Hunt unveils plans to 'profoundly transform' NHS culture

Jeremy Hunt

Consultant contract reform, a new Independent Patient Safety Investigation Service, further measures to improve transparency and the merging of two national bodies have been unveiled as part of a series of steps to "create a profound change in culture in the NHS."

Announced by the health secretary in a speech on Thursday (16 July), other steps includes a new international buddying programme and completion of the National Institute for Health and Care Excellence's (NICE) work on safe staffing. Find out more in the summary below.

Leadership and learning

In a bumper day for health announcements, Thursday also saw publication of Learning not blaming, the Government's response to three reports on patient safety and Lord Stuart Rose's long-awaited report on NHS leadership, Better leadership tomorrow.

Learning not blaming sets out the Government's position on the Freedom to Speak Up Review, Public Administration Select Committee's investigation into clinical incidents in the NHS and Dr Kirkup's report on Morecambe Bay. Key points for NHS boards can be found in the NHS Confederation's resource section.

Lord Rose's report makes 19 recommendations to help attract and develop talent from inside and outside the health sector into NHS leadership.  The Government has accepted all 19 recommendations, in principle, the health secretary announced to ParliamentView the Confederation's response.


In a wide-ranging speech at the King's Fund on Thursday morning, Mr Hunt said the NHS must become the world's largest learning organisation, transforming into a human-centred, rather than system-centred, healthcare system. 

The NHS Confederation welcomed the minister's focus on empowering NHS patients and staff, and commitments to locally led change, further transparency and the fostering of a culture of improvement rather than blame. View the full media statement.

Key points

Improvement and safety

  • The operating name for the new jointly led Monitor and NHS Trust Development Authority (TDA) will be NHS Improvement. Ed Smith (deputy chair of NHS England) will be the new chair, supported by Ara Darzi as a new non-executive director. Recruitment for new chief executive will be completed by the end of September.
  • Dr Mike Durkin’s (NHS England's national director of patient safety) will move to NHS Improvement. He will work with the Chief Nursing Officer to complete the work started by NICE on safe staffing levels, which will be reviewed by NICE, Sir Robert Francis and the chief inspector of hospitals.
  • Dr Durkin will set up a new Independent Patient Safety Investigation Service modelled on the Air Accident Investigation Branch used by the airline industry, specifically to help foster a “no blame” culture around patient safety.
  • The start of an international buddying programme. Five NHS trusts – Surrey and Sussex Healthcare, Leeds Teaching Hospitals, University Hospital Coventry and Warwickshire, Barking Havering and Redbridge, and Shrewsbury and Telford – will from this year be partnered with Virginia Mason in Seattle.
  • The national responsibility for nurturing and developing talented leadership in the NHS  will become the responsibility of Health Education England (HEE), In line with the recommendations of the Rose's report. NHS Leadership Academy to move to HEE.

Transparency and devolution

  • Move further and faster towards Valencia-style population-level commissioning. (Discover more about this in the NHS European Office's report The search for low-cost integrated healthcare).
  • Argued that more transparency and better metrics will lead to more local decision-making: “You can start to devolve power - safe on the basis not just of ‘earned autonomy’ for people delivering good quality care, but also because where there are problems, many of them will self-correct.. With smart metrics we can also be less prescriptive about models of care, allowing more space for local ingenuity and innovation.”

Patient choice and control

  • Next year, all GPs will be asked to tell patients not just which hospitals they can be referred to, but the relevant CQC rating and waiting time as well.
  • NHS England to develop “concrete proposals” to make sure there is meaningful choice and control over services offered in maternity and end-of-life care, and for those with complex long-term conditions.
  • New deal for general practice to boost GP provision in under-doctored areas, with NHS England giving particular attention to making sure that there are alternatives available when a practice has been rated ‘inadequate.’
  • Martha Lane-Fox (crossbench peer and former UK Government digital champion) to develop practical proposals on how to increase take-up of new digital innovationsfor the NHS National Information Board before the end of the year. 

Seven-day services

  • The consultant contract will be reformed to remove the opt-out from weekend working for newly qualified hospital doctors; doctors currently in service will not be forced to move to these new contracts. If agreement can’t be found with the British Medical Association (BMA), the health secretary will impose contract changes. View NHS Employers' response.
  • Expects the majority of hospital doctors to be on seven-day contracts by the end of this parliament.

Find out more

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