No Harm Done Jeremy; Youโve Just Told It How It Is. And Itโs Not Comfortable Reading…
Adam Townsend
Founder, VUITFormer NHS Ops Director and Co-Founder & COO of population health data platform Vuit, reviews Jeremy Hunt’s book Zero.
Jeremy Hunt lays bare the issues of why we continue to have unsafe healthcare in England โ and the Chancellor is bang on the money!
I didnโt want to like this book. I thought it would be political waffle, heartfelt memoirs of saving poorly children and elderly veterans whilst being misrepresented by the press and achieving immense things in spite of blah blahโฆ but it isnโt.
And I like it a lot.
It really does stare into the soul of the NHS and there are some uncomfortable truths here. Jeremy Hunt didnโt have to do this to sell his book, but I donโt believe thatโs why he wrote it.
A bit of context, I am a healthcare improvement consultant and data ninja by trade. I began my career when Jeremy Hunt was at his zenith as Health Secretary. I remember driving past striking junior doctors, huddled around a blazing barrel (Iโm still puzzled as to how a doctor could spell Hunt so wrong on a placard?).
At the time, I was part of a small team from a world-class UK company, and we were trying to instil some of the fundamentals of our operating model into the senior management team at an acute trust. At the same time, I was watching my late father suffer โhealthcare pass-the-parcelโ as his long-term conditions worsened and he began the decline into frailty and death, something which can be so easily slowed or stopped with better joined-up care. This is the lens I read this book through.
Spoiler alert! This book contains things you canโt unread:
- The NHS โ before, during and after the author was in post, killed thousands of people a year through preventable harm, around 150 people a week.
- This number isnโt reducing at anything like the pace it could.
- Despite being the Secretary of State for Health, Jeremy Huntโs ability to get stuff done was minimal, the NHS is not keen to get out of its own way, no matter how serious the issue.
- Contrary to my expectations, Jeremy Hunt hasnโt a good grip on what needs to change in the NHS to prevent avoidable harm.
- There are more horror stories about avoidable harm caused by the NHS than there are stories about advocates and disrupters.
- There are more stories of cover-ups and avoidance of blame than there are of selfless heroism or speaking truth to power.
From the start of the book, where civil servants shield ministers from the worst letters being sent by the public, to the belittling and dismissing of families โ who had lost loved ones unnecessarily and wanted credible explanations of what had gone wrong โ the book lifts stone after painful stone on the behaviour that, at best, is not conducive to learning from mistakes.
The worst of it โ Iโve witnessed those same things professionally and personally.
Quite rightly, the book also shines a light on people advocating for and delivering incredible improvements in patient safety. Some of these people are employees of the NHS (necessary and more are required please) and campaigners (shouldnโt be necessary but, unfortunately, they are).
The best of it โ Iโve met people like this. These are incredible people, who rage against the machine, chipping away at it, often with spectacular results but typically, at a huge personal cost in terms of effort expended vs traction achieved.
Unfinished business
Itโs far from a dull read and definitely not a โhow toโ book. It has incredibly moving human stories but also a clear structure. It moves logically through the authorโs experiences and learning, good and bad. It revolves around a single consistent thread, patient safety and avoidable harm. It takes what hasnโt yet happened to deliver meaningful change to the way we, as citizens, experience the NHS, including the things the author could have done differently and better and draws a set of conclusions about how change might occur if we learn from what we now know. It reads like a book written by someone with unfinished business, not a reflection on a job well/not well done.
This book speaks loudly to my lived experience of the NHS, what I know about how world-class organisations operate and what I experienced in terms of avoidable harm in my fatherโs care during his later years and ultimately, early death. Put simply, the fundamental gap between the NHS and world-class organisations, is doing the basics incredibly well every day. Itโs boring, repetitive and un-exciting but it is the surest root to the best quality at the lowest cost or โthe best care is the cheapest care,โ to quote the author.
World-class organisations do this brilliantly. We constantly hear about transformation being the answer to the NHSโ woes, itโs not, at least not in the way itโs routinely described. A culture that focuses on doing the basics brilliantly, consistently and at scale, would be, and is, transformational for the NHS. The finest examples of healthcare almost always exist where there is an unfaltering culture of doing the basics brilliantly every day, be that Sepsis6, GIRFT or accurate, accessible patient records, all things that consistently reduce avoidable harm. Common sense but, unfortunately, not yet common practice.
If you are a member of the general public, donโt read this book. It will distress you unnecessarily, the vast majority of NHS users get good care and arenโt harmed.
If you are in any way involved in or work with the NHS (or politics for that matter), read this book and think on. Zero harm will be hard to achieve, but one less harm might just be your gift to deliver today.
Jeremy Hunt doesnโt shy away from admitting mea culpa in this book, and neither should we.
Publisher
Zero is published by Swift Press