Patients should use A&E responsibly, says Hunt

10 Jan 17

The public should avoid “inappropriate” visits to A&E in order to help the NHS meet its four-hour waiting time target, the health secretary Jeremy Hunt reiterated at a conference today.

Hunt was speaking one day after becoming embroiled in a political row for stating he would water down the commitment to treat and then admit, transfer or discharge 95% of A&E patients within four hours of their arrival.

This should apply to all urgent health problems, he told MPs yesterday, “but not all health problems, however minor”.

Speaking at health think-tank the King’s Fund this afternoon, the health secretary said in order to give care to the people who need it quickly, the public needs to use alternatives to A&E when possible.

Referring to data in an OECD report launched at the event, he highlighted that Australia, Belgium, Canada, France, Italy and Portugal report that one fifth of visits to A&E are “inappropriate”.

“If we’re going to give that care to the people who need it quickly, we need the public to help us,” he said.

He described the four-hour waiting time target, which has been in place – without caveats – since 2004, as one of the “best things” in the NHS.

Addressing the theme of the event – waste – Hunt said that an ageing population and expectations of “24/7” services were putting “extraordinary pressure” on health systems, and in order to respond, resources were going to have to be put to better use.

“Too much of the debate has been about how much we are putting in, and not enough of it has been about how well we are using the money that we do put in,” he said.

“The truth is, no matter how much any government puts into the NHS, the pressures on healthcare are so enormous that we are going to need to have these discussions about getting value for money from every pound that we put in.”

Sharing data is the first step towards doing that, he continued, adding that the NHS is already ahead in this field.

Programmes that allow hospitals to share data on prices for common products like surgical gloves, agency spending and post-operation infection rates are helping hospitals close variations in price and care quality, he told the audience.

A data sharing tool for procurement, where hospitals report the price paid for the 100 most commonly used products, looks set to save £1bn through smarter procurement and information sharing, he noted.

As well as procurement, Hunt highlighted staff rostering – raising the spectre of last year’s junior doctors’ strike and his subsequent decision to impose a disputed new contract on to them.

One thing he said he learned from the “difficult and unfortunate” strike was that the health service is not good enough at rostering staff “flexibly and efficiently and in a way that actually motivates people who are often being asked to work very unsociable and challenging hours”.

He suggested an e-rostering system that allows staff to request days off or shift their working hours around would have a big impact for staff and prevent them from moving into agency work or becoming locums because those positions offer flexibility.

Challenged on what has been dubbed “humanitarian crisis” in the NHS at present, Hunt reiterated that he doesn’t “accept that description”.

“I think there are some A&Es that had very serious problems over Christmas and no one would want to minimise what happened,” he stated. “But the vast majority of hospitals under extreme pressure actually coped slightly better than last year.

“There have been a number of independent voices that say that language was not appropriate, so I don’t accept that description. Does that mean that we aren’t going to do anything about some of the problems that we had in the last couple of weeks? Absolutely not.

“Those problems are unacceptable, some of them are extremely distressing and worrying and of course we need to take action.”

Did you enjoy this article?