducted by University College London and other academic institutions, published in The Royal Society of Medicine’s journal, concluded that  patients who are admitted to hospital at the weekend are 15% more likely to die than if they came in on a Wednesday. Similar research from Imperial College London suggests that a patient who needs surgery on the weekend is 82% more likely to die 30 days following the procedure than someone treated on a Monday.

The ensuing social media campaign has cast a shadow over other proposals laid out by Hunt in his speech including:

  • A new system of investigation of patient safety incidents
  • GPs informing patients about the rating of their local hospital and the waiting time for treatment prior to sending them there for treatment
  • All hospitals publishing data on avoidable deaths
  • Pairing hospitals up with internationally renowned centres of excellence to take away key learnings on patient safety and how that can be implemented within the NHS

Labour has largely backed the changes, with Shadow Health Secretary Andy Burnham saying that, while the principle of improving seven-day services is welcomed, the manner in which the announcement was handled was “not appropriate.”

Burnham has also accused Hunt of making no reference to the “very fragile” state of the NHS at the moment, describing Accident & Emergency as “in crisis” and primary care as “overloaded”.

The bigger picture

These changes proposed are all part of the Conservative government’s bigger plan for the NHS, which is centred around the promise to make the NHS the world’s best National Health Service. This is to be achieved by committing to an increase NHS spending in England in real terms by a minimum of £8bn over the next five years, to fulfil the £30bn funding gap identified in the five year forward plan developed by Simon Stevens, Chief Executive of NHS England It is still unclear where the extra funding will come from but George Osborne announced in April 2015  , that the Conservative government will commit to plugging the current black hole. This was seen as a ringing endorsement of the five year plan and the party’s commitment to transforming the NHS. The remaining £22bn of this could be covered by making efficiency savings within the NHS.

On 21 July Simon Stevens gave evidence to the Health Select Committee on matters affecting the NHS, including its financial performance, prevention and public health, the NHS staffing, urgent and emergency care, mental health services, and the post-Francis Review progress on changing culture within the NHS.  At the hearing Stevens said ” [the] single most important thing we’ve got to do is turn around spending on agency staffing, which cost £3.3 billion last year.”