Hospital Dr News

“Consultants should start working weekends”

The NHS Medical Director has called on consultants to consider weekend working to improve hospitals’ productivity.

In an interview in the Telegraph, Sir Bruce Keogh criticised the culture in hospitals of only treating emergency cases at the weekend with little or no routine surgery or diagnostics performed outside normal office hours.

He said the current system “lacks compassion” because patients are forced to wait for investigations or take time off work or arrange childcare in order to be seen.

Patients admitted to hospital at the weekend have a significant increased risk of death within 30 days of admission, a study found recently in the in the Journal of the Royal Society of Medicine.

The research analysed all 14.2 million admissions to NHS hospitals in England during the 12 months from April 2009 to March 2010, and for every 100 deaths among patients admitted to hospital on a Wednesday, 116 similar patients admitted on a Sunday would die.

At the BMA’s recent consultant conference, part of a motion to support the drive to reduce hospital mortality at weekends was supported. But the section which called for hospital consultants to be rostered like their juniors to work in the evenings, at nights and at weekends in hospital “at rates of pay that are consistent with the 2003 consultant contract, in the interests of patients and the taxpayer” was rejected.

The committee concluded that a one-size-fits-all solution didn’t suit all specialties and would require a renegotiation of terms and conditions.

Sir Bruce is attempting to reform NHS hospital working hours by talking to hospital chief executives around the country to identify which services can be opened at the weekend first. Financial incentives could be offered to hospitals for providing care at the weekends.

He said: “What other industry shuts down for two and half days a week? People get sick seven days a week, they need help seven days a week. I want to get to a position where the NHS is indistinguishable on a Saturday from a Wednesday but we won’t get there overnight.”

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11 Responses to ““Consultants should start working weekends””

  1. joshek says:

    there is a valid argument: weekend work destroys family/private life. lots of industries shut down for 2 and a half days per week dear sir bruce – the uk’s most important industry for example (financial industry) … if the nhs wants 24/7 service from its senior personnel, it needs to not simply add more and more demands, it needs to benchmark against comparable personnel. airline captains come to mind – just look at the whole package.

  2. Bob Bury says:

    I think there’s no doubt that we are heading for 24/7 working, but only when the politicians grasp the nettle of providing the huge increase in funding for the extra staff required.

    In the meantime, it doesn’t help to have idiots saying things like “What other industry shuts down for two and half days a week?”. If we shut down, Sir Bruce, no-one would die in hospitals at the weekend. Presumably that would satisfy you? It’s equally irritating to hear the condescending suggestion that consultants should ‘consider’ working at the weekend. Most of them already do. It’s just that they don’t work every weekend, and they don’t do much elective work then (although an increasing amount of elective stuff is being slipped through as ‘urgent’).

    If we are to work normally at weekends, it isn’t just consultants who need to be involved, in fact that’s the least of it. There will need to be a huge increase in support staff at all levels.

  3. wmcc says:

    “What other industry shuts down for two and half days a week?”
    parliament, the DoH, the NHS Board, to name but a few

  4. joshek says:

    absolutely right bob bury! if the hospital shall be the same on sunday as it is on wednesday, EVERYONE needs to work 24/7, including the office dwellers! the entire infrastructure needs to be available.

  5. Malcolm Morrison says:

    The fact is that THE MAJORITY OF THE POPULATION regard weekends (and bank holidays) as ‘different’ from the ‘working week’.

    Many other ‘services’ provide ’emergency cover’ at weekends – as does the NHS, including consultants. And many consultants are actively working when they are ‘on call’. It is not as it was ‘in the good old days’!

    What is somewhat scary is that someone in his position can be so out of touch with reality!

  6. Fred Nath says:

    As a consultant Neurosurgeon for 26 years, I’ve done a lot of urgent stuff at weekends, smply because it won’t wait for surgery on a routine operating list later in the week. Saturday mornings also require ward surveillance, so I’ve often seen my post-ops then too. The problem never was a lack of willingness on my part, but the fact that the system wasn’t geared up to major surgery at weekends. I’ve spent years of time on the dog and bone, negotiating with the Anaesthetic department, the theatre nurses and our HDU to get cases done (eg aneurysms) at weekends, not because I’m a glutton for punishment, but because patients with serious conditions need out of hours procedures at times. I still clip aneurysms at weekends if I have to, The bottom line is that for weekend working to take place they will have to have all the staff in just like a weekday. The cost will be phenomenal.
    Complete w*****s like this ‘Sir Bruce’ chap don’t know what they are talking about since there is a veiled suggestion here that Consultants are the ones who want to obstruct patient treatment at week-ends. I’m afraid it makes me furious, having done so all my career.
    Please excuse the rant!

  7. Clare says:

    1. Most consultants in acute specialties already work weekends and the financial recognition of this is poor and at time not existent
    2. Those, like myself, lucky enough to work Monday to Friday put in our 48+ hours over those five days. If I work at the weekend, I’ll be needing days off in the week. Simples.

  8. Ramita says:

    I am aghast that someone in a position of power as ‘Sir Bruce’ is so ignorant of grass roots working – most of us are already working weekends routinely – my next routine on-call weekend is the whole of Easter. Where will he be holidaying then I wonder?

  9. NS says:

    Like Fred Nath I am also neurosurgeon who has worked flexibly for emergencies for many years to the detriment of my family but in a professional manner for my patients.

    Diary exercises for us all in the department have consistently run at about 14 PAs for many years and we have 1 in 2 and 1 in 3 unofficial vascular and spinal cover.

    Ignorant and ill informed comments from the like of Sir Bruce merely make you question why bother when clearly, and with appropriate political correctness apologies, lunatics are running the asylum !!! Is is easy posture and spin political opinions but less hard to deliver as politicians continually prove.

  10. Dr D I Clifton says:

    Forgive me if I am wrong, but I thought that consultants were already working week-ends. Emergency Medicine is a 24/7 issue. It is logical therefore to proceed to a 24/7 service for Emergency Medicine. This cannot be provided at weekday levels with current manpower. We do not even have enough radiographers to provide this for radiology. Furthermore, if consultants are working more week-ends, then they will need rest time on other days so there will still be some gap in continuity of care regardless. The need is to ensure that we have sufficient manpower to really manage week-ends. At present we do not even have enough junior staff to really manage the routine jobs over the week-end and using consultant staff to do this is a very expensive option.

    Emergency Medicine is running with too little reserve capacity, often with none at all. I have also kept diaries of my hours of work to present at my annual job appraisal but not once have management looked at them or truly cared about my excessive hours of work which still breach EWTD. The only thing is that they don’t pay for it.

  11. Ben M says:

    No hospital has a two and a half day weekend. I doubt (I think) that Sir Bruce is so out of touch he doesn’t know this. Exaggeration may be necessary to get the attention of the media but is irritating and insulting.

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