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Weekend hospital care: 'Seven-day week' for senior doctors | Weekend hospital care: 'Seven-day week' for senior doctors |
(35 minutes 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 higher death rates at weekends. | The measures form part of a vision unveiled by NHS England to tackle 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. |
Sir Bruce said the case for change was clinically and morally "compelling". | Sir Bruce said the case for change was clinically and morally "compelling". |
The British Medical Association, which represents doctors, said the case for seven-day services had been made and the focus needed to shift to delivering it. | The British Medical Association, which represents doctors, said the case for seven-day services had been made and the focus needed to shift to delivering it. |
'Expect more' | 'Expect more' |
Research suggests death rates are 16% higher for patients with emergency conditions admitted on Sundays compared with those admitted on Wednesdays. | Research suggests death rates are 16% higher for patients with emergency conditions admitted on Sundays compared with those admitted on Wednesdays. |
Sir Bruce told BBC One's Andrew Marr show "society has moved on and people expect more and more from services at the weekend". | Sir Bruce told BBC One's Andrew Marr show "society has moved on and people expect more and more from services at the weekend". |
"There is the issue about are we running our industry efficiently," he said. | "There is the issue about are we running our industry efficiently," he said. |
"It seems strange in many ways that we should start to wind down on a Friday afternoon and warm up on a Sunday... and [in the] meantime people are waiting for diagnosis and treatment." | "It seems strange in many ways that we should start to wind down on a Friday afternoon and warm up on a Sunday... and [in the] meantime people are waiting for diagnosis and treatment." |
He said that, historically, the NHS had been very good at providing a five-day-a-week service but medicine had advanced and care had become more complex. | He said that, historically, the NHS had been very good at providing a five-day-a-week service but medicine had advanced and care had become more complex. |
Sir Bruce said junior doctors felt particularly stressed at weekends because of the complexity of cases, and often felt "unsupported". | Sir Bruce said junior doctors felt particularly stressed at weekends because of the complexity of cases, and often felt "unsupported". |
"We worry about that, not only because it may relate to the higher mortality rates, but also because it implies that we could be training the next generation of doctors better," he said. | "We worry about that, not only because it may relate to the higher mortality rates, but also because it implies that we could be training the next generation of doctors better," he said. |
The proposals, which will be discussed by the board of NHS England on Tuesday, set out 10 new clinical standards for hospitals. | The proposals, which will be discussed by the board of NHS England on Tuesday, set out 10 new clinical standards for hospitals. |
These include: | These include: |
Sir Bruce said organisations would need to be "absolutely transparent" about whether they were meeting these standards. | Sir Bruce said organisations would need to be "absolutely transparent" about whether they were meeting these standards. |
He said the changes would be contractually binding. For example, he said it was possible a clause in consultants' contracts stating organisations could not compel them to work at the weekend could be removed. | He said the changes would be contractually binding. For example, he said it was possible a clause in consultants' contracts stating organisations could not compel them to work at the weekend could be removed. |
"These are pretty radical changes with some pretty hard levers behind them," he said. | "These are pretty radical changes with some pretty hard levers behind them," he said. |
He had earlier said a system of incentives, rewards and sanctions would be built into contracts by 2016-17 to encourage hospitals to follow the new standards. | He had earlier said a system of incentives, rewards and sanctions would be built into contracts by 2016-17 to encourage hospitals to follow the new standards. |
Breaches could cost hospitals up to 2.5% of their annual income of up to £500m and they could face losing their right to use junior doctors. | Breaches could cost hospitals up to 2.5% of their annual income of up to £500m and they could face losing their right to use junior doctors. |
Sir Bruce told the Marr show the changes would cost about 1.5-2% of the annual running costs of the hospital and said he was confident about finding money from other parts of the NHS to pay for the plans. | Sir Bruce told the Marr show the changes would cost about 1.5-2% of the annual running costs of the hospital and said he was confident about finding money from other parts of the NHS to pay for the plans. |
More consultants working weekends would stop inappropriate admissions and diagnoses would be speeded up, in turn helping hospitals run more efficiently financially, he said. | More consultants working weekends would stop inappropriate admissions and diagnoses would be speeded up, in turn helping hospitals run more efficiently financially, he said. |
Sir Bruce said the changes had been widely backed by doctors' groups and political parties. | Sir Bruce said the changes had been widely backed by doctors' groups and political parties. |
"We believe the arguments for this are absolutely compelling both clinically and morally," he said. | "We believe the arguments for this are absolutely compelling both clinically and morally," he said. |
'Seals the deal' | 'Seals the deal' |
Dean Royles, of NHS Employers, which represents hospitals, told BBC Breakfast the review "seals the deal" on the case for seven-day working. | Dean Royles, of NHS Employers, which represents hospitals, told BBC Breakfast the review "seals the deal" on the case for seven-day working. |
Professor Terence Stephenson, chairman of the Academy of Medical Royal Colleges, said it would not be easy to achieve but the organisation had "led the argument for this principle". | Professor Terence Stephenson, chairman of the Academy of Medical Royal Colleges, said it would not be easy to achieve but the organisation had "led the argument for this principle". |
Dr Mark Porter, chairman of the British Medical Association Council, backed the changes, saying "there should be no calendar lottery when it comes to patient care". | Dr Mark Porter, chairman of the British Medical Association Council, backed the changes, saying "there should be no calendar lottery when it comes to patient care". |
He said the BMA was in negotiations with NHS Employers and the government to find an "affordable, practical model for delivering this care, while safeguarding the need for a healthy and productive work-life balance for doctors". | He said the BMA was in negotiations with NHS Employers and the government to find an "affordable, practical model for delivering this care, while safeguarding the need for a healthy and productive work-life balance for doctors". |
Health Secretary Jeremy Hunt has commended the move, while shadow health secretary Andy Burnham said the government needed to clearly set out how it will be paid for. | Health Secretary Jeremy Hunt has commended the move, while shadow health secretary Andy Burnham said the government needed to clearly set out how it will be paid for. |
The Welsh government has not ruled out seven-day working, while the Scottish administration has committed to having consultants in wards seven days a week. | The Welsh government has not ruled out seven-day working, while the Scottish administration has committed to having consultants in wards seven days a week. |
A review in Northern Ireland earlier this year found disparities in out-of-hours hospital care, compared to weekdays. The Regulation and Quality Improvement Authority said specialist consultant ward rounds and formal weekend handovers were needed. | A review in Northern Ireland earlier this year found disparities in out-of-hours hospital care, compared to weekdays. The Regulation and Quality Improvement Authority said specialist consultant ward rounds and formal weekend handovers were needed. |