Hunt’s game plan for CCG ratings is to hasten the demise of weak commissioners

Hip-hop has enjoyed a surprisingly high profile in UK politics lately, from Labour leadership hopeful Liz Kendall’s love of Public Enemy to the chancellor’s unlikely attendance at an NWA gig. But few would have expected Jeremy Hunt to begin his lecture with a hip-hop video from US rapper and comedian ZDoggMD.

The decision, which the health secretary made literally minutes before beginning his lecture in front of both the TV cameras and an audience filled with the sector’s good and great, is typical of a man at home in the modern, digital enabled world, and in sharp contrast to those who previously filled his post. Whereas Andrew Lansley was mocked by a hip-hop YouTube video, Mr Hunt bent the medium to his end.

The current health secretary, unlike his tragic predecessor, can also contemplate leaving a more positive legacy.

Technology and transparency

He would like it to be a recalibration of the public’s relationship with the NHS. One in which ownership of health moves from a paternal relationship with a monolithic state provider to a more individualised approach in which the NHS acts as a partner.

Technology and transparency are the two tools which he believes can bring that change about.

In the first part of his lecture, Mr Hunt focused on the impact the improved use of technology can have on the NHS.

‘Hunt will have to move fast to address his “four elephant traps” hindering progress’

It was a sophisticated, heartfelt and often inspiring description of what the future could and should look like. Whatever NHS leaders may think of Mr Hunt, his politics or his tactics in recent controversies, they should read it, check their own preconceptions and prejudices and prepare to ask their teams “are you ready?”

Mr Hunt’s vision, of course, begs many questions about funding and what he called “the gritty job of implementation” – and he will have to move fast to address his “four elephant traps” hindering progress after the comprehensive spending review on 25 November.

The second part of Mr Hunt’s lecture focused on transparency – and here the argument felt more forced.

It is clear from the answers he gave to audience questions after the lecture that he expects the public to make little direct use of new ratings for six disease areas or the aggregated scores for clinical commissioning groups. He acknowledged that, as with hospital ratings, that they offered the public reassurance that services were good or that their inadequacy had been noted and was being acted on – and little else.

This is, of course, something well short of the fundamental retooling which Ofsted has brought about in how parents now relate to schools.

Plan of attack

So what is the game plan behind CCG ratings? HSJ believes it as follows:

• The aggregation of ratings to give an overall score for CCGs are largely to make sure the leadership of CCGs treat the disease scores as a priority.
• The aggregated scores exist to accelerate the demise of those CCGs whose role could be better undertaken by neighbouring groups, local authorities or, especially, emerging accountable care organisations.
• The idea of ratings for the care delivered to patient populations work with the grain of developing ACOs.

Had it not been for the Lansley wars – both the Department of Health and NHS England would be much more direct about the re-organisation of NHS care delivery that is now well underway. Mr Hunt’s desire for transparency needs to extend to acknowledging that, so the thrust of health policy can be more easily understood.