Hospitals warned they could face big fines for poor weekend care

Hospitals must deliver the same standard of care to patients seven days a week or face huge fines, NHS England’s medical director has announced.

Sir Bruce Keogh said he wants to scrap the “historic” practice of relying on junior doctors at weekends without consultants being present. It follows the end of a major review of seven-day services amid concerns over higher death rates for patients treated on Saturdays or Sundays.

Speaking ahead of the report’s publication today, he told the Sunday Times that hospital trusts will be contractually-bound to run a full service seven days a week –with breaches costing them up to 2.5 per cent of their annual income of up to £500m.

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Hospitals that refuse or fail to provide safe weekend care could also face loosing their right to use junior doctors – a prospect he said fills hospitals with “horror”.

He told the newspaper 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”.

Within three years all patients admitted to a hospital ward as an emergency will see a consultant within 14 hours, and those already in hospital will be reviewed by one every 24 hours.

Routine surgery will also be available for minor conditions, such as hernias, as well as blood tests, heart checks and biopsies, saving patients from having to take time off work.

Services such as X-rays, ultrasounds, CT and MRI scans will be carried out promptly at weekends, following the review.

“Two things are key to this,” he said. “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.”

The changes will cost about two per cent of the NHS’s operating budget of £97bn, he added.

The announcement comes as a group of senior consultants called for proper staffing of NHS wards at weekends. In an open letter published in The Telegraph last week, eight surgeons raised concerns that patients were being put at risk because inexperienced hospital staff were being forced 
to take on too much responsibility.

It follows the treatment given to one of the consultants, retired surgeon Russell Hopkins, whose after-care following a hip operation in June 2011 failed him
“catastrophically”, the surgeons wrote.