The clinical case

A substantial body of evidence exists which indicates significant variation in outcomes for patients admitted to hospitals in an emergency, at the weekend across the NHS in England. This variation is seen in mortality rates, patient experience, length of hospital stay and re-admission rates. Additionally medical, nursing, other health professional and managerial staffing levels, as well as trainee doctors’ perceptions of supervision by consultants, also vary by day of the week.

To tackle this, in 2013 the NHS Services, Seven Days a Week Forum developed 10 clinical standards to end variations in outcomes at the weekend. These standards, a Summary of Initial Findings from the NHS Services, Seven Days a Week Forum, along with an evidence base document, a survey of acute trusts and separate reports from the Forum’s workstreams, are available to download:

The 10 clinical standards

At a glance: Our partners at NHS Improvement have put together a short video which explains the standards.

First stage report and paper to the Board of NHS England

Workstream reports

Priority Clinical Standards

Professor Sir Bruce Keogh, the NHS Medical Director, supported by the Academy of Medical Royal Colleges, identified four of these standards which if met would be most likely to have the greatest impact on reducing variation in mortality risk.

These Priority Clinical Standards are:

  • Standard 2: Time to Consultant Review
  • Standard 5: Access to Diagnostics
  • Standard 6: Access to Consultant-directed Interventions
  • Standard 8: On-going Review

However, although these four standards have been prioritised, we also want to promote implementation of the six other clinical standards as these are considered best practice for improving quality of care on every day of the week.