Workload pressures and financial issues pose a significant risk to the government’s plans to make the NHS a “truly seven-day service” in England, according to leaked internal documents.
A confidential review of the government’s plans for a so-called seven-day health service by 2020 has identified 13 risks, according to The Guardian newspaper and Channel 4 News.
“Unless there is significant investment there will simply not be enough nurses to deliver their vision”
The leaked report, drawn up in July by the Department of Health, is understood to warn that the biggest risk comes from “workforce overload” but also raise concerns about a lack of detailed costings, risk assessment, and limited data supporting the policy.
The Royal College of Nursing responded by saying that without significant workforce investment there would “simply not be enough nurses” to implement the government’s plans.
Donna Kinnair, RCN director of nursing, policy and practice said: “We now know that the government admits what we have always argued – that an already overstretched service cannot be expected to do even more with the same resources without putting patients at risk.
“With 24,000 nursing vacancies at the last count, and years of pay restraint making staff retention even more difficult, the government needs to accept that unless there is significant investment there will simply not be enough nurses in the NHS to deliver their vision for seven-day care,” she said.
Dame Donna Kinnair
“For these plans to win the trust of patients and nurses, the government needs to demonstrate how it will provide the resources needed to provide seven day services without making staffing levels unsafe and compromising patient care, and as acknowledged in its own document, it must work to bring nursing staff on board,” she added.
Dr Mark Porter, chair of the British Medical Association, said the government’s disregard for its own risk assessment about the lack of staffing and funding needed to deliver further seven-day services, was both “alarming and incredibly disappointing”.
“If the government wants to make more services available across seven days, then it needs to urgently address how it will staff and fund them rather than continue to mislead the public,” he said.
Diane Abbott, Labour’s shadow health secretary, accused the government of pressing ahead with its plans when “when campaigners and NHS staff argued they were unworkable”.
“It has now been confirmed by the advice the government received from its own civil servants,” she said. “The government is undermining the NHS with plans it knew to be unworkable.”
She added: “I will be writing to [health secretary] Jeremy Hunt to ask him to explain how why has contravened his civil servants’ advice and to ascertain whether he has misled parliament.”
A DH spokesman said: “Over the past six years eight independent studies have set out the evidence for a ‘weekend effect’ – unacceptable variation in care across the week.
“This government is the first to tackle this, with a commitment to a safer, seven day NHS for patients and £10bn to fund the NHS’s own plan for the future, alongside thousands of extra doctors and nurses on our wards,” he said.