Jeremy Hunt has said there are ‘too many trusts’ in the NHS and the health service needs to ‘up the pace’ of work on hospital chains and other provider reforms.

  • Health secretary tells HSJ there are “too many trusts as independent organisations”
  • “We need to up the pace” of provider sector reform, says Jeremy Hunt
  • Becoming health secretary is “one of the biggest learning curves mankind could imagine”

The health secretary’s comments come amid renewed interest in hospital chains in Whitehall and Westminster, and as NHS England is selecting sites for its “acute care collaboration vanguard”.

The Dalton review, commissioned by Mr Hunt last year, endorsed a range of organisational forms for NHS providers, including hospital chains, Moorfields style single service chains, and management franchises.

Asked if he agreed with Salford Royal Foundation Trust chief executive Sir David Dalton that having around 240 NHS providers was no longer a “sensible and affordable” way of delivering reliable care, Mr Hunt told HSJ: “I think we do have too many trusts as independent organisations, but I don’t think the way to solve this is by me as secretary of state coming up with a blueprint, and trying to roll it out across the NHS.

“I think there will be different structures that are appropriate in different areas.

“We’ve already seen some mergers of community trusts and mental health trusts. I’m sure there will be more mergers, more chains that develop, and I think we need to allow people the space locally to work out what the right solution is.”

University Hospitals Birmingham

University Hospitals Birmingham has new systems that could ‘be rolled out quickly to other trusts’, Jeremy Hunt said

He said “outstanding” FTs like Salford Royal, University Hospitals Birmingham, and Frimley Health had “developed superb personnel systems, superb IT systems, superb quality improvement processes” which could “be rolled out relatively quickly to other trusts”.

Asked to give a sense of the pace at which he would like to see these reforms, he said: “I think the answer is we need to up the pace. We need to up the pace for the very simple reason that we have £22bn of savings that we need to find…

“Where you have smart managers like a Clare Panniker [chief executive of Basildon and Thurrock University Hospitals FT] or an Andrew Morris [Frimley Health chief executive], or a Dame Julie Moore [University Hospitals Birmingham chief executive], really those people and their teams, because they’ve all built up very good teams around them, would be quite capable of running multiple hospitals, and we should be tapping into their ability to do that.

“I’d say exactly the same thing for smart GP practices, and I’d say exactly the same thing for our best [clinical commissioning groups]. I think we need to allow people who have proven they are able to manage big healthcare organisations… to be able to use those talents more broadly.”

Asked if he could imagine the development of a non-geographically contiguous chain of CCGs, he said: “I absolutely can.”

He added: “You go on one of the biggest learning curves mankind could imagine when you become health secretary, and there are things you realise three years into the job that you didn’t realise at the start of the process.

“One of them is that the pace of change can be really quite rapid if the purpose of the change is improving care for patients and if everyone accepts that’s the purpose.”