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02.01.15

Plans for seven-day NHS care could ‘threaten patient safety’

Ill-informed plans to transform the NHS into a seven-day service could be “wasteful” for the NHS and threaten patient safety, the British Medical Association (BMA) has warned. 

Its submission to the DDRB (Doctors’ and Dentists’ Review Body) on consultant and junior doctor contracts does reiterate its general support for seven-day services. However, it called for urgent and emergency care to be the priority for investment, and for adequate safeguards around working hours and patient care. 

The submission also calls for detailed evidence and modelling from the government on the changes it wants to introduce. 

Within the BMA’s document it states: “A body of credible evidence, such as robustly evaluated local pilot schemes, is necessary for implementation. The BMA therefore strongly feels that it is currently impossible to make an informed decision about the seven-day service model the NHS should operate, which renders strategic planning for implementation impossible. 

“Furthermore, we believe that pursuing an ill-informed seven-day service model would be, at best, wasteful for the NHS and, at worst, threaten patient safety. Implementation of seven-day services should enhance patient outcomes and experience, be sustainable for the NHS and fair for doctors.” 

The proposal to make NHS hospitals offer a full range of healthcare, including elective operations and diagnostic tests, seven days a week was first announced in 2013 by NHS England medical director Sir Bruce Keogh. 

But Dr Mark Porter, chair of the BMA council, said: “The BMA has been clear in its support for better seven-day services, but the government needs to be clear about what an expansion of services will look like and, crucially, how it can be safely staffed and resourced, without existing services being scaled back. Doctors already work around the clock, 24/7, so the existing contract is not a roadblock to seven-day services. 

“We hope that, in its submission, the government has provided the detail, evidence and modelling on the changes they want to introduce, which it failed to produce throughout negotiations.” 

He added that the BMA believes patient need – not political rhetoric – should decide what services are available over seven days, which is why the organisations has 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,” said Dr Porter. “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.” 

A spokesperson for the Department of Health said that 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,” he noted. “This is why we’ve asked independent pay experts [the DDRB] to advise on how employment contracts could be changed to make seven day services a reality.” 

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