NHS seven day care plan to combat weekend hospital deaths
Hospitals face sanctions if the increased risk of death at weekends is not cut to provide a consistent standard of care across seven days.
Hospitals will face sanctions if they do not deliver the same standard of care seven days a week under a new shake-up aimed at cutting the current increased death risk at weekends.
NHS England Medical Director Sir Bruce Keogh said he was setting out “radical changes” which would be backed with some “pretty hard levers” to make sure hospitals comply.
He told the Sunday Times hospital trusts will be bound by contract to run a full service seven days a week, breaches will cost up to 2.5 per cent of their annual income of up to £500m.
The increased risk of mortality at the weekend could be as high as 11 per cent on a Saturday and 16 per cent on a Sunday, according to an analysis of more than 14 million hospital admissions in 2009/10.
Under the new plan, within three years all patients admitted to a hospital ward as an emergency will see a consultant within 14 hours. Those already in hospital will be reviewed by a consultant every 24 hours.
Surgery will also be available for minor conditions, such as hernias, as well as blood tests, heart checks and biopsies, saving patients from taking time off work. Services such as X-rays, ultrasounds, CT and MRI scans will also be carried out promptly at weekends, following the review.
‘Particularly stressed’
Speaking on the the Andrew Marr Show, Sir Bruce said: “Junior doctors are feeling particularly stressed at the weekends because of the complexity of patients, the complexity of diagnosis and treatment, and they feel unsupported.
“This has been brought to our attention and we worry about that, not only because it may relate to the higher mortality but also because it implies that we could be training the next generation of doctors better.”
Sir Bruce indicated that the changes would add around 1.5 per cent to 2 per cent of the annual hospital running costs.
“We have identified 10 clinical standards which will deal with what our expectations are in terms of diagnostic capacity in organisations at the weekend – so how their labs work and consultant presence as well.
“Those seem to be the two things that are at the heart of this matter. We are going to put those into the NHS contract for organisations over the course of the next three years.”
Organisations which do not have suitable levels of consultant presence will be prevented from contracts to train junior doctors.
The Care Quality Commission will ensure that no hospitals receive the highest ratings unless they meet the conditions and “for acute services to be judged safe, they have to be safe 24/7”.
He will also ask NHS England to set up pilot schemes in to improve GP access for at least 500,000 people to help move to a seven-day model across the health service.