What do you think?
Rate this book
Zero: Eliminating Preventable Harm and Tragedy in the NHS
Could this be our 1948 moment?
Mistakes happen. In most fields the consequences are limited, but in healthcare they can be fatal. Every week in England, there are 150 avoidable deaths. Most tragedies are treated as 'inevitable' when in fact they could be prevented simply and cheaply if we were better at learning from mistakes.
By committing to a profession where the consequences of a mistake can be life or death, people in healthcare are braver than most of us. The problem is that the system that 'goes after' someone when something goes wrong, and the result is a blame game that stops learning and allows the same mistake to be repeated, often countless times.
Zero is a book about how the NHS can reduce the number of avoidable deaths to zero, and in the process save money, reduce backlogs and improve working conditions. Delivering the safest, highest quality care in the NHS post-pandemic is our very own 1948 moment.
Mistakes happen. In most fields the consequences are limited, but in healthcare they can be fatal. Every week in England, there are 150 avoidable deaths. Most tragedies are treated as 'inevitable' when in fact they could be prevented simply and cheaply if we were better at learning from mistakes.
By committing to a profession where the consequences of a mistake can be life or death, people in healthcare are braver than most of us. The problem is that the system that 'goes after' someone when something goes wrong, and the result is a blame game that stops learning and allows the same mistake to be repeated, often countless times.
Zero is a book about how the NHS can reduce the number of avoidable deaths to zero, and in the process save money, reduce backlogs and improve working conditions. Delivering the safest, highest quality care in the NHS post-pandemic is our very own 1948 moment.
320 pages, Hardcover
Published May 24, 2022
6 people are currently reading
131 people want to read
Ratings & Reviews
Friends & Following
Create a free account to discover what your friends think of this book!
Community Reviews
Displaying 1 - 7 of 7 reviews
May 28, 2022
As an ex-NHS surgeon and whistleblower (and author), losing my career during the author's tenure, I didn't expect to like this book much, but felt duty-bound to read it.
In fact, it is surprisingly accessible and easy to read. Despite being tired and at the end of a busy week, I finished it in one sitting (at 3 am); the first book that I've read cover-to-cover in one go for many years.
There's a big blooper close to the beginning, praising Morecambe Bay's NHS management in 2015 for improved culture when, in fact, they were quietly and busily covering up scandals in various specialties including breast screening, urology, and (allegedly) orthopaedics and also forcing out several whistleblowers (inc' myself), but the "blame" and "rotten apple" culture dissected in the same chapter of Hunt's book certainly rang true.
This isn't a heavy academic tome; not something that'll attract seasoned healthcare campaigners, nor does it pretend to be a tour-de-force of all the issues facing an organisation that Jeremy Hunt (quite rightly and refreshingly) labels as "rogue". It serves, however, as an easy-to-read introduction to a healthcare network and monopoly employer that, even to veteran insiders, can be frustratingly opaque and terrifyingly brutal.
Most of the suggestions have been visited before (leadership, transparency, communication, etc) but it does, overall, a good job of pulling them all together and weaving them into a seamless review of the good, bad and downright ugly of our national icon.
I'll be setting aside some more evenings to go through this in more detail and may come back and amend this review, but, for the moment at least and, slightly to my surprise, I think this deserves five stars.
Peter Duffy
In fact, it is surprisingly accessible and easy to read. Despite being tired and at the end of a busy week, I finished it in one sitting (at 3 am); the first book that I've read cover-to-cover in one go for many years.
There's a big blooper close to the beginning, praising Morecambe Bay's NHS management in 2015 for improved culture when, in fact, they were quietly and busily covering up scandals in various specialties including breast screening, urology, and (allegedly) orthopaedics and also forcing out several whistleblowers (inc' myself), but the "blame" and "rotten apple" culture dissected in the same chapter of Hunt's book certainly rang true.
This isn't a heavy academic tome; not something that'll attract seasoned healthcare campaigners, nor does it pretend to be a tour-de-force of all the issues facing an organisation that Jeremy Hunt (quite rightly and refreshingly) labels as "rogue". It serves, however, as an easy-to-read introduction to a healthcare network and monopoly employer that, even to veteran insiders, can be frustratingly opaque and terrifyingly brutal.
Most of the suggestions have been visited before (leadership, transparency, communication, etc) but it does, overall, a good job of pulling them all together and weaving them into a seamless review of the good, bad and downright ugly of our national icon.
I'll be setting aside some more evenings to go through this in more detail and may come back and amend this review, but, for the moment at least and, slightly to my surprise, I think this deserves five stars.
Peter Duffy
February 24, 2025
Zero by former MP Jeremy Hunt is a difficult book to rate. On the one hand, its focus on transparency and culture change as means to drive improvements in the NHS are clearly well intentioned. On the other, the author’s unparalleled opportunity as the Secretary of State for Health to improve the service he is critiquing, coupled with the inevitable ‘untrustworthy narrator’ issues that arise with Hunt marking his own homework, make it challenging to view this account with anything other than suspicion.
The book does seem to reveal a man passionate about patient care, capable of changing his view and clearly eager to listen to others. These are laudable traits in a Minister. Hunt is also surprisingly happy to cover deeply troubling failures in the service while he was at the helm and discusses at great length changes made in response, from inquiries, to new legal mechanisms such as a Duty of Candour to patients, to Ofsted-style ratings of hospitals by the Care Quality of Commission (begun in 2013). Hunt also reflects on the limitations of these changes with a, on the face of it, refreshingly honest tone.
At the same time, it is difficult to avoid the nagging suspicion that the author is choosing examples that represent his ‘best work’ or, as in the case of the junior doctors’ strike, covers arguable failures too glossily. Hunt does acknowledge this friction early on, quoting some memorably blunt tweets including “Jeremy Hunt on Channel 4 News bemoaning the NHS staffing crisis. He’s going to be furious when he finds out who did sod-all about this between 2012 and 2018”. Yet the tension between taking the author at face value and dismissing the book as self-serving remains, leaving the question: was this the correct book for a former Secretary of State to write?
At its core, Zero is a fairly repetitive, somewhat superficial discussion of the benefits of moving from a blame culture to a learning culture in healthcare to reduce avoidable deaths to zero. Readers are much better placed to read books by experts in health systems to explore the sorts of reforms that could benefit the NHS. Such books would avoid the biases that Hunt’s book has while at the same time offer much more depth and breadth. They should also avoid some of statistical pitfalls Hunt falls into, such as focussing on very small numbers in some examples or a somewhat Pollyanna-ish view of the power of genomics.
What, then, would have been a more valuable book for this author to write? The quotation on the front of the book from Dame Clare Gerada, “A deeply moving personal account … I wish I had read it when I started out as a doctor”, is suitably hyperbolic as such ‘puff’ usually is. But it reveals precisely what opportunity has been missed here. Jeremy Hunt was the longest-serving Secretary of State for Health. His views on running the Department of Health, and on being a senior Minister, could have been much richer and offered much greater insights. What blocked him in his earnest attempts to change the NHS system? How did the civil service apparatus interact with NHS England? What were his day-to-day challenges?
Far better than an impassioned but ultimately jobbing-amateur book on improving health systems, a guide on what it was like to run this massive department could have done wonders for the public’s understanding of the interface between politics and the real world as well as influenced his successors to make key changes quicker than Hunt himself could.
The book does seem to reveal a man passionate about patient care, capable of changing his view and clearly eager to listen to others. These are laudable traits in a Minister. Hunt is also surprisingly happy to cover deeply troubling failures in the service while he was at the helm and discusses at great length changes made in response, from inquiries, to new legal mechanisms such as a Duty of Candour to patients, to Ofsted-style ratings of hospitals by the Care Quality of Commission (begun in 2013). Hunt also reflects on the limitations of these changes with a, on the face of it, refreshingly honest tone.
At the same time, it is difficult to avoid the nagging suspicion that the author is choosing examples that represent his ‘best work’ or, as in the case of the junior doctors’ strike, covers arguable failures too glossily. Hunt does acknowledge this friction early on, quoting some memorably blunt tweets including “Jeremy Hunt on Channel 4 News bemoaning the NHS staffing crisis. He’s going to be furious when he finds out who did sod-all about this between 2012 and 2018”. Yet the tension between taking the author at face value and dismissing the book as self-serving remains, leaving the question: was this the correct book for a former Secretary of State to write?
At its core, Zero is a fairly repetitive, somewhat superficial discussion of the benefits of moving from a blame culture to a learning culture in healthcare to reduce avoidable deaths to zero. Readers are much better placed to read books by experts in health systems to explore the sorts of reforms that could benefit the NHS. Such books would avoid the biases that Hunt’s book has while at the same time offer much more depth and breadth. They should also avoid some of statistical pitfalls Hunt falls into, such as focussing on very small numbers in some examples or a somewhat Pollyanna-ish view of the power of genomics.
What, then, would have been a more valuable book for this author to write? The quotation on the front of the book from Dame Clare Gerada, “A deeply moving personal account … I wish I had read it when I started out as a doctor”, is suitably hyperbolic as such ‘puff’ usually is. But it reveals precisely what opportunity has been missed here. Jeremy Hunt was the longest-serving Secretary of State for Health. His views on running the Department of Health, and on being a senior Minister, could have been much richer and offered much greater insights. What blocked him in his earnest attempts to change the NHS system? How did the civil service apparatus interact with NHS England? What were his day-to-day challenges?
Far better than an impassioned but ultimately jobbing-amateur book on improving health systems, a guide on what it was like to run this massive department could have done wonders for the public’s understanding of the interface between politics and the real world as well as influenced his successors to make key changes quicker than Hunt himself could.
September 30, 2022
Jeremey Hunt was Health Secretary for a long time, long enough to be able to understand some of the issues and challenges facing the NHS. So much so, that he decided to write a book on the subject and still devote a lot of time to the issue (judging by his Twitter feed).
I became interested in the NHS when my wife was in hospital for 3 months and it was not known what was wrong with her. This was largely because she was moved between wards and it was forgotten (i.e. buried deep within her handwritten notes) why she was admitted in the first place. I was appalled at the lack of electronic record keeping, and also the narrow focus of each ward she was admitted to on "their" part of the body. Eventually, her illness was diagnosed, but only when she had to got admitted to ICU and they looked finally at the bigger picture.
I was hoping that this book would confirm my suspicions of what I saw in 2019-2020, and it does indeed. The lack of continuity in care, and poor IT in hospitals (where pen and paper, and the fax machine still reign) both deserve chapters to themselves.
Every chapter identifies an issue and at least a partial solution. My only observation is that the chapters generally begin with a terrible case (usually from Hunt's own day) and what could be done to avoid it. The problem is, doing so could very much cause other problems, and responding to individual issues in this "whack a mole" way might cause other unforeseen problems. Not every chapter was like that, and Hunt seems to have done some good work in getting better stats and metrics to identify areas which need improving.
I am not sure where this book will go, it's obviously something Hunt wanted to get off his chest. It would certainly be worth future health secretaries and hospital administrators reading. For the general public, like myself, it may confirm failings they have identified, but there is not much action one can really take other than voting and maybe writing to your MP if you feel really strongly about something.
In the meantime, if the Tories are in government and need a health minister, then Hunt is your man.
I became interested in the NHS when my wife was in hospital for 3 months and it was not known what was wrong with her. This was largely because she was moved between wards and it was forgotten (i.e. buried deep within her handwritten notes) why she was admitted in the first place. I was appalled at the lack of electronic record keeping, and also the narrow focus of each ward she was admitted to on "their" part of the body. Eventually, her illness was diagnosed, but only when she had to got admitted to ICU and they looked finally at the bigger picture.
I was hoping that this book would confirm my suspicions of what I saw in 2019-2020, and it does indeed. The lack of continuity in care, and poor IT in hospitals (where pen and paper, and the fax machine still reign) both deserve chapters to themselves.
Every chapter identifies an issue and at least a partial solution. My only observation is that the chapters generally begin with a terrible case (usually from Hunt's own day) and what could be done to avoid it. The problem is, doing so could very much cause other problems, and responding to individual issues in this "whack a mole" way might cause other unforeseen problems. Not every chapter was like that, and Hunt seems to have done some good work in getting better stats and metrics to identify areas which need improving.
I am not sure where this book will go, it's obviously something Hunt wanted to get off his chest. It would certainly be worth future health secretaries and hospital administrators reading. For the general public, like myself, it may confirm failings they have identified, but there is not much action one can really take other than voting and maybe writing to your MP if you feel really strongly about something.
In the meantime, if the Tories are in government and need a health minister, then Hunt is your man.
August 12, 2023
This is a book about the politics of healthcare in the UK - which means the NHS. The focus is on reducing errors and the book is consequently filled with heart-rending stories of accidental death. Hunt is clearly a good politician and this is a politician's book. He has various broad and credible solutions, especially when it comes to changing the culture of blame, but as Peter Drucker once said, culture eats strategy for breakfast - and making changes is not easy.
April 23, 2025
Sad but important book
May 28, 2022
Read only for perspective. Not evidence based opinion. Please go on and read a decent patient safety journal on Just culture and lillypond theories to recover!
December 30, 2022
I was hoping for inspiring thought leadership, instead I got safe, cagey advice from someone who knows they need to protect their public image.
Displaying 1 - 7 of 7 reviews