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“We need to rediscover clinical accountability,” Hunt says

24 June 2015

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Targets will be replaced by ‘intelligent transparency’ to improve clinical accountability, Hunt said today at a conference in London.

Jeremy Hunt, secretary of state for health, said that intelligent transparency is “at the heart of the changing culture we want” and that the main engine for improving quality in the NHS should be learning and peer review.

He did not mention the call on him to introduce an ‘immediate pause’ in routine inspections of GP practices to relieve pressure on surgeries which it warns are “on the brink of meltdown”, which the Royal College of GPs issued yesterday.

Hunt said: “I think we need to rediscover true clinical accountability, where as a GP you feel you’re not just a gatekeeper or a signpost. You’re actually accountable for delivering the care your patients are receiving, and that means a model where we empower GPs to have much more control over the services that are delivered both inside hospitals and outside hospitals.

“I want intelligent transparency to replace targets and top-down initiatives as the way that we improve the service that we offer to patients and I think we can do that and if we learn from the database published and we make it the engine of improvement and I think this also goes right the way through to the front line,” he said.

The academy of medical royal colleges are currently doing a piece of work on what clinical accountability means in an out-of-hospital setting, which Hunt said he hopes will be at the heart of a new relationship and a rebuilding trust between doctor and patient.

Speaking to the audience of commissioners and GPs, Hunt also said he wanted to stop GPs feeling like they are on a hamster wheel and work towards re-strengthening relationships with patients.

He said that he thinks this relationship has “been made very difficult by the structures, for example the current GP contract, which sometimes feel more like piece work than a truly strong relationship between doctor and patient,” he said.

Hunt chose to use the term intelligent transparency as he said that sometimes transparency can mean “dumping a lot of data out in the public domain and seeing what happens, and defined intelligent transparency as “actually answering the questions the public want to know.”

The second part of intelligent transparency is “empowering patients to use that transparency” and part of that is having a better debate about the use of data and creating an electronic healthcare records for patients that is shared across the entire system.