Weekend working could harm training

THE way hospitals are run at weekends is putting increasing strain on junior doctors, NHS England’s national medical director has said.

Sir Bruce Keogh raised concerns over the lack of consultant cover and its impact on medical training.

He spoke recently at an Agents for Change event in London where he highlighted the issue of seven-day working.

He said: “Many of you will know that I have raised a debate over the last couple of years about why our health service shuts down at about lunchtime on a Friday – or it certainly does for consultants – and then reopens again first thing on Monday morning and then grinds up to full speed by lunchtime on Monday.

“So we have a healthcare system that is only really working at most efficiency four and a half days a week.”

He cited surveys that showed junior doctors felt “increasingly strained” at weekends.

“Medicine is more complicated than it was when I was a junior,” he said. “There’s much more scrutiny, expectations are much higher, and when you start to combine that with the European Working Time Directive and the fact that you were saying as a group that you weren’t getting enough consultant support at the weekends – that made me worry about the adequate training of the next generation of doctors,” he said.

He highlighted figures that show an 11 per cent increase in mortality rates for patients admitted on a Saturday while rates for those admitted on a Sunday were 16 per cent higher.

He said: “I found myself thinking: not only are we running a service which is not that helpful in some ways for supervision and training, which clearly has evidence of high mortalities at weekends, which has evidence of inefficiencies and the lack of economy – it’s also not that compassionate a system.”

Sir Bruce said the provision of seven-day services across the NHS is his “number one priority” and that the emphasis should be on the people receiving the service rather than the people delivering the service.

 “This is about how and not about why,” he added. “The two how questions are: how much is this going to cost? And how are we going to do it? The answers are beginning to emerge.”

Source: BMJ Careers