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NHS staff may be asked to provide seven-day service in future

A new group will look at the barriers that prevent the NHS from functioning as a seven-day service, offering procedures such as day surgery at weekends.

The NHS Commissioning Board will announce the group when it publishes its planning guidance for the health service on Tuesday, the BBC reported.

The group - which will include patient representatives, health providers and external analysts - comes on the back of recent research which suggested mortality rates were much higher for patients admitted to hospital on a Saturday or Sunday.

The government said it “fully supported” a seven-day service, with health minister, Lord Howe, insistent that patients needed the NHS “every day”.

“Offering easier access to hospital consultants, GPs and routine hospital services seven days a week will reduce delays and ensure that patients get seen and treated by experienced healthcare professionals,” he said.

The British Medical Association said it was “open to discussion” about the move.

Commissioning Board medical director Sir Bruce Keogh said the new group would have to examine hospital staffs’ “terms and conditions”, as well as proposing possible incentives, but stressed that it was not about forcing employees to work at the weekend.

“I am just trying to build a practical, moral and compassionate case on behalf of patients. You have got to get people to believe in the moral case,” Sir Bruce said.

“It is time for the NHS to offer more routine services at the weekend, in addition to emergency services. This will be a big cultural change, but our focus should be on convenience and compassion for those seeking our help.”


Readers' comments (44)

  • of course hospitals should provide services 7 days a week, it's just common sense. anyone working for the nhs knows how ridiculous it is that patients have to wait until Monday until they can have 'routine' tests and see their consultant.

    people are still shocked when they are discharged at weekends which is a relatively new thing.

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  • Anonymous | 17-Dec-2012 12:25 pm

    It makes sense to have services provided 7 days a week and it would be great to have them, but is it realistic and achievable? Given the existing problems with staffing and resources, the NHS provides a barely adequate service as it is. I don't see how extra money is going to be made available.

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  • 1. "Commissioning Board medical director Sir Bruce Keogh said the new group would have to examine hospital staffs’ “terms and conditions”, as well as proposing possible incentives"
    Normal terms and conditions for week time work will be further reduced, enabling employers to pay a previously 'normal' rate and pass it off as a weekend enhancement/incentive

    2. "but stressed that it was not about forcing employees to work at the weekend."
    In my best pantomime voice...."Oh yes it is!"

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  • Susan Markham

    Do we not already do this? I have been a nurse since the 70's. Weekends? Holidays? Please tell me what are they??

    The only people that this will affect are the senior management and consultants... and jolly good luck to you if you think that that crowd are going to voluntarily change their job contracts. The fact is that you can’t get these people to budge from their 9 to 5 Monday to Friday jobs.... it’s just too cushy.

    I am speaking out for all of us who have done 24/7/365 for the NHS. Not just nurses but junior doctors, radiologists, et. al.

    It is time that the “Fat Cats” (Hospital CEOs and Consultants) learn what we nurses learnt years ago.... Caring for the sick and dying is NOT a 9 to 5 Monday to Friday occupation!

    I dislike having to agree with a minister (or whatever he is) but in this case he is right!

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  • Tiger Girl

    Susan Markham | 17-Dec-2012 1:48 pm

    Susan, this seems to be connected to the acceptance that NHS care at weekends is measurably worse than on weekdays for emergencies, something usually put down to lower availablilty of senior medics at weekends.

    But logically you need adequate emergency services 24/7, and elective services need to be competent whenever they are provided - some of this seems to be about eqipment being unused at weekends, part of it is about avoiding time-off-work for tests (the example I saw given, was 'why should a niece need to take a day off work to take her immobile elderly gran to hosiptal for tests), and perhaps part is that if more staff are to available at weekends, someone thinks more testing has to be available (so why not use it electively as well as for emergencies).

    But they obviously don't want to spend more money, to put the idea in to practice.

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  • what costs more money -having patients in hospital over the weekends and bank holidays or employing staff to run a 24/7 service?

    why are pharmacy only open for a few hours at weekends?

    why don't consultants see their own patients at weekends?

    why can't patients have routine ops, tests and procedures at weekends?

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  • Susan Markham | 17-Dec-2012 1:48 pm

    Having spent 30 years 24/7/365 and the last 2 years (still nursing) in a 9-5 Mon to Fri job, I can reflect upon the cost in terms of health and my fantastic family of doing our job 23/7/365. Believe me, it is good to have no more 24 hour rotational work, much better for my health and worklife balance, but there is nothing cushy about it. I and my colleagues still work very hard. Without a doubt, there are those in senior management and consultant positions, who are all about feathering their own nests. But most people try to do jobs which suit their own circumstances, whether or not that means out of hours and weekend work or mon-fri.
    I think the idea of weekend procedures, better availablity of services, etc would be something to add to my wishlist. (ironically, more so now that I am working weekday hours and can't see my GP or Dentist on my weekend days off). However, given my degree of 'ancientness', (I have been a nurse since the early Thatcher years), I cannot see how these services can be provided (given that there probably won't be any extra money available) without coercion of staff and further dilution of their terms and conditions. So whilst I applaud the idea, I am sceptical about this government's motives and how it would work in real terms.

    Anonymous | 17-Dec-2012 5:01 pm

    Having more services at the weekends, bank holidays and out of hours will inevitably cost more (extra health care staff, electricity, support services and staff, etc)..... unless the government intend to pay staff less......

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  • tinkerbell

    you could still offer a weekend service that was 9-5 and those who work 9-5 weekdays could have 2 days off midweek instead.

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  • The difficulty may be that charges for child care where available at weekends may cost much more. In common with many others I spent many years working weekends and nights (it was/is the only way to get a living wage as a junior member of staff). I no longer work weekends as a more senior member of staff but when that first happened, I lost nearly £5000 by being promoted!!

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  • Rudolph/tinkerbell | 17-Dec-2012 6:04 pm
    Seems reasonable. But will the government pay weekend rates? And if it did, how would it afford it? Would it mean that weekday services would then be cut? How many years have we been on a pay freeze(cut)now?

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  • tinkerbell

    Anonymous | 17-Dec-2012 6:37 pm

    just a starting point, rotation so people still get some weekends off, of course, week end pay rates, creches etc., but of course all very unlikely.

    THE NHS managers will never get it sorted, but wait till the private sector get their hands on it, people will have to do it regardless if they want to keep their jobs, that sadly will probably be what happens. Can't do anything for the right reasons this shower, like providing an efficient service, but will do it for the wrong reasons like making loadsa money for the private sector.

    2 tier service.

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  • Seven days service sounds good to patients, bad to staffing levels and bad to costs. However, i think before coming up to this decision it has been evidenced based elsewhere. If not, it is going to be a short term trial that will soon prove its effetiveness.

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  • What about very small units and specialities where there are, say, 1-4 staff to cover all this weekend work? If they work Saturday and Sunday and have days off in the week, this necessarilty means a cut of up to a quarter in the amount of work that can be done in the week. Some commentators seem to think think everything in the health service is ward or department based, with back up available via Bank or Agency, but there are so many jobs which are single handed and without either recruiting more staff or expecting the existing ones to work a 7 day week, this cannot be achieved.

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  • tinkerbell

    this new group will be looking at the 'barriers' that prevent this happening. Who, what are the 'barriers'. I think they mean the staff mostly.

    Remember 49% of the NHS is now privatised. This service, unfortunately, will probably be for the select 49% who can afford it.

    When what was the NHS have sacked, redeployed, made redundant, altered terms and conditions, sold off hospitals, brought in new contracts and private companies there will be enough nurses/staff to re demploy on whatever surgeries bring in the most money.

    This is not being done out of any altruistic concern for our society sadly. Look at their track record so far for the evidence 'the times they are a changing' and not necessarily for the better.

    No the NHS as was can't afford it but the private sector to be can, once they start charging us.

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  • never trust the tories with the nhs

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  • Susan Markham

    What a silly lot of twaddle you people speak.

    No wonder why the (nay any) government finds it so easy to manipulate and crush us...

    We/us/registered nurses already work weekends.... it’s a no-brainer!

    So why shouldn’t we demand that everyone else does exactly what we have been doing for the past 200 years?

    Put the boot on the other foot then and see how ridiculous it looks.... Should nurses work 9-5 Monday to Friday? Nurses have families too - surely they deserve some “family time!” Nurses work hard - they need their weekends off. Hey, child-care is difficult to arrange on the weekend...

    Can you imagine what the follow-up to these calls would be if you had your way?

    999 - Hey my kid is running a temp - he’s fitting, can I get a nurse here?
    999 - Me and my buddies just got smashed on the M1
    999 - Someone just just jumped off the Colchester A12 flyover bridge
    999 - I am 13 and I just slit my wrists because my boyfriend disrespected me.

    The 999 opertator says “Sorry Honey - it is passed 5pm on Friday and there are no nurses to answer your call.... Please call back on Monday - after 9am.”

    Hospital care is ALWAYS about CARING.... The fact that we (as nurses - meo culpa) have let this fact go unnoticed is despicable... the fact that nurses on this site are even debating it is the true proof that Nurses are stupid!

    And that includes me too - just in case you were wondering....

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  • Yes, we do already work weekends. However, most wards and units are staffed at lower levels than during the week due to less going on (less staff nurses, more HCAs). So, in order to provide a 7 day service, staffing levels at weekends would need to be increased to weekday levels. It is not realistic for nurses to work 9-5...but it is also not realistic to expect a weekday service with weekend staffing levels. And with no finances to pay for the increase in staff, the idea is unfeasible to begin with. After all, most Trusts don't even have the staff to safely provide basic care to it's patients as it is, thanks to the ruthless and indiscriminate removal of staff to save money with no thought for patient care or safety.

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  • And how will they afford the extra staff to cover weekends? You guessed it. say bye bye to your unsocial hours pay.

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  • Susan Markham | 18-Dec-2012 12:21 pm

    Don't be ridiculous. Not ALL nurses work weekends, providing just as necessary and valuable services. Not all services are necessary at the weekends. Are you advocating that nurses should not have a choice in their working hours? Like someone pointed out earlier, after decades of working 24/7, there has been a huge cost to him/her. Go and do some reading on the negative health (mental and physical) on staff who work the shifts that you so blythely advocate. Seriously. It is frightening. Simply throwing a hissy fit because you want others to have as hard a deal as you is not very progressive
    That aside, there is NO extra money for this. You will lose your weekend/night/unsocial rates, at least, to pay for it. Yes, some nurses are stupid and the government has a special place in its heart for them.

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  • Anonymous | 18-Dec-2012 8:57 pm

    I rather think (and hope) that Susan posted that with her tongue firmly in her cheek. Anything else would be daft.

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