Coasting culture can kill, Jeremy Hunt warns hospitals


Too many middle-of-the-road hospitals are “hitting targets but missing the point”, the Health Secretary is to warn.

Jeremy Hunt will say that hospitals which simply meet minimum standards should tackle "mediocrity and low expectations before they turn into failure and tragedy".

During a speech at the Nuffield Trust's health policy conference in Dorking, Surrey, Mr Hunt will warn hospital bosses about the dangers of simply aiming for "not coming last".

Average hospitals which meet national targets but are not doing anything to improve their services are "not good enough", he will add.

He is expected to say: "Imagine for a moment that the main objective for our Olympic athletes was not to win but to 'not come last'. How many gold medals would we have won then?

"It sounds ridiculous, doesn't it? But today I want to suggest that too much of the NHS is focused on doing just that.

"Not on achieving world-class levels of excellence - the gold medals of healthcare - but meeting minimum standards, the equivalent of 'not coming last'.

"Coasting can kill. Not straight away, but over time as complacency sets in, organisations look inwards, standards drop and then, suddenly, something gives.

"The lesson of Mid Staffs is surely that we need to understand why they fail in the first place - which means tackling mediocrity and low expectations before they turn into failure and tragedy."

He is expected to add: "There are plenty of other hospitals where their staff friends and family scores are about the same today as they were in 2009.

"They're hitting their targets, they're not failing but, on the basis of this indicator anyway, they're standing still.

"Hospitals must not be allowed to cruise along, hitting the targets but missing the point.

"Because 'not bad' is not good enough. Not if we want the NHS to be the best in the world. Not if we want everyone to have access to the best healthcare. Not if we are to meet the challenges of increasing expectation alongside increasing age."

He said that one hospital significantly improved standards by listening to patient feedback and introducing a "new culture of patient-centred ambition".

"In the 2010 national patient survey, Walsall Manor Hospital scored in the bottom 20% on more than half the questions asked," he will say.

"They were not in a good place and they knew it. So they introduced the friends and family test. They now ask every patient, very simply, how likely they are to recommend Walsall Manor to their friends or family and to name one thing they could do to improve their stay.

"From TV remote controls, to warmer rooms to staff shortages, patient feedback led to fast corrective action, including focusing more resources in wards that were under pressure.

"A year ago, their own patient satisfaction scores averaged 65%. Today, they're up to 75%.

"In that same period, C. Diff infections are down 80%, pressure ulcers are down 30% and falls down 20%. Not all of this is because of patient feedback, but it is thanks to a new culture of patient-centred ambition - as Richard Kirby, the chief executive says: 'It's changed the nature of the discussion."'

Labour's shadow health secretary Andy Burnham said: "It's no good for ministers to blame hospitals and staff when it is they who have thrown the whole system into chaos with a huge re-organisation, which has siphoned £3 billion out of front-line care.

"Hospitals across England are on a knife-edge and they need a Government that provides support rather than points the finger."

Dr Peter Carter, chief executive and general secretary of the Royal College of Nursing, said: "Our members will agree that all hospitals should be aiming for excellence, but this requires investment and leadership.

"Front-line staff want to work in excellent hospitals, but they need the proper support to be able to do this. Team GB's fantastic success is down to a combination of ambition supported by proper investment and resources, and this needs to be emulated in the NHS."