Providing consistent hospital care and services over seven days requires multi-professional solutions and must be based on robust research, data and analysis. These are the findings of an expert workshop on the issue, reported in this month’s Journal of the Royal College of Physicians of Edinburgh.
Most published evidence suggests admission to hospital at the weekend is associated with increased mortality rates, but the precise scale and causes of this so-called ‘weekend effect’ is uncertain. The workshop discussed the factors that may influence patient outcomes including type of illness, staff ratios, access to diagnostic scans and tests, and the presence of senior doctors.
Workshop participants concluded that any solutions should recognise the complexities involved in delivering care across the system as well as the roles played by key staff and services including medical, nursing, pharmacy, diagnostic and allied health professionals. There also needs to be appropriate access to specialty, mental health, and community and social care at weekends. Any solution must also address the negative perceptions that exist – from both patients and staff – regarding their experience of care over weekends.
Prof Derek Bell, President of the Royal College of Physicians of Edinburgh said:
“A truly seven-day NHS can only be successful if it is properly resourced and implemented across the whole system of care. It is essential that a broad, evidence-based approach is taken to seven-day working rather than simply focusing on increasing the number of doctors working at weekends.
“Many services already provide seven-day cover and not all services need to be available 24/7, but understanding how all services interact is essential as we plan care. Looking at any aspect in isolation will not produce a sustainable solution.
“Any approach to providing more consistent acute medical services should be phased and prioritised in order to maintain a sustainable quality of care throughout the week and at weekends”.
Dr Mike Jones, RCPE’s Director of Standards and one of the authors of the paper, said:
“The Action Effect Diagram and Service Model Output, which the workshop participants produced, demonstrate the complexity of providing high quality care for acutely unwell patients throughout the week and at weekends.
“These show the various staffing and support services required to meet medical standards no matter what time of day or day of the week patients require care.
“Understanding this complexity is essential to delivering the correct solutions to improve patient outcomes and their experience of care”.
ENDS
Contact: Sara Collier, RCPE - 0131 247 3658 / s.collier@rcpe.ac.uk
Notes to Editors
1. ‘Consistent services throughout the week for acute medical care’ is available here and supporting diagrams are available here and here
2. Findings are based on an expert workshop held at Durham University on 22 September 2015 hosted by the Royal College of Physicians of Edinburgh in collaboration with the Centre for Healthcare Improvement and Research.
3. The invited expert audience included representatives from a range of healthcare professions, commissioners, researchers, policymakers and patient communities, from across the UK.
