28 May 2015

7-day service in the NHS right for patients, but what about staff?

The moral case for a 7-day NHS is unquestionable. One report published states that patients admitted on a Saturday could be 11% more likely to die compared with a weekday, while on a Sunday that figure rises to 16%. It’s primarily an issue of patient safety and improving outcomes, but at what cost for the nurses and healthcare staff that have to deliver it?

This issue featured in a recent #NurChat twitter discussion, and drew comments from staff members working is many areas of both the NHS and private sector. The potential benefits of a 7-day service for patients are several fold, not least of which is the reduced mortality rate for weekend admissions. Better continuity of care, shorter hospital stays, quicker access to treatment and the resulting cost savings are also anticipated.

Many #NurChatters were in support of the 7-day model of care, all seeing the benefits that patients could experience.

@shizc1 #NurChat definitely needed stop admissions and bed blocking, also increased death rates at w/e unacceptable

 @DaniG4_ defo agree. Full multidisciplinary teams needed at Wknd & bank hols, as wk day, pts are no diff, so why are teams #nurchat

However, the practical implementation of a true 7-day health service could be incredibly challenging. The integration of social care into the 7-day model is essential to allow a smooth transition between hospital and the community, and to avoid patients waiting in hospital for services to open / become available. If it can be achieved then bed-blocking may become a thing of the past.

@LynneBowers2 #NurChat essential social care involved. Facing many similar challenges to NHS - pay restraint, recruitment, not valued

@DonnaNewcross Social care will play a huge part of improving services. I hope it becomes more joined up #nurchat

Journalist Shaun Lintern reported that previous discussions with some medics had not been in support of the 7/7 service plans, but that opinions had started to change in recent years.

While the benefits for patients are clear, a great deal of concern from healthcare staff and nurses exists. Staff who already work on a 7 day rota may find that unsociable hours enhancements will be removed in order to help fund the additional staff that will be needed.

@StevenAE_21 Personally, I'd loose £hundreds per month without 'technically' taking a cut #nurchat

It’s a very real concern following the government’s proposal to the NHS Pay Review Body, which includes a number of options from the complete removal of the enhancement to the introduction of a new ‘flexibility premium’ that would reward staff for working more flexibly. It has been suggested that any reduction in the out of hours payments could result in strike action, which was not ruled out by some who took part in the discussion. Others felt the risk to patient care was too great and would not strike.

@joolzl23 it sure is I wouldn't want patients to suffer &I see striking as a risk to delivering optimum care #nurchat

There is no doubt that all healthcare and nursing staff want to see the best possible care for their patients, which is why there appears to be overwhelming support for the 7-day approach. However, the reality may yet prove to be one of reduced pay and incomplete integration with other services leaving those working the traditional ‘out of hours’ shifts unable to provided fully integrated care.

Join us again on #NurChat on 9th June when we’ll be talking about getting the most out of student nurse placements and making the transition into a newly-qualified position.