Coverage of speeches by Sir Bruce Keogh and Jeremy Hunt at the Nuffield Trist, and the rest of today’s news

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15.28pm: The head of the Royal College of Physicians has contradicted Jeremy Hunt’s “coasting” accusation and the idea that some staff were prepared to accept “mediocrity”.

RCP president Sir Richard Thompson said: “The secretary of state is right to highlight that there is variation in the standards of hospital care across the NHS. All involved in healthcare must continuously strive to increase standards to their highest possible level for all patients.

“However, I believe the secretary of state is wrong to imply that hospital staff are prepared to accept mediocrity; this is not my experience. Most trusts are struggling to cope with an impossible burden of a relentlessly increasing workload coupled with financial restrictions. The RCP have highlighted the systemic problems in the NHS in our September 2012 report Hospitals on the edge? which calls for all health professionals to promote patient-centred care and to treat all patients with dignity at all times.”

13.55pm: Hunt speech and Q+A is over. In summary, he didn’t announce anything but he gave some hints as to what was influencing his thinking, especially on regulation. Quite a hospital-centric speech in which he says the public don’t believe there are Mid Staffs all over England “but they find a little bit of that everywhere”. Not quite clear what he meant by this, seems to be indicating that he wants to see higher minimum standards. But a focus on hitting the minimum standards for things were part of his “garden of mediocrity” speech (copy attached).

On whistleblowing, he said: “There are parts of the system where people feel the system stops them doing the right thing”

When the Nuffield Trust’s Jennifer Dixon asks what levers Hunt will have to make improvements he says we “We want a system where we have greater autonomy and rigorous inspection”. Notes the system in the police, who are “set targets by politicians but don’t tell them who to arrest.” An interesting parallel here is when PCTs started rationing IVF treatments and Lansley wrote to order them not to do this.

13.36pm: Hunt has just admitted that “hospitals are much more complicated than schools”, important admission considering the “OFSTED-style” hospital inspectorate.

13.30pm: Dixon tries to draw Hunt on backing for reconfiguration. He says the public understand the arguments around specialised services now, like with children’s heart surgeries. He mentions Bruce Keogh’s “future” work on A&Es. Thought that had already started.

13.25pm: Jennifer Dixon question: What levers do you have to make the changes you want? Hunt answers: “We want a system where we have greater autonomy and rigorous inspection”.

13.03pm: Jeremy Hunt due to speak at the Nuffield Trust in a minut. You can watch live here. This is of course the speech that has been widely trailled about “coasting hospitals” that are insufficiently similar to our Olympic athletes in striving for greatness.

11.21am: Fresh evidence that medicine has become over-specialised to the detriment of patient care in this story.

Echoing an earlier report from the Royal College of Physicians, the Surgical Forum of Britain and Ireland has said the increas in specialists meant there were too few medics who can cope in any urgent situation.

11am: Legal regulations are expected to confirm shortly that the clinical commissioning group quality premium bonus can be paid to individual GP practices but must “improve services for patients”, HSJ has learned.

Read the full story here.

10.32am: In case you missed it yesterday, here is HSJ’s story on Mark Britnell being offered the deputy chief executive’s job.

10.12am: Are you and NHS manager? Expect “new ethical guidance” today.

The Times this morning quotes Harry Cayton, head of the Professional Standards Authority for Health and Social Care as saying the NHS needs to return to old fashioned moral concepts.

In a move which the paper says piles pressure on commissioning board chief executive Sir David Nicholson, Mr Cayton says that taking moral responsibility “will sometimes mean people resigning”.

New ethical guidance is being issued to top NHS managers today, the Times reports.

10.09am: Training and education story, Foundation programme medical students have been given their results after earlier exam-marking problems. Health Education England are now going to do a review.

10.07am: A local GP has warned of 111 services causing “extreme pressure” in the system at the Royal United Bath Hospital. More details when we get them.

10.01am: The RCN has responded to Hunt’s complacency remarks.

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

“Frontline 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.”

9.55am: Sir Bruce says there will be a problem if social services start to fail and more and more people come into hospital who cannot then be discharged because of a lack of community services.

GP Charles Alessi points out the fundamental problem between providers ho are paid on the activity they perform whereas commissioners have to get the best deal they can for their population with the cash they have been allocated. You can follow all this on Twitter at #ntsummit.

9.49am: Here is the BBC on Jeremy Hunt’s “complacency” comments. University Hospitals of Coventry and Warwickshire Trust chief nurse Mark Radford asks Twitter: “Hunt attacks ‘complacent’ hospitals - anyone come to work with low aspirations/mediocrity for pts care? Not me/team”

9.45am: NHS medical director Sir Bruce Keogh and Care Quality Commission chief exectuive David Behan are talking about quality at the Nuffied Trust summit. Live feed here. Behan reveals he has met his opposite number at Monitor three times this week and 15 per cent of his time is spent talking other agencies.

Sir Bruce told delegates the National Quality Board was “now at a level of maturity where we are allowed to hold each other to account and can have some awkward conversations”,

8am: Jeremy Hunt’s forthcoming speech at the Nuffield Trust has been widely trailed. The Secretary of State said “lives were being lost” because hospitals weren’t striving hard enough and were “coasting”. He said hospitals should aim always for the best quality in the manner of an Olympic athlete.

7.58am: Good morning, a project to find placements for undergraduate student nurses in general practice has helped to nurture a new era of integrated working, writes Louise Berwick on HSJ today.

The Advanced Training Practices project proactively recruits and manages placements for undergraduate student nurses in general practice. These placements build an understanding and experience of integrated working − and allow the silos of the past to be flattened by a focus on interprofessional education.  

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