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Weekend patients plan to be set out

Plans to improve care for patients taken into hospitals at weekends are set to be unveiled after a major review of seven-day services.

Sir Bruce Keogh, the medical director of NHS England, will announce his recommendations on Sunday after a year-long inquiry into NHS care, amid concerns over higher death rates for patients treated on Saturdays or Sundays.

It is understood Sir Bruce will call for changes to increase the number of senior doctors working on weekends after research found that 4,400 lives a year are lost largely because of inadequate staff cover, the Daily Telegraph reported.

The announcement comes as a group of senior consultants called for proper staffing of NHS wards at weekends.

In an open letter published in the Telegraph, eight surgeons raised concerns that patients were being put at risk because inexperienced hospital staff were being forced to take on too much responsibility.

It follows the treatment given to one of the consultants, retired surgeon Russell Hopkins, whose after-care following a hip operation in June 2011 failed him "catastrophically", the surgeons wrote.

Mr Hopkins, a former Wales British Medical Association chairman, was left with nerve and bladder damage after being left for days without seeing a consultant as his condition worsened, the Telegraph reported.

"The NHS is repaying a lifetime of service with negligence and long-term disability," the surgeons wrote.

"We, the other signatories, are experienced consultants who share his analysis of how the system failed him and why it fails so many others.

"Surgery is too large and technical for a shift system of junior staff."

In the letter, the consultants called for a return to the system that pre-dated the "working time directive", which limits surgeons' hours, with doctors organised into firms.

"Many surgeons yearn to put ethics before directives and to practise these old-fashioned, fundamental values," they wrote.

NHS England declined to comment on the review ahead of its publication.

Dean Royles, chief executive of the NHS Employers organisation, said: "Seven-day working is probably the most important issue facing the NHS at the current time, and movement in this direction is essential if we are to ensure its sustainable long-term future.

"The NHS can't afford to sit back and rest on the laurels of its 65-year history. We are increasingly seeing hospitals and community-based health services develop innovative services that anticipate and respond to patient needs, but all too often NHS employers find the terms and conditions of doctors are getting in the way of progress.

"We are now facing a once in a generation opportunity to change how the NHS works. Patients, employers, medical royal colleges and the Government all want to see seven-day care."

A British Medical Association (BMA) spokeswoman said: " The BMA has been clear in its support for consistently high quality patient care being delivered seven days a week. Doctors firmly believe that patient outcome should not be affected by what day of the week they fall ill.

"The vast majority of consultants lead on the delivery of urgent and emergency care at evenings and weekends. The BMA is in discussions with the Government on how to develop working patterns which deliver more services across seven days while safeguarding the need for a healthy and productive work-life balance for doctors.

"In seeking to provide better access to more emergency care, we need to start with the quality standards that should be in place and what resources, including necessary staffing levels, are required to deliver them, rather than solely focussing on one part of the consultant contract.

'It's not just about having more consultants, it's also about having enough diagnostic and support staff and community facilities to ensure a doctor can do basic things like order a scan, a blood test or discharge a patient on a weekend.

"This is a complicated problem which will not be easily resolved by one single 'quick fix' solution."

Shadow health secretary Andy Burnham said the Government must set out how Sir Bruce's recommendations would be paid for.

He said: "This idea is right in principle but, with the NHS in increasing financial distress, the Government must set out clearly how it will be paid for.

"It would not be progress if it is achieved by closing smaller A&Es or raiding other services, such as community or mental health services. This would take the NHS in the wrong direction - forcing even more people into hospital, when the future demands more care in the home.

"If this plan is to have any credibility, the Government must urgently stop the cuts to front-line staffing. On David Cameron's watch, over 6,000 nursing jobs have been lost and there's a dangerous shortage of senior A&E consultants.

"Things will not get better unless the Government first stops the rot."

Health Secretary Jeremy Hunt said: " Patients should be at the heart of the NHS and be able to depend on it every day - not just Monday to Friday.

"I want the NHS to expand to provide seven day services so that more patients get the right care, when they need it. It is great news that Sir Bruce Keogh will be setting out his plans for the NHS to provide seven day services."


From Belfast Telegraph