BMJ 2016;355:i5980 doi: 10.1136/bmj.i5980 Page 1 of 1
Views and Reviews BMJ: first published as 10.1136/bmj.i5980 on 9 November 2016. Downloaded from
VIEWS AND REVIEWS
NO HOLDS BARRED
Margaret McCartney: What Hunt did next
Margaret McCartney general practitioner
Glasgow
Jeremy Hunt has pinned his NHS badge back on. “Let’s not that he would order newly graduated doctors to work for the argue about statistics,” he said recently.1 NHS for four years, resulting in “more home grown doctors.” In his Conservative Party conference speech, however, the health Where’s the evidence? We have no idea whether this will result secretary was talking about four key standards that the Academy in more doctors bailing out to the city sooner, though I suspect of Medical Royal Colleges recommends. One was that, that it will damage morale. But don’t fear: Hunt, we’re told, “whatever day of the week it is, highly vulnerable patients intends to improve morale by using the lure of honours.6 should be checked by a consultant twice a day.” Hunt said that Seriously? The NHS is in meltdown, but the Empire strikes this happens “in just one in 20 hospitals.” He added that back. “patients should be checked by a senior doctor within 14 hours And he claimed, “When you look at our safest hospitals . . . it’s of being admitted,” which was happening “in just one in 10 http://www.bmj.com/ 2 not about the level of funding but the quality of leadership.” hospitals.” Please don’t tell us that catastrophic cuts to social care, small Let us, indeed, argue about statistics. It sounds as though only GP surgeries being declared “unviable,”7 and the resulting crush a small minority of patients are seen by consultants frequently in emergency departments have nothing to do with inadequate enough or in good time. The first target Hunt mentioned is that funding. patients in high dependency care should be seen twice a day by In a way, however, all of these problems are about poor a consultant and once daily in other areas, in all specialties. The leadership—originating from the office of the secretary of state. second is that 90% of patients are seen by a consultant within on 29 September 2021 by guest. Protected copyright. 14 hours of admission in all specialties. One in 20 hospitals is Competing interests: See www.bmj.com/about-bmj/freelance- meeting the first 90% target; one in 10 is meeting the second. contributors/margaret-mccartney. Although not meeting the targets, the hospitals aren’t doing as Provenance and peer review: Commissioned; not externally peer badly as he suggested. In fact, 85% of patients in intensive care reviewed. units are seen twice a day by a consultant. And Hunt referred Follow Margaret on Twitter, @mgtmccartney to “senior doctors,” but the data audit included only consultants.
Similarly, most patients are seen by a consultant within 14 hours 1 Oliver D. David Oliver: Let’s argue about statistics. BMJ 2016;355:i5649. doi:10.1136/ 3 4 of arrival at hospital—an average of 79%. bmj.i5649pmid:27770009. 2 Full text: Jeremy Hunt’s Tory party conference speech. Spectator 2016 Oct 4. http://blogs. No wonder the UK Statistics Authority has written to the spectator.co.uk/2016/10/full-text-jeremy-hunts-tory-party-conference-speech/. Department of Health urging it to pay “greater attention” to “a 3 NHS England. Seven day services baseline data collection. https://www.england.nhs.uk/ wp-content/uploads/2015/10/7d-services-primary-pub.xlsx. description of methods, including the approach to sampling; 4 Spiegelhalter D. Jeremy Hunt, the Guardian, and the importance of getting stats right. quality assurance; a balanced description of findings; [and] Understanding uncertainty (blog). 21 Nov 2015. https://understandinguncertainty.org/ jeremy-hunt-guardian-and-importance-getting-stats-right. frankness, in terms of setting out any limitations of the 5 UK Statistics Authority. Letter to Department of Health. 1 Nov 2016. https://www. 5 approach.” statisticsauthority.gov.uk/wp-content/uploads/2016/11/Letter-from-Ed-Humpherson-to- Chris-Wormald-011116.pdf. Hunt, we’re told, intends to improve morale by using 6 Matthews-King A. Jeremy Hunt “wants to boost GP morale by awarding more gongs.” Pulse 2016 Oct 7. www.pulsetoday.co.uk/news/political-news/jeremy-hunt-wants-to-boost- the lure of honours. The NHS is in meltdown, but the gp-morale-by-awarding-more-gongs/20032953.fullarticle.article. Empire strikes back 7 Pym H. Let struggling GP surgeries fail, says NHS England letter. BBC News 2016 Oct 12. www.bbc.co.uk/news/health-37617114. Hunt has also pledged to nurture more home grown doctors by Published by the BMJ Publishing Group Limited. For permission to use (where not already increasing places at UK medical schools. But then he announced granted under a licence) please go to http://group.bmj.com/group/rights-licensing/ permissions
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