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'Seven-day week' for senior hospital doctors Weekend hospital care: 'Seven-day week' for senior doctors
(about 3 hours later)
Hospitals in England will have to ensure senior doctors and key diagnostic tests are available seven days a week under new plans.Hospitals in England will have to ensure senior doctors and key diagnostic tests are available seven days a week under new plans.
The measures form part of a vision unveiled by NHS England to tackle the higher death rates at weekends.The measures form part of a vision unveiled by NHS England to tackle the higher death rates at weekends.
The changes, proposed by medical director Prof Sir Bruce Keogh, will be applied to urgent and emergency services over the next three years.The changes, proposed by medical director Prof Sir Bruce Keogh, will be applied to urgent and emergency services over the next three years.
But the cost and staffing implications have yet to be finalised.But the cost and staffing implications have yet to be finalised.
'Five-day model''Five-day model'
Research suggests death rates are 16% higher for patients admitted on Sundays compared with those for patients admitted on Wednesdays.Research suggests death rates are 16% higher for patients admitted on Sundays compared with those for patients admitted on Wednesdays.
Sir Bruce said it was time to "undo more than 50 years of custom and practice that have failed to put the interests of patients first".Sir Bruce said it was time to "undo more than 50 years of custom and practice that have failed to put the interests of patients first".
His review said that, while some hospitals had started improving care at weekends, most still operated on a "five-day model", staffed largely by junior doctors and with little access to specialist equipment and tests on the weekend.His review said that, while some hospitals had started improving care at weekends, most still operated on a "five-day model", staffed largely by junior doctors and with little access to specialist equipment and tests on the weekend.
The proposals, which will now be discussed by the board of NHS England this week, set out a series of new standards for hospitals. "Two things are key to this. One is the availability of diagnostic tests at the weekend...Then you need someone experienced to interpret those tests and to institute the right treatment," he told the Sunday Times.
"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 proposals, which will be discussed by the board of NHS England this week, set out a series of new standards for hospitals.
These include:These include:
To encourage hospitals to follow these standards a system of incentives, rewards and sanctions will be built into contracts by 2016-17. To encourage hospitals to follow the new standards a system of incentives, rewards and sanctions will be built into contracts by 2016-17.
Sir Bruce warned hospitals could face multimillion-pound penalties if they failed to keep up their standards at weekends.
He told the Sunday Times hospital trusts would be contractually-bound to run a full service seven days a week - with breaches costing them up to 2.5% of their annual income of up to £500m.
Hospitals that refuse or fail to provide safe weekend care could also face losing their right to use junior doctors, he said.
Sir Bruce said the changes would cost about 2% of the NHS's operating budget of £97bn.
More efficient
The review also acknowledged that hospitals would need better support from community services, such as social care, if the seven-day ambition was to be achieved - so patients could safely be discharged when ready.The review also acknowledged that hospitals would need better support from community services, such as social care, if the seven-day ambition was to be achieved - so patients could safely be discharged when ready.
A report on how care outside hospital needs to change will be produced in autumn 2014.A report on how care outside hospital needs to change will be produced in autumn 2014.
That report may also include details of how the non-emergency work which hospitals do, such as hip and knee replacements, could be provided on a seven-day basis.That report may also include details of how the non-emergency work which hospitals do, such as hip and knee replacements, could be provided on a seven-day basis.
In the meantime, the review team will concentrate on the cost and workforce implications.In the meantime, the review team will concentrate on the cost and workforce implications.
This is to be twinned with the work of the urgent and emergency care review, which last month recommended the creation of a two-tier A&E system.This is to be twinned with the work of the urgent and emergency care review, which last month recommended the creation of a two-tier A&E system.
The review team believes those changes would help the NHS become more efficient, freeing up money to pay for these changes.The review team believes those changes would help the NHS become more efficient, freeing up money to pay for these changes.
This comes after advice given to the review suggested seven-day working could cost up to £2bn a year.
'Whole NHS system''Whole NHS system'
Sir Bruce said it was clear that patients "want us to act now to make seven-day services a reality in all parts of the NHS".Sir Bruce said it was clear that patients "want us to act now to make seven-day services a reality in all parts of the NHS".
He added: "This is not just about hospitals but the whole NHS system. One part cannot function efficiently at the weekend if other parts don't."He added: "This is not just about hospitals but the whole NHS system. One part cannot function efficiently at the weekend if other parts don't."
Ahead of publication of the review, Health Secretary Jeremy Hunt said he was keen to see a change in the way the system works. Ahead of the publication of the review, Health Secretary Jeremy Hunt said: "Patients should be able to depend on the NHS every day - not just Monday to Friday."
"Patients should be able to depend on the NHS every day - not just Monday to Friday," he said. Dean Royles, of NHS Employers, which represents hospitals, said: "Seven-day working is probably the most important issue facing the NHS at the current time.
Meanwhile, Dean Royles, of NHS Employers, which represents hospitals, said: "Seven-day working is probably the most important issue facing the NHS at the current time.
"We are now facing a once-in-a-generation opportunity to change how the NHS works.""We are now facing a once-in-a-generation opportunity to change how the NHS works."
A British Medical Association (BMA) spokeswoman said it supported high quality care seven day a week and "doctors firmly believe that patient outcome should not be affected by what day of the week they fall ill".
But she said it is a "complicated problem which will not be easily resolved by one single 'quick fix"'.
Dr Paul Flynn, chairman of the BMA's consultants' committee, said more money would be needed if the proposals were to be a success.
"There are concerns that, without careful planning and careful management, this is not going to be possible for a lot of units without a big investment," he said.
Shadow health secretary Andy Burnham said: "This idea is right in principle but, with the NHS in increasing financial distress, the government must set out clearly how it will be paid for."