As the debate regarding seven-day care in the NHS rumbles on, the British Medical Association (BMA) have had their say on the subject.
Analysis has recently been published in the British Medical Journal which suggests that weekend admissions lead to fewer but sicker patience than during weekdays.
The discussion on the topic follows Prime Minister Mr David Cameron’s assertion that the NHS must develop a seven-day culture in order to meet the demands of a contemporary health service.
Responding to the issue, Dr Mark Porter, BMA council chair, indicated his support for the concept:
“Doctors want the care we provide for sick patients to be of the same high standard, seven days a week. Urgent action on this has been undermined by calls for the entire NHS to be delivered on a seven-day basis without any clear prioritisation,” Porter commented.
Porter also underlined that the British Medical Association is fully committed to the concept of seven-day care, and indeed suggested that this will even become a priority for the organisation in the foreseeable future.
“The BMA wants better access to seven-day urgent and emergency care to be the priority for investment. This will ensure seriously ill patients receive the best care at all times. Nine in 10 consultants already work around the clock delivering this care,” Porter pointed out.
But despite the support for the concept from the British Medical Association, there are still question marks over the logistics of the concept according to Porter.
Numerous senior health figures in the United Kingdom have already queried the practicality of what Cameron is suggesting, and Porter is certainly no exception to this rule.
“Additional services will require not just more doctors, but extra nurses, diagnostic and support staff,” Porter not unreasonably asserted.
The BMA council chair also suggested that the government must resolve to flesh out the details of this particular scheme as quickly as possible.
Although David Cameron has indicated his belief in a truly seven-day NHS, there has been insufficient detail to back up the concept, let alone any information regarding how it will be delivered.
Porter critiqued this aspect of the concept, and placed the issue into a wider context.
“David Cameron promised a ‘truly seven-day NHS’ but there has been no detail to define what he means, how he plans to fund and staff it, and its impact on weekday services. Given the current funding squeeze on NHS Trusts, the only way for many hospitals to increase the number of doctors over the weekend would be to reduce the number providing care during the week,” Porter stated.
Porter concluded his comments on the matter by delivering something of a mild ultimatum to the government.
“If the government really want to deliver more seven-day services then they need to show patients, the public and NHS staff their plan for how this will be delivered at a time of enormous financial strain on the NHS and when existing services and staff are under extreme pressure.”
A BMA Survey of consultants found that 80 per cent currently work evenings and weekends in addition to the normal working week. Only 1 per cent of existing consultants utilise the so-called ‘weekend opt-out’.
These figures indeed suggest that the opinions of Porter are entirely sound, and that the government will have to make considerable changes to the NHS, not least with regard to recruitment, in order to even come close to achieving its supposed vision.
With public sector pay and austerity still a thorny issue, one NHS trust has taken the law into its own hands.
Kingston Hospital NHS Foundation Trust has decided to award its senior staff a 1% pay rise in line with lower paid staff, in clear defiance of government guidance.
In making the decision, the trust evidently considered the potential impact on staff retention of freezing salaries across pay bands.
In a note on the decision, the trust’s papers stated that the “rationale was that in the light of the recent staff survey results and staff able to work at local trusts who would pay inner London weighting, it was thought that it would improve the retention of staff”.
Earlier this year, the government had agreed to a 1 per cent pay rise for all staff salaried below £57,069, as part of its Agenda for Change pay framework.
But the trust has now defied this decision and become the first to offer an improvement in pay to those ranked above the band 8C grade.
Staff surveys conducted last year certainly indicated that employees working for the NHS in the Kingston region were not overly enamoured with the existing situation.
Forty-seven per cent of the trust’s staff who completed the survey stated that they were either “dissatisfied” or “very dissatisfied” with their pay level.
In this context, it was deemed to much of a risk to freeze the pay of valued employees within the trust, and thus Kingston Hospital NHS Foundation Trust acted in order to retain talent.
Releasing the information into the public domain, the trust also provided data on the potential cost to the public purse.
Increasing pay for staff above the band 8C mid-point will cost the trust £22,000 this year; a relatively trivial figure considering that the trust anticipates a deficit of £8.8 million in 2015 in its overall financial figures.
A spokeswoman on behalf of Kingston Hospital NHS Foundation Trust stated: “While the majority of staff, approximately 2,250, received the nationally agreed 1% unconsolidated pay rise this year, 22 members of staff at the bands 8C mid-point and above, did not.
“To maintain good staff morale and retention within this small group of staff, and to achieve a level of equity against their colleagues, a decision was made by the trust board that staff at band 8C mid-point and above would receive a 1% pay rise for one year only.”
Managers in Partnership, the British Trades Union for healthcare managers, also welcomed the move. Chief executive Jon Restell asserted that “Kingston FT has made a wise decision in the face of increasing pressure on recruitment and retention as the economy improves”, and stated his belief that the move “is the only logical way to push back on agency and interim costs. I hope and believe that others will follow Kingston FT’s example.”