Seven day service part of NHS England's vision

The NHS will offer a full seven-day service by 2017, if plans put forward by the service’s medical director, Sir Bruce Keogh, are given the green light.

Under the proposals, hospitals across the country will be contractually bound to offer a full service on every day of the week, including weekends. Any hospitals found to be failing to comply with these rules could be fined up to 2.5 per cent of annual income up to £500 million, which could equate to as much as £12.5 million.

Hospitals that do not comply with the rules could also be forced to do without the right to use junior doctors.

Mr Keogh cited high death rates among patients admitted to hospitals on Saturdays and Sundays as one of the main drivers behind the plans, and confirmed that there was a great deal of public pressure to “act now to make seven-day services a reality in all parts of the NHS.”

He listed a difference in death rates of 11 per cent on a Saturday when compared to weekdays, and 16 per cent on a Sunday, according to more than 14 million hospital admissions from 2009-10 that were analysed for the study. This could be due to many hospitals only having skilled consultants on call over the weekend, with less experienced doctors present on wards on those two days.

New NHS standards covering the full seven days must apply no later than April 2017, Mr Keogh confirmed. These will include a requirement that all emergency admissions must be given a detailed clinical assessment as soon as possible and at least within 14 hours of arrival. Existing patients must also be able to access diagnostic services including X-ray, computerised tomography, ultrasound and pathology seven days a week, he added.

Other changes would see consultant-directed diagnostic tests made available within an hour for critical patients and 12 hours for urgent patients. Non-urgent patients must be able to access the tests within 24 hours. Mr Keogh said that it was “inefficient” that many hospitals do not make full use of costly diagnostic machines and laboratory equipment at weekends, while many operating theatres “remain empty.” Access to specialist care was also “dogged by waiting lists” he said.

The proposed changes will only cost 2 per cent of the NHS’s total £97 billion operating budget, Mr Keogh confirmed.