Mixed response to ‘seven-day’ NHS
pharmafile | December 20, 2012 | News story | Sales and Marketing | BMA, CCGs, NHS, RCP
The NHS’s possible move to seven-day working has received a mixed welcome, with the BMA dubbing the proposals ‘too crude’.
The NHS Commissioning Board announced this week that it would set up a forum, chaired by medical director Sir Bruce Keogh, to look at how a seven-day operation might work.
The first areas on the agenda for a shake-up to weekend working will be diagnostics and urgent and emergency care.
Feedback will come from national and local commissioners, providers and regulators to see what is required for better access to routine services.
This is due to report next autumn, but will concentrate on the ‘how’ rather than ‘if’, assuming the Board’s new document Everyone Counts: Planning for Patients in 2013-14 is to be taken at face value.
Leaving little room for doubt, it states categorically: “The NHS will move towards routine services being available seven days a week. This is essential to offer a much more patient-focused service and also offers the opportunity to improve clinical outcomes and reduce costs.”
NHS Employers welcomed a move to a seven-day operation. “The way patients are cared for and the way they want to be cared for is changing rapidly,” said its director Dean Royles.
Weekend services “could be so much better and we owe it to patients to change the way we work”, he went on.
However, he added, there will need to be contracts and a reward system that are ‘better aligned’ to delivering services through the week.
But BMA council chair Dr Mark Porter was unimpressed, warning that plans to provide routine care seven days a week were ‘too crude’.
His concern is that England’s 211 local clinical commissioning groups (CCGs), led by GPs, may find it beyond their capabilities at a time of great economic pressure and structural change.
“While many of the aims are laudable, new CCGs will have the very real challenge of putting these aspirations into practice,” he added.
Sir Richard Thompson, president of the Royal College of Physicians (RCP), disagrees, saying: “For some time the RCP has been concerned that acute hospital care at weekends needs to improve.”
The RCP’s Future Hospital Commission, due to report in spring 2013, is already looking at seven-day working, he says.
And the organisation recommended two years ago that a consultant physician should be on-site at any hospital taking emergency admissions for at least 12 hours per day, seven days a week.
“We believe that to make this aim a reality, some services will need to be redesigned and may have resource implications,” he went on.
Limited availability of hospital services at certain times has a detrimental impact on all five domains of the NHS Outcomes Framework, the Board believes.
Its new forum will look at what happens when clinical services are not available across a seven-day week and “provide proposals for improvements to any shortcomings”.
The Board insists that emergency care should not be used when patients would benefit from care in other settings.
Adam Hill
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