HOSPITAL services should be run on a seven-day basis, with the same access to scans, tests and medical staff at the weekend as during the week, a new report says.
The study, from a commission set up by the Royal College of Physicians (RCP), makes 50 recommendations on the future of NHS hospital care, including a move to seven-days-a-week provision to tackle concerns over reductions in quality during out-of-hours periods.
The report also says hospitals must be reorganised so patients do not have to move beds or wards unless medically necessary – a major concern raised recently by Scottish doctors.
Leading medics in Scotland welcomed the recommendations. However, others have questioned whether the NHS can afford to provide the levels of cover being proposed.
The latest report comes from Professor Sir Michael Rawlins, chairman of the Future Hospital Commission, which was established by the RCP last year.
The authors called for a shift to seven-day working, with consultants having a presence on wards and a full range of tests available every day of the week.
Several studies have shown that patients admitted to NHS hospitals at weekends and on bank holidays have higher death rates and poorer “outcomes”.
The report said: “Acutely ill medical patients in hospital should have the same access to medical care on the weekend as on a weekday. Services should be organised so that clinical staff and diagnostic and support services are readily available on a seven-day basis.”
Earlier this year, it emerged that the new £840 million South Glasgow Hospital will organise its shift patterns so more consultants are present in the evenings and at weekends when it opens in 2015.
The RCP report said that “tough decisions lie ahead” including the reorganisation – and possible closure – of existing services. It acknowledged that no hospital on its own could provide the range of services and staff needed to treat patients across the spectrum of all clinical conditions on a seven-day-a-week basis and it called for a new model of “hub and spoke” hospital care.
This would involve a smaller number of acute general hospitals, surrounded and supported by local hospitals providing follow-on care.
The report also raises concerns that an increase in admissions and more older patients with complex needs mean “hospitals are struggling to cope”.
“All too often, our most vulnerable patients – those who are old, who are frail or who have dementia – are failed by a system ill-equipped and seemingly unwilling to meet their needs,” the report said.
The Royal College of Physicians of Edinburgh (RCPE) said it strongly supported the recommendations that services should be redesigned to ensure a consultant presence, with available diagnostic and support services, seven days a week.
At its conference in Edinburgh earlier this year, the British Medical Association (BMA) expressed concerns about whether the NHS could afford to run a seven-day service, with its chairman Mark Porter branding the idea of a 24/7 “Tesco NHS” as “ridiculous”.
Yesterday, a BMA Scotland spokeswoman said: “Consultants are already working seven days a week in specialties where it is necessary for patient safety, but to increase this across all specialties would require a massive input of resources.
“Without these resources, more cover at the weekend would lead to less cover and service during the week. Flexibility is the key – solutions that work for one specialty may not work for others.”