Patients tell 7-day service forum: “Be ambitious and not constrained by the past”

NHS England’s National Medical Director, Professor Sir Bruce Keogh, has warned patients and health care professionals the introduction of seven day services will be “difficult and radical.”

Sir Bruce also issued a challenge calling them to “be up for it” as he addressed a 7-Days Services workshop staged before NHS England’s inaugural Annual General Meeting at the Queen Elizabeth 2 conference centre in London.

The workshop was made up of 30 people, many representing patient groups and health charities.

Sir Bruce explained his passion for seven day services began earlier in his career as a heart surgeon when he introduced operating lists on a Saturday.

“Mortality rates improved, stays in hospitals shortened, the amount of money we had available in the budget went up and there was better training for junior doctors at weekends,” he explained.

He said his belief in the need for seven day services was reinforced when he was involved in research, adding: “We did a study looking at more than 14 million hospital admissions and found there was an 11 per cent higher risk of dying among patients admitted on a Saturday, and a 16 per cent higher risk of dying on a Sunday compared with patients who were admitted on a Wednesday.

“We also looked at similar statistics compiled in America and saw their findings were the same. This was compelling evidence.”

He also told the workshop the need for seven day services was also about the NHS showing compassion for the patients it serves.

“While people got to work for the NHS with compassion in their hearts, we are only set up to work for four and a half days – so where is the compassion at weekends?

“We need to think about our compassion for our patients in all this no matter what day of the week.

“There needs to public demand and public outrage that enough is enough. If enough people say they want something to happen, such as seven day services, then it will happen.

“It’s going to be radical. It’s going to be difficult but we have to be up for it.”

The 7-Day Services workshop gave the public another chance to have a major input into the thinking of the NHS Services, Seven Days A Week Forum which is due to report its findings in the autumn.

Earlier, the 7-Day Services project manager, Deborah Williams, had told the workshop the Forum was initially focusing on improving urgent and emergency care and diagnostic services.

“We need to start talking about services and better access to them for patients, instead of talking about beds and buildings,” she said.

“We need to know more about what our patients think of the services we commission and act on the information in the way we design and deliver them.”

There was lively debate with many important issues being raised by the group. One of the most poignant comments to be made was: “If you were starting the NHS from scratch, 7-Day Services would be taken as read.”

The views and comments from the workshop were captured and fed back to the Forum as well as to the NHS England Board.

The workshop groups were asked to rank their priority reasons for a move towards seven day services.

Concern over weekend mortality rates and recovery outcomes topped their concerns, but other comments included: “We need the right services, at the right times, with the right support” and “We want to have a consistently high service standard.”

They also called for “appropriate admissions” to hospitals and “integration across the system with support services and social care”.

Warned that ensuring all patients receive high quality urgent and emergency care seven days a week means hospitals will have to collaborate with each other, and that not all services might be available at weekends, the group was asked if it would support services being centralised in their communities if it meant higher quality services at weekends?

The subject of reconfiguration was met with a call from the workshop for “local, bespoke and safely driven services.”
The workshop groups also called for change, saying they wanted the NHS to be “ambitious for the future and not constrained by the past.”

• For further coverage of the 7-Days Services workshop and how it was received at NHS England’s inaugural AGM, go to:

• Flickr – photos of the day including some of our patient and public representatives Fiona Carey and Alan Keys

• Video – Fiona Carey feeds back on 7DS and Bruce Keogh responds – the coverage begins nine minutes in:

• Simon Bennett, NHS England’s project lead on the 7-Day Services Forum, and NHS Improving Quality’s director of improvement programmes Dr Janet Williamson are interviewed as part of the HSJ’s analysis of its online conversation about seven day services: