Hunt: Safety and technology are key to surviving squeeze

Jeremy Hunt told HSJ that the NHS would also need to maintain its current rate of efficiency savings in 2015 and beyond, but said the emphasis would have to shift to safety and technology.  

“There’s a very big step change over safety,” he said.

“It’s very clear that unsafe care is the most expensive thing we could possibly do in the NHS… I don’t think we’ve focused nearly enough on understanding the savings that can be made through safer care.”

He pointed to avoidable mistakes, “never events” and clinical negligence claims as sources of unnecessary expense.

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The Salford Royal Foundation Trust had saved money by improving safety, while the safest US health systems were also the most cost efficient, Mr Hunt said.

While the focus on safety over the past year has led to many trusts spending more through hiring extra nurses, Mr Hunt said “the long term impact of safer care is to significantly reduce costs”.

He would not be drawn on whether the NHS was financially sustainable without a real-terms funding increase. Instead, Mr Hunt emphasised that the NHS had to “live within its means”.

He acknowledged there had been “very big sacrifices” made by NHS staff over the past four years, and also “some very big changes in the way we deliver services.”

“Whether we’re sustainable going forward depends on whether or not we’re able to continue to sustain that pace of innovation… The cost improvement programme will have to continue, and I think it will have to continue at broadly the same pace, but it will have different elements.

“There’s a role for reconfigurations but I think we also need to look at cost improvement that can be made inside hospital – that’s also the case inside GP surgeries and inside the social care system.”

Mr Hunt said he was confident in the abilities of local and national NHS leaders. “We have to operate within the money we have, but in my term as health secretary I’ve had to ask the NHS to do the impossible on a number of occasions and they’ve delivered.”

In the next five years, he said, innovation must be focused on integrating care and adopting new technologies. Contact time between nurses and patients should increase at the expense of “bureaucratic processes”, he added.

Mr Hunt also claimed the NHS was “ahead of schedule” on his aim for it to become paperless by 2018.

This was despite nearly a quarter of the Safer Wards, Safer Hospitals funding for 2013-14 being clawed back by the Treasury after it went unallocated by NHS England.

“We’re only scratching the surface when it comes to innovation. The primary motivation is to improve services for patients, but there is a secondary massively important benefit which is that it saves cost.”

Mr Hunt said retail banking had cut costs by a third by embracing the internet. “We are just at the start of that revolution when it comes to IT in the NHS.

Jennifer Dixon, chief executive of the Health Foundation, told HSJ that while improving safety could yield financial gains, it was less clear how much could be saved and how quickly.

“Nobody really knows what the quantum of resource can be saved in this way,” she said. “There is huge potential here but we don’t know whether it is going to be the ticket that will get us out of the problems the NHS faces.”

“It often takes a long time to show benefits… Salford is a classic case. It took 12 or 13 years to get to where it is. Any high performing system – they’ve all had stable leadership, they’ve all had the board in position for ten or more years, they’ve all taken the long view, it’s been a slow upward trend.”

“It’s not something you can immediately do off the shelf, that people aren’t doing and should be doing.”