‘Seven-day’ NHS in Scotland plans to be announced

More doctors would be in Scots hospitals at weekends. Picture: TSPL
More doctors would be in Scots hospitals at weekends. Picture: TSPL
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PLANS to create a “genuinely seven-day” NHS in Scotland, including more doctors working in hospitals at weekends, will be announced by health secretary Alex Neil today.

Recent research has raised concerns about standards of care in English hospitals outside normal working hours, with lower staff numbers and poorer access to equipment thought to be hampering patient care.

Mr Neil said Scottish Government research had found no evidence that mortality rates for patients were any different if they were treated in the day or evenings and weekends in Scottish hospitals.

But he said the Scottish Government still wanted to see a move away from variations in how care is provided at different times of the week, with a taskforce of senior NHS and government officials set up to oversee any changes.

“While the quality and safety doesn’t vary, the NHS must be a genuinely seven-day service where it needs to be,” he said.

The plans will put ministers on a collision course with doctors, who have already expressed concerns about the impact on staff and weekday services if more workers are expected to cover out of hours.

Mr Neil will outline his vision at the International Society for Quality in Healthcare conference in Edinburgh today, including £4 million to test different systems for moving patients through the healthcare system based on approaches in other countries.

Speaking to The Scotsman ahead of his speech, Mr Neil stressed that Scotland did not have a patient safety problem at the weekends or evenings.

“This is about improving patient outcomes, it is not about dealing with any problem of 
patient safety,” he said.

Mr Neil said one problem was that patients may end up staying in hospital over a weekend when they could have left earlier, but there was nobody available to discharge them until the Monday.

“That is not good management of the resources in the hospital. The longer somebody stays in hospital, sometimes that can adversely affect their outcome because of their vulnerability to hospital-acquired infections, for example, being higher but also people do recover much better in a home setting rather than in a hospital,” Mr Neil said.

The minister said they hoped to increase access to expensive hospital equipment which often sat idle at the weekends, such as MRI scanners.

He said they also envisaged more senior doctors being on site at weekends, rather than on call at home.

“Since we are paying them anyway, very often triple time, to be on call it would be a far better use of their talent and resources to have them working and, for example, discharging patients who are ready to be discharged,” he said.

Scottish Conservative health spokesman Jackson Carlaw said: “Having piloted a genuine seven- day-a-week, 24-hour service, the health secretary should look again at ensuring the most efficient use is made of hospital facilities.”

But Dr Nikki Thompson, who chairs the British Medical Association’s Scottish Consultants Committee, said: “It is important that the government recognises the limits of the capacity of the NHS – further overstretching existing hard-pressed staff, medical or otherwise, will not serve any benefit to the NHS nor to patient care.”