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Surgeons Support Move to Seven-day Consultant-led Patient Care


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18 Nov 2013

 

Most patients in hospital over a bank holiday or a weekend would benefit from a daily review of their care led by a consultant, according to a new report published today by the Academy of Medical Royal Colleges.

Seven day services, it argues, would create a transformational shift in the way the NHS delivers medical care. If healthcare teams carry out their patient reviews on Saturday and Sunday, patients could, in many cases, be discharged sooner; freeing up beds for new admissions, leading to more effective, safer and speedier care for all.  The report makes clear though, that for the proposals to succeed, strong links between hospitals and community care need to be in place, particularly for frail, elderly and vulnerable patients.   

Today’s report, builds on the Academy’s recent work on standards for better inpatient care. It concludes that to achieve seven-day service is also likely to need additional consultant appointments as well as a reorganisation of the current workforce, and more resources to integrate primary and social care more effectively.

The Academy, which represents 20 medical Royal Colleges and Faculties, also acknowledges that there is likely to be a financial impact, at a time when there are serious resourcing pressures on the NHS across secondary and primary care.  Moving to the new system will require more funding initially, although re-organising services and reducing morbidity could well reduce overall costs over time.  

Seven Day Consultant Present Care has been contributed to by 50 medical specialties and includes the results of a survey to determine the implementation implications in terms of staffing and access to a range of facilities and support services, both in hospital and in the community that will be essential to making seven day care a reality.

The report also finds that:

  • The majority of specialties surveyed in the report indicated the need for diagnostic radiology services including ultrasound, CT, MRI and access to an expert radiology opinion.
  • Support services such as physiotherapy, occupational therapy, pharmacy, dietetics, specialist nursing, operation theatres, administrative and clerical support are also key to provide care over seven days.
  • Currently, 11% of people occupying hospital beds do not have an on-going serious medical problem; their discharge is delayed by non-medical factors.  The report states that early weekday engagement and advance discharge planning between hospital and community based staff would increase the ability to transfer care from the hospital at the weekend.

Commenting on the Academy of Medical Royal Colleges (AoMRC) report into consultant seven-day working, Ian Ritchie, President of the Royal College of Surgeons of Edinburgh (RCSEd), the UK’s oldest Royal Surgical College, said:

IanRitchie"The College strongly supports the principle that the highest quality, consultant-led patient care must be available seven-days-a-week. The report from the Academy of Royal Medical Colleges, to which the College contributed, rightly highlights that weekend and bank holiday consultant care, and a more effective interface with primary and social care, would lead to improved and safer care.

“However, this would have far-reaching implications for not only the way that consultants train and work in the future, but also on the resources of the NHS. With current funding limitations it is difficult to see how increasing consultant and other staffing levels could be expanded. Also, many consultants are trained in sub-specialities, and it would take several years before a trained workforce with generalist skills would be ready. Resource allocation for seven-day working must be considered holistically together with the training and support needs for all health care staff.

"While seven-day working across the NHS would not be easy to achieve, a move to establish consultant-led emergency medicine and surgery would transform patient care.”

 


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