Commenting on the Prime Minister’s speech today in which he pledged to create a ‘seven-day’ health service, Nuffield Trust Chief Executive Nigel Edwards said:
“The Prime Minister is right to aspire to seven-day access for patients to hospital and GP services – this will help to improve the consistency of care people receive at all times of the week. We have known for some years that there is a higher risk of mortality in our hospitals at weekends – this needs to be dealt with. Moving to a seven-day service will also help improve the flow of patients though hospital and the problems that result from the surge of demand on Mondays. Whether the Government will provide the funding available to achieve this aspiration is a key question though – the extra £8bn it has pledged by the end of 2020/21 will be enough to keep existing services running but little else.
Making seven-day working a reality may [...] mean closures or mergers of local services, such as emergency surgery or maternity units. So, this will not only cost additional money beyond the £8bn but it will also require political bravery.
Nigel Edwards, Chief Executive
“But the Government should be under no illusions about the impact a seven-day NHS will have. It will mean significant changes to the way services are run across the country, and it will also require recruiting a critical mass of specialist staff. Making seven-day working a reality may also mean closures or mergers of local services, such as emergency surgery or maternity units. So, this will not only cost additional money beyond the £8bn but it will also require political bravery.
“Getting the right workforce in place will be a critical challenge as the main driver will be the need to recruit highly paid medical staff, as well as support staff. General practice in particular is very stretched and it takes time to recruit in extra capacity. In addition, the NHS currently pays a premium for weekend working so negotiations over terms and conditions for staff will need to be handled carefully.
“One of the key questions is what effect this will have on patient behaviour and whether this will merely create additional demands on local services that wouldn’t otherwise have happened – a problem of ‘supply-induced demand’ – or whether it will help smooth demand over seven days rather than traditional peak periods, such as Monday mornings where GP surgeries can be up to 40 per cent busier than on the average working day.
“In all of this the Government needs to be clear about the problem it is trying to solve by moving to a seven-day NHS, and crucially how the measures it is suggesting will achieve this in the resources available, as it is not immediately clear from the detail we have seen so far. It will be important for the Government to explore the different ways seven-day working could be achieved, particularly thinking about skill mix, the different ways of deploying staff, and the use of technology.”