Health Secretary Jeremy Hunt has said he is prepared to impose seven-day working on hospital doctors in England.
The current consultant contract means senior doctors can opt out of weekend work as long as it is non-emergency in nature; although they are still expected to be on call. By ensuring all new consultants do not have the right to opt out, Mr Hunt believes over the course of the Parliament he will gradually get enough senior doctors in place to drive up standards at weekends. While Mr Hunt is within his powers to impose such a deal, the move threatens to sour relations with the medical profession, especially as a number of hospitals have already started altering rota patterns to create a more even spread cover.
There is robust evidence showing that a weekend admission is linked to a higher chance of death, although the exact cause is still not obvious. Research from three years ago published in the Journal of the Royal Society of Medicine showed 1.3% of people who are admitted to hospital die within 30 days. Death rates were higher for weekend admissions compared with admissions on a Wednesday. They were 16% higher for Sunday and 11% for Saturday. But, crucially, it was not clear to what extent this was down to a lack of experienced staff. Another factor could have been that people with a greater severity of illness may be admitted at weekends because of a lack of services in the community.
Mr Hunt’s comments came just a month after he tried to entice GPs to move towards more seven-day working by promising to recruit extra staff to relieve the pressure on services.
The British Medical Association has argued that to improve care at weekends, support services such as diagnostics and pathology are needed as well as care in the community to allow patients to be discharged. Dr Mark Porter, BMA council chair, said: "Today's announcement is nothing more than a wholesale attack on doctors to mask the fact that for two years the Government has failed to outline any concrete proposals."
Rebecca Morgan, an associate in Penningtons Manches’ clinical negligence team, commented: “A compulsory seven-day contract for consultants may not go far enough in dealing with the current problems within the NHS. Doctors are only the tip of the iceberg of hospital care. There has been no mention of enforcing a seven day working week on employees such as specialist nurses or technicians, who are often critical in situations where consultants would not make much of a difference. There are also questions about funding. It has not been made clear where the funding for the proposed extra staff is coming from. The proposals could result in services being spread more thinly, causing the danger period to shift away from the weekend.”