BMJ 2013;347:f6522 doi: 10.1136/bmj.f6522 (Published 28 October 2013)
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NEWS Emergency care should take priority in plan to introduce seven day working in NHS, says BMA Gareth Iacobucci BMJ
The government’s drive to offer high quality NHS care seven days a week in England should focus on emergency, urgent, and acute services, as the resources are not available to provide “routine and elective services” at evenings and weekends, the BMA has warned. The government wants to ensure greater consistency of service across the week as part of its drive to raise standards of care and improve access and convenience to patients. A new Seven Day Forum, led by NHS England’s medical director, Bruce Keogh, is due to report on the feasibility of the proposals later this year.1
The plans are supported by the Academy of Medical Royal Colleges,2 which recommends that patients in hospital have a right to the same standard of care seven days a week, and include a recent pledge from Prime Minister David Cameron that patients in England should be able to see a GP any day of the week and in evenings.3
In a position paper published on Monday 28 October,4 the BMA said that it was committed to working with other organisations towards this goal but called for more work to be done to understand the “practical and financial implications” of a full seven day service. It said, “The BMA believes that urgent and emergency services should be the priority for investment to bring the standard up to the very best, every day. As such, care quality improvement should be the primary driver of seven-day service development for acutely ill patients. Only then can the debate start as to whether a full weekday service can also be afforded at nights, weekends, and bank holidays. “In the current and foreseeable economic climate, with huge financial pressure on the NHS, the BMA does not believe that
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the resources could be freed up to deliver routine and elective services seven days a week.”
The BMA said it would support GPs taking part in the recently announced extended opening pilots but warned, “We remain concerned that the current workforce is stretched trying to provide high quality care within current access arrangements.” Mark Porter, the BMA’s chairman of council, said, “There is much work to be done on determining a model for seven day services, especially around the practical and financial implications for the NHS and for doctors’ working patterns.
“The BMA is committed to playing a key role in addressing the system-wide change this will require. “We are already in negotiations with the government on how to develop working patterns which meet patient demand and deliver greater consultant presence at weekends, while safeguarding the need for a healthy work-life balance.”
He added, “Given the NHS has finite resources, we have to look at what services can be provided within the existing workforce and budget. We believe delivering consistently high quality emergency, urgent, and acute services across seven days should be the priority.” 1 2 3 4
Iacobucci G. Group is set up to look at seven day working in the NHS. BMJ 2012;345:e8601 Iacobucci G. Patients should be reviewed by a consultant once every 24 hours, say royal colleges. BMJ Careers , 5 Dec 2012. http://careers.bmj.com/careers/advice/view-article. html?id=20009964. Iacobucci G. Cameron announces plan for seven day access to GPs. BMJ 2013;347:f5949. BMA. Position paper: 7-day services. Oct 2013. http://bma.org.uk/working-for-change/ the-changing-nhs/nhs-culture/seven-day-services.
Cite this as: BMJ 2013;347:f6522 © BMJ Publishing Group Ltd 2013
Subscribe: http://www.bmj.com/subscribe
Page 1 of 1
News
NEWS Emergency care should take priority in plan to introduce seven day working in NHS, says BMA Gareth Iacobucci BMJ
The government’s drive to offer high quality NHS care seven days a week in England should focus on emergency, urgent, and acute services, as the resources are not available to provide “routine and elective services” at evenings and weekends, the BMA has warned. The government wants to ensure greater consistency of service across the week as part of its drive to raise standards of care and improve access and convenience to patients. A new Seven Day Forum, led by NHS England’s medical director, Bruce Keogh, is due to report on the feasibility of the proposals later this year.1
The plans are supported by the Academy of Medical Royal Colleges,2 which recommends that patients in hospital have a right to the same standard of care seven days a week, and include a recent pledge from Prime Minister David Cameron that patients in England should be able to see a GP any day of the week and in evenings.3
In a position paper published on Monday 28 October,4 the BMA said that it was committed to working with other organisations towards this goal but called for more work to be done to understand the “practical and financial implications” of a full seven day service. It said, “The BMA believes that urgent and emergency services should be the priority for investment to bring the standard up to the very best, every day. As such, care quality improvement should be the primary driver of seven-day service development for acutely ill patients. Only then can the debate start as to whether a full weekday service can also be afforded at nights, weekends, and bank holidays. “In the current and foreseeable economic climate, with huge financial pressure on the NHS, the BMA does not believe that
For personal use only: See rights and reprints http://www.bmj.com/permissions
the resources could be freed up to deliver routine and elective services seven days a week.”
The BMA said it would support GPs taking part in the recently announced extended opening pilots but warned, “We remain concerned that the current workforce is stretched trying to provide high quality care within current access arrangements.” Mark Porter, the BMA’s chairman of council, said, “There is much work to be done on determining a model for seven day services, especially around the practical and financial implications for the NHS and for doctors’ working patterns.
“The BMA is committed to playing a key role in addressing the system-wide change this will require. “We are already in negotiations with the government on how to develop working patterns which meet patient demand and deliver greater consultant presence at weekends, while safeguarding the need for a healthy work-life balance.”
He added, “Given the NHS has finite resources, we have to look at what services can be provided within the existing workforce and budget. We believe delivering consistently high quality emergency, urgent, and acute services across seven days should be the priority.” 1 2 3 4
Iacobucci G. Group is set up to look at seven day working in the NHS. BMJ 2012;345:e8601 Iacobucci G. Patients should be reviewed by a consultant once every 24 hours, say royal colleges. BMJ Careers , 5 Dec 2012. http://careers.bmj.com/careers/advice/view-article. html?id=20009964. Iacobucci G. Cameron announces plan for seven day access to GPs. BMJ 2013;347:f5949. BMA. Position paper: 7-day services. Oct 2013. http://bma.org.uk/working-for-change/ the-changing-nhs/nhs-culture/seven-day-services.
Cite this as: BMJ 2013;347:f6522 © BMJ Publishing Group Ltd 2013
Subscribe: http://www.bmj.com/subscribe
