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Dr Janet Williamson, NHS Improving Quality’s Director of National Improvement Programmes, outlines six key messages for commissioners and providers.
NHS England’s Everyone Counts has given a commitment to the NHS moving towards routine services being available seven days a week. Professor Sir Bruce Keogh at the inaugural NHS England AGM said of seven day services: “It is going to be radical, it is going to be difficult but we have to be up for it.”
Last week I had the pleasure of chairing a conference in London on Delivering a 7 Day Health Service. The impressive line-up of speakers was drawn from many leading organisations who have already made significant progress towards moving towards 7 day services. The majority of whom had featured some 18 months ago as a compendium of some 30 case studies, the early evidence of models of 7 day services published by NHS Improvement: Equality for all – Delivering safe care seven days a week.
Organisations such as Northumbria Healthcare NHS Trust, Torbay Hospital , University Hospital Southampton NHS Foundation Trust, Heart of England NHS Foundation Trust, and Torfaen Council part of Pan Gwent .
With Sir Bruce Keogh’s quote in my head I took the chairs prerogative to ask each of the speakers for their key messages for other organisations in their quest to move toward seven day services
Six key messages emerged, with general consensus amongst the speakers that the “how?” is not easy.
Professor Bell, Professor of Acute Medicine, Imperial College stated: “This is a real challenge for healthcare, understanding the how we do this and how we translate into practice.”
The notion of learning from others and developing a better understanding seems a key requirement going forward.
So here are the six messages on 7-Day Services:
- Find out what’s wrong, the first step: Seven days is a complex problem and a wicked problem which requires definition . Each organisation citing the need to be clear about the issue that they are trying to solve with the notion that there is not one model or solution.
- Go back to the pathway of care and walk the pathway and experience in the shoes of the patients and carers: Walk through the buildings and focus on pathways.
- It requires a vision that focuses on the whole system and integrated coordinated care: It is not just about the hospital – it is about healthcare providers, local authorities and the social care system. There are many interdependencies and multiple partners. The emphasis on committed and consistent leadership is being emphasised here.
- Ask the staff: Early engagement of staff is seen as a key factor in moving to 7-DayServices.
- Importance of the clinical team: Recognising that this is not just about the consultant and doctors but about the role of the clinical team and the part they can play in early decision making. Reference was made to clinical pharmacists as independent prescribers, professions allied to medicine leading rehabilitation, recovery and regalement.
- A journey and not a sprint: Transformation takes time, most organisations presenting had been engaged in moving to 7-Day Services upwards of six years, the majority 10-plus years.
This “How to” is going to require committed leadership that has the drive, commitment and an eye for radical redesign. Learning from those already on this journey is key but also learning from others who are just starting out.
The leaders of the organisations who presented at this conference were definitely up for it, the innovators in the field , the enthusiasts from which we have much to learn for the benefit of the wider system.
NHS Improving Quality will be working with NHS England to help support the move to 7-Day Services. The 7 Day Improvement Programme commencing later this year will reach out to every provider and commissioner across the healthcare system. This is a radical transformational change programme and not for the transactional leader.
The ambition: Over the next five years, 7-Day Services will start to become a reality. The “How?” calls for widespread engagement, and learning from these six key messages is a useful starting point distilled from those already in the thick of it.