HSJ online conversation gives backing to 7-day services

Andrew Snowball, the Health Service Journal’s Head of Engagement, explains how the magazine’s readers are supporting the call for 24/7 care:

There is a growing sense of inevitability behind the recent calls for the NHS to be a seven-day service.

In June, health secretary Jeremy Hunt described the new £3.8bn social care commissioning pot – on condition that services operate seven days – as a “game changer” and   a “huge moment in NHS history”.

Then later in the summer he outlined his expectations for patients to receive the same quality of care at the weekend as they do during the week.

And NHS medical director Sir Bruce Keogh has backed the ambitions, putting pressure on consultants to accept weekend working and launching a Seven-Day Services Forum initially looking at urgent and emergency care and diagnostics services to try to make it a reality.

These hopes for the NHS to provide services when patients need them are not just the latest top-down directive – they are shared by the NHS workforce, as HSJ discovered when we held a “conversation” with our readers.

Using the crowdsourcing platform Clever Together, we asked our readers: “What are the behaviour and process changes you believe are needed for the NHS to deliver consistent, financially sustainable 24/7 working?

Over three weeks they were able to make suggestions, comment on them and vote them up or down. More than 1,000 people took part, between them making more than 6,000 contributions. The anonymous format allowed all types of HSJ readers – executives, junior managers, clinicians, commissioners and providers – to talk openly and without prejudice.

Their ideas ranged from specific actions that trust or directorate leaders could pick up immediately:

  • “Introducing seven-day radiology to include reporting by a radiologist will reduce length of stay for acute admissions by up to two days. Torbay Hospital is already using this practice.”;

To action needed at national level by policy makers:

  • “GPs should be salaried rather than be independent practitioners. The ability of the system to change pathways is hampered by them being outside rules that apply to the rest of the system.”).

Finally, there were the big picture questions that might shape future debate:

  • “Integrated care, without an internal market.”

What surprised us – and should delight Sir Bruce when he publishes his own findings in the autumn – was how open the respondents were to the ideas and to seven-day working itself.

Rather than debating its feasibility, participants tacitly accepted that it is essential to the future health service and set about discussing how to overcome the problems. Even the least popular suggestions were discussed rationally and reasonably.

HSJ will be watching closely when Sir Bruce publishes his forum’s findings later this year. We expect to see it address many of the problems and opportunities identified by our readers and where they are not we will ask why.

There is a clear mandate from the service, its patients and leaders to make the NHS provide care every day. If they can combine their will it could prove to be NHS England’s greatest legacy.

On all this week, and in the magazine, we are analysing the results and considering in greater detail some of the problems and opportunities the ideas present ( We will also publish some of the most highly rated ideas so the debate can continue and the ideas can be put to work.

Andrew Snowball

Andrew Snowball is head of engagement at HSJ.