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Does Britain need a seven day National Health Service?

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After an unpredictable election, the British people woke on 8 May 2015 to the news that the Conservative party were set to secure a majority government. One month on and with David Cameron firmly back inside no.10, how might the Tory win impact upon the health service in the UK in the next five years?

On 18 May 2015, in his first major speech since the election David Cameron spoke of his promises to increase funding to the NHS and pledged a ‘seven day’ NHS saying that the aim is make sure free healthcare is available for everyone- ‘wherever they are and whenever they need it.’ He called a 2012 study published in the Journal of the Royal Society of Medicine, which concluded that death rates for patients admitted to hospital on a Sunday were 16% higher than on a Wednesday, ‘shocking’ as he vowed to make changes.

A&E overcrowding 

Research by The Kings Fund published in January 2015 shows that not only has the number of people attending at A&E increased by over 30% in the last decade, but that numbers continue to grow, with weekly data showing 14,500 more attendances a week in 2014/15 than in 2013/14. With this increase there has (unsurprisingly) also been an increase in waiting times with the proportion of patients waiting longer than four hours to be treated, admitted or discharged on the rise.

In January 2015 Dr Clifford Mann, president of the College of Emergency Medicine, called the overcrowded conditions in Britain’s A&E departments ‘unacceptable and dangerous’ as he claimed that up to 500 patients died last year as a direct result of harm they suffered when hospitals became  dangerously overcrowded.  At times of overcrowding the public are at an increased risk of suffering from negligent treatment when attempting to access emergency care.

A recent sample of 3,000 patients in 12 A&E units conducted for the College of Emergency Medicine found that 15% of those patients could have been treated in the community. Whilst some responsibility may lie with patients who attend at A&E when it is clearly not appropriate to do so, many commentators blame the cause of this overcrowding on lack of access to out of hours care.

Lack of senior staff and limited access to diagnostic tests  

As we all know, our health does not run on a timetable and there is the same probability that we will fall ill and need medical assistance on a Monday morning as there is that we will need care on a Sunday night.  If you feel that you require non-emergency medical attention at a weekend your options can be limited depending on your location: you may be fortunate enough to have an NHS walk in centre or minor injuries unit nearby. However, for many people calling the NHS non-emergency ‘111’ number is the first port of call. This service is staffed by advisers who assess the symptoms of the caller and direct them to a local service. Sometimes this means you will be told to attend your nearest A&E.

If you are told to attend at A&E out of hours you may find yourself in an environment where access to consultants is limited. If you require diagnostic tests you may simply have to wait until Monday when those services are available again. Sir Bruce Keogh (Medical Director of the NHS) admitted in March this year that, “we have operating theatres that echo laboratories which remain largely empty and highly expensive diagnostic kit is going unused at weekends.”

Horror stories of patients being neglected in hospitals over weekends and bank holidays are frequently reported in the media and are tales all too familiar to clinical negligence solicitors.

Is a seven day NHS achievable? 

Whilst concerns have been raised by NHS staff that they will be forced to work longer hours, David Cameron has insisted that ‘out of hours’ demand for healthcare will be managed by using more flexible shift patterns. Sir Bruce Keogh has recently suggested that the current system of paying staff who work evenings and weekends in hospitals a ‘premium pay rate’ has stood in the way of the provision of providing care at any time of the week.

Another challenge that the Conservatives may face in achieving their vision is the well reported struggle that the NHS has experienced over recent years to recruit A&E consultants. This may be something of a vicious cycle as it is not difficult to see why the thought of working in an already understaffed and high pressure environment is not appealing to those entering the medical profession.

Although it is not yet clear exactly how the Conservative plan to implement their vision, or whether their goals are achievable, what is evident is that at present we are a long way from having an NHS service that is able to safely deliver care to patients ‘wherever they are and whenever they need it.’

If you think you, or your child, may have suffered an injury as a result of negligent medical treatment and would like to speak with a member of the Lester Morrill clinical negligence team, please call on 0113 245 8549 or contact us by email at