NHS Chief Calls For Quality Seven-Day Service

Hospitals in England could face multi-million pound fines if they fail to maintain standards seven days a week, the NHS's medical director has warned.

Sir Bruce Keogh is set to announce his recommendations after a year-long inquiry into NHS care, amid concerns over higher death rates for patients treated on Saturdays or Sundays.

He told the Sunday Times a seven-day NHS "would undo more than 50 years of accumulated custom and practice which have failed to put the interests of patients first". 

The obligation to run a full service 24/7 will be written in to hospital trusts' contractual agreements, with breaches leading to potential fines of up to 2.5% on budgets that can be more than £500m.

Sir Bruce will also publish clinical standards, which set out the level of care that patients can expect in any NHS hospital at the weekend.

He added: "Two things are key to this. One is the availability of diagnostic tests at the weekend, because the key to treating somebody is a diagnosis.

"Then you need someone experienced to interpret those tests and to institute the right treatment." 

Sir Bruce plans to end the practice of junior doctors staffing hospitals at weekends without consultants present and hospitals that fail to adapt will face losing the right to use junior doctors altogether.

He said: "Historically at the weekend our service has been delivered largely by junior doctors in training and now we are changing that."

The practice of junior doctors staffing hospitals at weekends could end

The intention is that within three years all patients admitted as an emergency at the weekend will be seen by a consultant within 14 hours.

Those already in hospital at the weekend will have their condition reviewed by a consultant every 24 hours, while routine surgery will be available at weekends for minor conditions such as hernias.

X-ray, ultrasound, CT and MRI scans will carry on at the same level as during the week, while heart checks, biopsies and blood tests will also be available seven days a week.

The hospital support network of pharmacies, physiotherapy and occupational therapy will run every day.

Sir Bruce said the NHS lacked compassion by failing patients at the weekend. "People are still kept waiting at the weekend for a diagnosis. We have a system that is not built around the convenience of patients and is not compassionate to patients for part of the week.

"Why should somebody have to take time off work, why should someone else have to take time off work to take them to and from hospital, when, if they were to have their operations on a Saturday, they could spend Sunday recovering and, in many cases, get back to work sooner?"

The inquiry team believe the change will cost about 2% of the NHS's annual operating bill of £97bn, but could be less after potential savings.

Blood tests, heart checks and biopsies would be available seven days a week

Critics suggest the cost could be billions more, but Sir Bruce believes the system of having theatres, consulting rooms and recovery wards lying empty at the weekend could be tackled to cut costs.

The BMA said it supports high quality seven-day patient care.

A spokeswoman said: "Doctors firmly believe that patient outcomes should not be affected by what day of the week they fall ill.

"The BMA is in discussions with the Government on how to develop working patterns which deliver more services across seven days while safeguarding the need for a healthy and productive work-life balance for doctors.

"This is a complicated problem which will not be easily resolved by one single 'quick fix' solution."

Health Secretary Jeremy Hunt said: "Patients should be at the heart of the NHS and be able to depend on it every day - not just Monday to Friday.

"I want the NHS to expand to provide seven-day services so that more patients get the right care, when they need it. It is great news that Sir Bruce Keogh will be setting out his plans for the NHS to provide seven day services."

Labour shadow health secretary Andy Burnham said: "This idea is right in principle but, with the NHS in increasing financial distress, the Government must set out clearly how it will be paid for."

:: Watch NHS medical director Sir Bruce Keogh live on Sky News at 11am on Sky channel 501, Virgin Media channel 602 and Freeview channel 82.

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