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Doctors warn seven-day service will damage weekday services

89% of doctors say 24/7 NHS will mean fewer doctors in the week

Adrian O'Dowd

Wednesday, 13 January 2016

The vast majority of doctors fear that introducing a seven-day working contract for hospital consultants will lead to a reduction in secondary care services on weekdays.

An exclusive survey carried out among more than 1,230 primary and secondary care doctors across England, via Binley’s online community OnMedica, found a high level of concern about the impact of introducing a truly 24 hours a day, seven days a week NHS.

Of the survey’s respondents, 92% thought some weekday hospital service reductions would be inevitable because trusts could not afford to run a truly 24/7 service.

Consequently, 89% of respondents thought that introducing compulsory seven-day working contracts for hospital consultants would mean a shortage of those consultants during the week.

Comments from doctors who took part in the survey included: “It is absolutely insane to try to increase the amount of routine work done at weekends when hospitals are already bankrupting themselves trying to maintain the current service levels.”

Another doctor said: “It is frankly stupid to think that elective work should be extended at weekends when my department lacks the resources and staff to adequately cover care for 9-5 on weekdays. More weekend staffing/services in real terms means reduced services during the week.”

Sarah Eglington, healthcare intelligence director of Binley’s, said: “Our survey highlights deep concern among doctors about the consequences of offering a full seven-day service in which routine and elective work become the norm at weekends.

“What is best for the patient needs to be the primary consideration for the government and doctors as they work together to find a solution to this situation. The government needs to engage with doctors to better understand their concerns about the strain that increased weekend services will have on existing weekday ones.”

Another survey of more than 1,230 primary and secondary care doctors in England carried out by OnMedica asked them to cite the most important factor in weekend hospital death rates.

Responses suggested that they were due to multiple factors rather than the availability of doctors.

Staff shortages at all levels, overcrowding, sicker patients and diagnostic test results delays were among the reasons given for the increase in hospital death rates at weekends.

A fifth (20%) of respondents said either overcrowding due to a rise in unplanned admissions, or a slower turnaround in diagnostic test results were causes, while 13% said lighter or reduced rostering of nursing staff was the cause and 11% said a lack of consultants reviewing sick patients was a reason.

Three quarters (75%) of doctors did not think hospital death rates would be reduced by consultants performing routine work at weekends, while 11% thought it would improve the situation, and 14% did not know.

When asked to cite the most important action that needed to be taken to reduce hospital death rates at weekends, around a quarter (23%) of respondents suggested an increase in community services to support terminally ill patients wishing to die at home.

This was closely followed by faster access to diagnostic testing (22%) and then an increase in the number of ward sisters and senior nurses working at weekends (15%).

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