Health secretary Jeremy Hunt has dismissed as “harsh” a suggestion that problems with the recently published “learning from mistakes” league table raised a “question of competence” over the government’s handling of improvement initiatives.
The table, the creation of which was revealed by HSJ last month, splits trusts into four divisions: those with “outstanding levels” of openness and transparency, those which are “good”, those which raise “significant concerns”, and those with a “poor reporting culture”.
Watch Jeremy Hunt and Claire Murdoch debate the “learning from mistakes’ league table in our video:
Mr Hunt was responding to a detailed and lengthy criticism of the table from Central and North West London Foundation Trust chief executive Claire Murdoch who argued the league had a “significant methodological flaw in terms of fairness” and that it risked undermining the government’s focus on patient safety.
Ms Murdoch was taking part in a meeting convened by HSJ that also featured BMA council member and Tower Hamlets Clinical Commissioning Group chair Sir Sam Everington and Health Foundation chief executive Jennifer Dixon.
Asked by HSJ editor Alastair McLellan if the publication of a table with so many flaws raised a “question of competence”, the health secretary said: “I think that’s harsh. The truth is that we are trying to do something for the first time anywhere in the world. You will always be able to pick holes in something that’s done for the first time.”
However, Mr Hunt acknowledged “there are lots of things we can learn from and improve” and asked Ms Murdoch to “work with us to help get the methodology right”.
Ms Murdoch, whose trust was ranked 125, flagging it as raising “significant concerns”, took Mr Hunt to task for the methodology used to compile the rankings.
The community and mental health trust chief executive told the health secretary he could have been “better advised” when creating it.
Ms Murdoch said: “[Your focus on safety as health secretary] has been undermined by the publication of the league table because the first 120 trusts on the list were classified as ‘good’ or ‘outstanding’ and then the next  were classified as cause for ‘serious concerns’.
“Thinking that [number] 120 is good but 121 is a cause for serious concern challenges people as to the validity of a table presented in that way.
“Some of us were ranked in accordance to two board measures and others were ranked in accordance with one. We were all ranked around our staff survey scores and then some of us were ranked around the national reporting of incidents and others were not.”
Ms Murdoch added this amounted to a “significant methodological flaw in terms of fairness” and asked why the findings of “major” CQC inspection findings and the “72 pieces of information” sent to the commission each month by trusts as part of their “quality and risk profiles” were also not used.
The CNWL chief executive said she had “no idea” the table was being published and as soon as the results were announced had asked her analytics team to check the results.
“I discovered that the answer to the staff survey modelling would have put us in the top 30,” she said. “But our incident reporting was nil because we had just introduced an even better system for recording incidents.
“The national team were working with us to make sure they were uploaded. They couldn’t crack the problem for November, even though we had always reported incidents and we were refining it. So we were down as a nil return for incidents. So we then slipped to 125.”
Originally developed by NHS Improvement, the league table will now be published by the CQC.
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