NHS group to consider weekend services

Surgeons performing an operation The group will consider whether services, such as routine surgery and scans, can be provided seven days a week

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A group is to be set up to examine why the NHS in England cannot provide some routine services at weekends - like day surgery - the BBC understands.

The NHS Commissioning Board is due to announce the move on Tuesday, when it publishes its planning guidance for the NHS for the first time.

The group will include patient representatives, health providers and people from outside the health service.

The government said it "fully supported" a seven-day service.

The health minister, Lord Howe, said patients needed the NHS "every day".

"Offering easier access to hospital consultants, GPs and routine hospital services seven days a week will reduce delays and ensure that patients get seen and treated by experienced healthcare professionals," he said.

The British Medical association said it was "open to discussion" about the changes.

The setting up of the group follows research that suggests patients are more likely to die if they are admitted to hospital over the weekend.

Start Quote

This will be a big cultural change, but our focus should be on convenience and compassion for those seeking our help.”

End Quote Sir Bruce Keogh NHS Commissioning Board

Board medical director Sir Bruce Keogh told the BBC the new group would look at "the barriers that stop us heading in the direction of a seven-day service."

'Moral case'

He said the new group would "invariably have to look at terms and conditions [of hospital staff] and see what incentives there might be". But he stressed that "this is not about forcing people".

"I am just trying to build a practical, moral and compassionate case on behalf of patients.

"You have got to get people to believe in the moral case," he said.

Sir Bruce added: "It is time for the NHS to offer more routine services at the weekend, in addition to emergency services. This will be a big cultural change, but our focus should be on convenience and compassion for those seeking our help."

He also said the focus of the new NHS Commissioning Board - which was set up under the government's re-organisation of the health service - is to be patient focused, and that that was why he was setting up the group.

Our political reporter, Susana Mendonca, says Sir Bruce has long been a supporter of the idea that patients would be better served if routine services - like scans - were available at weekends.

Research suggests that patients are more likely to die in hospital if they are admitted at the weekend.

Earlier this year, research, carried out at University College London and the universities of Birmingham and East Anglia, was published showing patients in England were 16% more likely to die if they were admitted on a Sunday, rather than mid-week.

Staffing - and in particular the presence, or absence, of senior doctors - has been highlighted as a key factor.

The Department of Health said some hospitals were already thinking about treating patients at weekends for non-urgent operations and procedures.

For example, in Birmingham and Torbay, hospitals have had scanners open to provide tests over the weekend, as well as operations being carried out.

They also have more more senior staff and consultants around at weekends.

Responding to Sir Bruce's comment, the British Medical Association - which represents doctors - said it was "open to discussions on ways of further improving the service patients receive at evenings and weekends".

"Flexibility will be key - solutions that work for one specialty may not work for others," a spokesman said.


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  • rate this

    Comment number 125.

    Patients are more like to die at weekend because junior doctors are working up to 19 days in a row, without a day off. They are left to make live and death decisions when they are exhausted

  • rate this

    Comment number 124.

    The NHS Commissioning Board is a new organisation and no-one knows what influence or power it has. Operating a comprehensive weekend service is good because it will provide more jobs, but cost more money. If the funds are ring-fenced then the only outcome would be demoralised staff and a deflationary effect on wages. Contrary to what some of the contributors are saying, MORE STAFF WILL BE NEEDED.

  • rate this

    Comment number 123.

    Albatross - This is precisely why there will never be 7 days a week working in the NHS. While people in admin and clerical positions in the NHS (of which I am one) are put on 7 day week contracts which specify they should be available to work work weekends, doctors and consultants resist and therefore nothing gets done. Its the clinicians that make the NHS adapt to change slowly. Sorry, it's true.

  • rate this

    Comment number 122.

    What is best practice in the rest of the world? Which health service in the world provides a good service and VFM without killing it's staff. For over £100 billion a year we should be able to sort something.

  • rate this

    Comment number 121.

    About time. Why shouldn't the NHS be serving the people every day of the week. Afterall the people that pay for it are the tax payer which a vast proportion work weekends so shy not the NHS.

  • rate this

    Comment number 120.

    its not necessarily just a case of getting some people to work more hours, keeping a facility in permanent use has implications for maintenance & planning, without fixed downtime periods its more difficult to fit maintenance & facility development work in & can require increased staff levels over & above those indicated by a simple calculation of the extra hours a facility is in use.

  • rate this

    Comment number 119.

    With European time directive enforced a doctor can not work more than certain hours."

    Well, would you want to be treated by a doctor who'd not slept enough any more than you'd want to be flown by a pilot who'd not got enough sleep.

    However, adjusting working hours would be easier if doctors had not been given huge pay rises for doing less work a few years ago.

  • rate this

    Comment number 118.

    If I begin to feel ill on a Monday I will hold off running to see a doctor and see if it passes like millions of others if its Thursday or Friday I rush to see one who wants to be in A&E for five hours on a Saturday or Sunday I know its inconvenient to be ill after 6 pm or at weekends but sometimes it cant be helped

  • rate this

    Comment number 117.

    "The Health Service loses around £300million each year because of missed appointments, 60 per cent of which are a result of patient apathy," [Mail online].

    Why should the NHS care for those that don't care for it? If we want a better service I think we need to ensure we all show more respect for the one we've already got.

  • rate this

    Comment number 116.

    Why not? After all, you don't get the weekend off when you are ill... Nobody will work 7 days a week, just do shifts so that there are adequate staff there on weekends.

    Dearly beloved was in for a minor eye operation on a Thursday. When told he'd have to stay in over the weekend, he asked what was to be done. You will be seen Monday, he was told. So I took him home & brought him back in then.

  • rate this

    Comment number 115.

    Crazy that our surgical resources are only used for 36hrs/week (168hrs).

    Get them working 24/7.

  • rate this

    Comment number 114.

    Taxes go up and the service gets worse. I tried to get a home visit for my late mother and was promised that a Dr was "on the way". Nobody turned up in the end. NHS civil servants are a disgrace. When I call my local health centre it just rings out for ages.

  • rate this

    Comment number 113.

    Sadly Jenny is right. My mother had the misfortune to end up in hospital on a Friday afternoon on a couple of occasions; one occasion when the doctors came round on Monday they told her to go home and nothing had been done for her. The problem is no proper assessments are made and she wasn't fed properly either and was starved. It is a disgrace what goes on at weekends and needs sorting urgently.

  • rate this

    Comment number 112.

    So this will just be a case of spreading 5 days work out over 7 days then, right?

    Only, if it isn't, sadly extra staff will be needed, as virtually no-ones workload can afford to go up by an extra 40%.

    Also, if everyone else is working 7 days per week, then how come A+E departments are heaving with drunks on a Friday/ Saturday night, casualties of the traditional British start to the weekend?

  • rate this

    Comment number 111.

    I've been part of two hospitals where physio and OT have moved to seven day working and more staff, as well as flexible working have BOTH been required. Its cheaper to hire more staff on part time contracts than make existing full timers go overtime. ie, they work three and half days each with no extra pay (or minimal enhancement for unsocial days). Oh and GP 24 hours..why? just to keep it even!?

  • rate this

    Comment number 110.

    Suppose you were told you needed an MRI scan.
    Would you really object to an appointment on a Saturday or Sunday?
    Too much of our saintly sacred NHS is run for the benefit of the high ups and not the patients ie public ie the taxpayers who pay for it all

  • rate this

    Comment number 109.

    lab staff already have to work long hours during the week and at weekend when most medical staff are not in work, they are not allowed flexible working for whatever reason due to the demands of the current service. this will only make things worse for them and all staff involved, leading to difficult working conditions and yet more restrictions on them, leaving no family time whatsoever

  • rate this

    Comment number 108.

    In the context of a GP surgery, for example, closing on Weds pm and opening on Sat am would allow better access for patients (those that work) without additional staff requirements.

    @83.Tony Gray

    I incorrectly assumed you were a GP. I don't see the point of offering out-patient services (planned care) at weekends but with GP opening hours I think it should be compulsary. I apologise.

  • rate this

    Comment number 107.

    My post 89 has collected 4 minus marks. I expected more. You Brits just don't get it do you! Service isn't good here whether it's the NHS, shops, utilities or anything. You are a nation satisfied with 2nd best. The US is infinitely better from the first day. You can get a phone connection within hours rather than days, weeks & sometimes months. Ditto everything else. Yes, we have problems too!

  • rate this

    Comment number 106.

    All hospital staff should work a shift system which keeps the hospital working for 7 days a week. We can't arrange to be ill on 5 days only , so the scandal is that we are having to discuss the matter. It's obvious.


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