NHS chief Sir Bruce Keogh wants senior doctors to work at weekends
Hospitals will face sanctions unless they deliver same standard of care seven days a week.
Ambitious plans to ensure that senior doctors and key diagnostic tests are available seven days a week in NHS hospitals were announced on Sunday by NHS England’s medical director, Professor Sir Bruce Keogh. He said hospitals would face sanctions unless they delivered the same standard of care seven days a week and that consultants could have clauses barring hospitals from making them work weekends removed from their contracts.
Describing the moves aimed at cutting the increased death risk at weekends, Keogh said: “Society has moved on and people expect more and more from services at the weekend. There is the issue about are we running our industry efficiently?” He told the BBC’s Andrew Marr show: “It seems strange in many ways that we should start to wind down on a Friday afternoon and warm up on a Sunday … and [in the] meantime people are waiting for diagnosis and treatment.”
He admitted his plans, details of which were revealed by the Guardian on Saturday, were “pretty radical” and warned that any hospital that failed to provide full seven-day care could risk financial sanction and losing their right to use junior doctors in training.
The British Medical Association, the doctors’ union, recently dropped its opposition to the NHS offering more services at weekends and accepted that senior doctors needed to help tackle the increased mortality among emergency patients admitted over the weekend.
On Sunday Dr Mark Porter, BMA chairman, said the organisation was in negotiations with NHS Employers and the government to find an “affordable, practical model for delivering this care” while safeguarding the work-life balance of doctors. “There should be no calendar lottery when it comes to patient care.”
The health secretary, Jeremy Hunt, commended the proposals, though the shadow health secretary, Andy Burnham, said that more clarity was needed on how they would be paid for. Keogh told the Sunday Times that a seven-day NHS “would undo more than 50 years of accumulated custom and practice which have failed to put the interests of patients first”.
He added: “Two things are key to this. One is the availability of diagnostic tests at the weekend, because the key to treating somebody is a diagnosis. Then you need someone experienced to interpret those tests and to institute the right treatment.
“People are still kept waiting at the weekend for a diagnosis. We have a system that is not built around the convenience of patients and is not compassionate to patients for part of the week.”
He clarified that routine minor surgery would also be available at the weekend, adding: “Why should somebody have to take time off work, why should someone else have to take time off work to take them to and from hospital, when, if they were to have their operations on a Saturday, they could spend Sunday recovering and, in many cases, get back to work sooner?
“We have hospitals that function four and a half or five days a week and we have the cost of keeping operating theatres, outpatient clinics, expensive diagnostic equipment maintained over the weekend.
“We have got to have the same amount of activity centred through less real estate and resource.
“For many people, they don’t think it still costs money at the weekend to keep these buildings warm, to keep them clean, to keep them guarded by security staff.”
The chief executive of NHS Employers, which represents hospitals, said the “clinical case for change is now overwhelming”. Dean Royles told BBC Breakfast that Keogh’s review “seals the deal” for seven-day working. The plans also received the backing of Professor Terence Stephenson, chairman of the Academy of Medical Royal Colleges. He said that, while they would not be easy to implement, his organisation had “led the argument for this principle”.
Keogh said offering a seven-day service would only require a 2% increase in the NHS’s budget – around £2.2bn.