04.12.12
Seven Day Consultant Present Care published – AoMRC
Patients should be reviewed by consultants at least once every 24 hours, a new report published by the Academy of Medical Royal Colleges recommends.
This includes bank holidays and weekends, where evidence shows that mortality and complication rates rise for patients. Consultant care currently varies across location and areas of medicine and the AoMRC is calling for greater standardisation throughout the NHS.
The report proposes three standards: that patients should be reviewed daily by a consultant, unless there is a good reason not to; that consultant-supervised interventions with reports should be provided daily if the results will change the outcome of overall care before the next normal working day; and support services should be available daily to ensure the next steps in patient’s treatment can be taken.
The AoMRC acknowledges that 24-hour consultant care will not be a panacea for all patient safety issues, but could provide a “strong contribution to improving consistent quality care for patients”.
Professor Terrence Stephenson, chair of the AoMRC, said: “We hope these standards will be supported and acted upon by the NHS Commissioning Authority so patients can receive the best care and treatment regardless of when they need it.”
Professor Norman Williams, steering group chair and president of the Royal College of Surgeons of England, said: “Clinical staff and managers must work together to re-shape hospital services in a way that strengthens the quality of care given to patients regardless of the time of day they are admitted. Similar arrangements will be necessary to support patients in the community when discharged at weekends.
“Ensuring that key staff are available to provide this support will come at a cost. However this is crucial for the full benefit of seven day consultant-led care to be realised.”
Sir Richard Thompson, president of the Royal College of Physicians said: “While the RCP accepts this principle as an aspirational standard for all physicians, we believe this will require service redesign and may have resource implications to make this standard a comprehensive reality.
“The RCP is currently reviewing the standards of care for medical inpatients, including seven day working, in our groundbreaking Future Hospital Commission, which will report in spring 2013.”
Dean Royles, director of the NHS Employers called the report “an excellent initiative” and said: “We know there will be significant challenges and we can expect some resistance to change. A different way of working requires a pay system that recognises weekends and evenings as normal working times. It needs to be patient care not overtime rates that drive this change forward.”
And Dr Chris Roseveare, SAM President and co-chair of the Academy seven-day Working Sub-Group added: “Delivering these standards will be an enormous challenge for the health service, particularly for medical specialties which care for large numbers of patients in hospital.
“The document recognises that this will take time and financial investment, as well as changes in work patterns and hospital configuration. However the benefits for patients are likely to be substantial.”
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