Acute care, Patient experience, Quality

The Keogh Review, where do we go from here? asks Matt Tee

Matt TeeI was ‘out and about’, as my press office put it, discussing the Keogh Mortality Report yesterday. I spent a significant part of the day working out the Confed’s position and then touring radio and TV studios doing interviews – taking in a chat with Channel 4′s Jon Snow about the joys of cycling in London as we sat in the make-up chair.

The Keogh report feels a bit like my career – large teaching hospital, the Commission for Health Improvement, Dr Foster, Department of Health – rolled into one. The themes were certainly familiar.

I came away from the day with several reflections.

I’ve been a Government press officer and done my share of unattributable briefings, but whoever briefed the Sunday Telegraph for the story that was headlined ’13,000 died needlessly at 14 worst NHS trusts’ did the NHS a grave mis-service and utterly misrepresented the report.

In fact, Professor Sir Bruce Keogh barely mentions mortality statistics, except as an indicator that this sort of review was necessary. I do hope that this report sees the end of circular discussions about the validity of different mortality indices, which have taken up time and resource that should have been spent reviewing services in the way Sir Bruce has, to understand whether there is a problem and do something about it.

Yesterday’s measured announcement of the outcome of the review was in stark contrast to the mud slinging we saw between the political parties. The problem with slinging that much mud is that you both come out filthy. I really struggle to believe that any party will bolster public support for its policies on health by saying that another party is to blame when the NHS is not up to scratch.

The danger of an atmosphere like we saw yesterday is that we only hear about the things that are wrong in the NHS, and people are drawn into talking the NHS down. Don’t get me wrong, I am a firm advocate of transparency and the exposure of variation, but we have a huge amount to celebrate and be proud of, and I think those in the public eye (including me) have a duty to balance what we say.

So do I emerge from yesterday gloomy and downcast? Well, no actually. Cutting through the noise of yesterday, two things gave me considerable cause for optimism.

Firstly, as I read the report, I reflected that we were genuinely hearing the voice of patients and staff; there were patient and public representatives on the review groups, and the review spoke to patients and staff at all levels – there were even junior doctors involved. It’s not before time, but I feel positive about it.

The second cause for my optimism is that – say it quietly – I think we may have done a sensible thing here, in a good way. Fourteen organisations that have been on various worry lists for years have been reviewed in a rigorous way and been given action plans that they will be held to account for on a monthly basis. Although the media preferred to label them as ‘hit squads’, if you scratch beneath the surface, we seem to be talking expert support. The Queen of Hearts, with her mantra of “Off with their heads” seems to have been given a day off.

In an NHS in which transparency is increasingly the order of the day, Sir Bruce has lessons for all of us in how to shine the light in the interests of better patient care.

Matt Tee is chief operating officer of the NHS Confederation. Follow him on Twitter @MattTee

About NHSConfed .

The NHS Confederation is the membership body for the full range of organisations that commission and provide NHS services. We are the only body to bring together and speak on behalf of the whole NHS. We have offices in England, Wales (the Welsh NHS Confederation) and Northern Ireland (Northern Ireland Confederation for Health and Social Care) and provide a subscription service for NHS organisations in Scotland.


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