7 Day working for NHS. So how would that work?

We are into the period when the political parties try to bring out their eye catching policy initiatives.

David Cameron has said that if in government they will bring about 7 day working for the NHS.  http://www.bbc.co.uk/news/32094681

 

This is of course a discussion that has been going on for at least the last 5 years. It is clearly desirable for patients that there should be access to services 7 days a week, but there are also reasons why so far the move towards this is patchy.

The responses to the proposals so far seem to be on the lines:

• ·         It won’t happen.

• ·         There is no money to pay for it.

• ·         Where are you going to get the staff?

Personally I think that it would happen – but at a cost.

It is clear that there is no additional money on the table so how could 7 day working be made to happen?

If we were in a position where hospitals worked in co-operation with each other, one could imagine the creation of networked provision so that there is cover for a range of different conditions provided in different centres during weekends. This would make good use of existing facilities.

But we are in a position where hospitals compete with each other, and there is insufficient funding, especially for acute & emergency services, and there is a finite pool of staff in many areas.  All of this means that only a limited number of hospitals will in the end be able to provide 7 day a week services.

Ability to provide seven day consultant services will in these conditions become a proxy for a hospital’s ability to survive in a situation where there is competition for scarce resources, and media focus on hospitals "failing" to provide a seven day service will drive patient choice.

The reason why I think that this policy will seem attractive to some is because it will drive the centralisation of services. The provision of 7 day services will happen in the big centralised hospitals, and the smaller DGHs will see another step in the downgrading of what they can offer to their communities.

There is also of course the potential for private enterprise to set up or run acute centres to provide the weekend cover.

So yes – expect 7 day consultant services to become a reality, just don’t expect it to be in a hospital near to where you live.