Austerity ‘threatens seven-day NHS plan’

Paul Flynn, chairman of the British Medical Association’s (BMA) consultants committee, asked how NHS bosses will be able to afford to staff operating theatres throughout the week if required to offer more “patient-focused” services at the weekend.

Research shows that patients are more likely to die if they are admitted to hospital at the evenings or weekends, which has led to calls for greater presence of senior doctors out of hours.

The NHS Commissioning Board (NHSCB) has proposed that routine NHS services, including GP and hospital appointments, should provided on Saturdays and Sundays to “offer greater customer convenience”.

‘Who will pay?’

But in a letter published in the British Medical Journal (BMJ), Mr Flynn, who also works as an obstetrician and gynaecologist, argued that NHS providers have only a limited availability to seek out new revenue in the way that other businesses can.

“Who’s going to pay for this?” he asked.

“Many NHS providers are already in dire financial positions to the extent that some of them are consulting on making staff redundant.

Many NHS providers are already in dire financial positions. Paul Flynn, BMA

“It is inconceivable that they will be able to staff operating theatres and clinics seven days a week, let alone provide all the other resources that this activity will consume.

“The public, I think, would rather such resources were focused on the sickest people who come to hospital.”

NHS Medical Director Professor Sir Bruce Keogh said the move would offer a more patient-focused service.

In December last year, the NHSCB announced that Sir Bruce was to establish a forum to find a way to implement a seven-day service.

Also writing in the BMJ, Sir Bruce said the move would enable the NHS “to be truly patient centred” for the whole of the week, rather than two thirds of it.

Higher mortality rates

He said: “Extending the service would offer the opportunity to improve clinical outcomes with the added benefit of a much more patient focused service.

“The NHS provides essential emergency care but not regular routine services on Saturdays and Sundays.

“Yet we have hard evidence that mortality for patients admitted to hospitals on both sides of the Atlantic is higher at weekends, that our junior doctors feel clinically exposed at weekends, and that hospital chief executives are worried about weekend cover.

“This has led to calls for greater consultant presence in hospitals at the weekend.”

He added: “We must ask why, in many hospitals, expensive diagnostic machines and pathology laboratories are under-used, operating theatres lie fallow, and clinics remain empty.

“Yet, access to specialist care is dogged by waiting lists, and general practitioners and patients must wait for diagnostic results.”

Sir Bruce will report on his findings in the autumn.