Doctors in warning over NHS seven-day working

PLANS for a seven-day NHS are “not realistic” and will need more funding, doctors have warned.


Proposals to make NHS hospitals offer a full range of healthcare including planned operations and diagnostic tests, seven days a week was first announced in 2013 by NHS England medical director Sir Bruce Keogh, who suggested hospitals could be contractually obliged to do so and face fines for breaches.

But in strongly-worded criticism published yesterday the British Medical Association (BMA) said there was a “lack of credible evidence” to support changes being proposed.

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It was not clear what the overall service would involve, how much it would cost and what the impact would be on patients and staff.

It warned the changes could have a “huge impact on patient safety, doctors’ welfare and the sustainability of the NHS”.

It said: “Badly thought through implementation could threaten both the standard of service patients receive and the viability of the service.”

BMA chairman Mark Porter warned delivering on services on Saturdays and Sundays would lead to them being cancelled during the week, amounting to a “diversion of services” rather than an expansion.

He said: “It’s not realistic to carry on doing what we are doing at the moment and then add a new service on top of it within existing resources. More money is vital.”

In evidence submitted to the Doctors’ and Dentists’ Review Body, which is looking at changes to doctors’ contracts triggered by seven-day working, the BMA reiterated support for the move.

But it calls for urgent and emergency care to be the priority for investment and for safeguards around working hours and patient care. Detailed evidence about the changes was required from the Government setting out how services would be expanded, without others being scaled back.

Dr Porter said: “This includes detail on what additional services they want to make available, how much they will cost to deliver, and guarantees on what support services need to be in place to provide them safety.

“Without this detail, we are being asked to sign up in the dark to changes without knowing how patient care and doctors’ working lives will be affected - something the BMA cannot do.

“We believe patient need – not political rhetoric – should decide what services are available over seven days, which is why the BMA has repeatedly called for the Government to work with doctors to make urgent and emergency care the priority for investment. In doing so we can ensure the most seriously ill patients have access to the best possible care around the clock.

“Only once this has been achieved can the debate begin as to what other services the NHS can afford to deliver within the current work force and budget.

“Changes to contracts must be best for patients, fair for doctors and sustainable for the NHS.

“Contracts must value and protect the importance of doctors’ training and education and safeguard consultants and junior doctors from burnout and dangerous working patterns.”

A Department of Health spokesman said: “Patients expect to receive the same standard of care regardless of the day of the week.

“A seven-day NHS service will speed up diagnosis and discharge times as well as reducing the amount of time patients need to spend in hospitals at weekends.

“This is why we’ve asked independent pay experts to advise on how employment contracts could be changed to make seven day services a reality.”