Can toilet rolls save the NHS? Reflections from Jeremy Hunt’s Confed ‘dance floor’

Jeremy Hunt resisted the lambada as he slipped off his jacket and moved across the stage, or dance floor as he labelled it, full of wit at the annual NHS Confederation conference this year. The reappointed health secretary was very glad to be back in Liverpool after spending previous months grappling with his political opponents to secure an election win. Now he was ready to move forward at pace to back Simon Stevens’ Five Year Forward View, which, along with a pre-election promised £8bn annual injection from the government by 2020, would now mean another £22bn in efficiency savings from the NHS in order for it to cope with the trajectory of demand.

These were not £22bn of cuts, Hunt insisted. But in a speech that revealed plans to release major savings by improving the quality and safety of care, by creating hospital chains and by using data and standardised metrics to hold both providers’ and commissioners’ feet to the fire, it became clear that significant change is going to happen quickly.

Safer, better care, was also cheaper care, and so a resolve to be the safest healthcare system anywhere in the world was now firm.

Inconsistency too was a big theme. Inequalities and varying standards and outcomes in care would be targeted, as transparency on performance would come to new levels, with the aim of making the NHS a world first in universalising quality, not just access.

The basics around a consistent and best practice approach were there to be tackled too. NHS England’s Tim Kelsey apparently hadn’t made a bet with the health secretary for him to work bathroom consumables into his speech, but nevertheless toilet rolls did feature and there was a serious point to be made. Some hospitals were paying as much as £66 for a box of these essential items, whilst others were paying just £30, recalled Hunt. And that wasn’t the last item on the sheet either. A box of syringes cost one hospital £12 and another hospital £4. Surgical gloves too cost £1.27 for a box in one part of the country, whilst another trust got exactly the same product for 50p.

These variations, of which there were many, had to end, as did many other findings from Lord Carter’s recent investigations. Amongst many other things he had revealed that a nurse in one hospital would spend as many as 78 hours per year more on administration compared to a nurse working in another hospital. Individual trusts can expect to be informed by September of just how much they can save by changing the way they do things.

Words that have resounded across public sector efficiency drives like being leaner, agile, open, transparent, accountable and more intelligent, are apparently going nowhere as the NHS now strives to save another £22bn. With Hunt’s insistence that the time for discussion is now over, and that a time for words and action is already starting, the tempo has been set.