Poor weekend care in NHS hospitals is leaving the most vulnerable patients feeling neglected and unsafe, and wasting money on operating theatres, laboratories and diagnostic equipment lying idle, Sir Bruce Keogh, medical director of NHS England has said.
But he warned it can only be tackled by ending premium rates paid to staff for working weekends.
Keogh was speaking before giving evidence to the NHS Pay Review body later this week, and said the health services had a moral duty to tackle the issue to prevent avoidable deaths and substandard care.
“We have a moral, professional and societal duty to address this issue because unless we do so there will either be unnecessary deaths or care of a quality that could be better,” he told the Sunday Telegraph.
A study by the British Medical Journal in 2013 found that patients with surgery planned for the end of the week or at weekends, had a dramatically greater risk of dying than those at the start of the week, probably due to poorer weekend care with fewer and less experienced staff on duty.
Keogh said staff knew the current situation was wrong and wasteful.
“Everybody knows that it’s wrong to start winding down on a Friday afternoon and start cranking up again on a Monday morning,” he said. “We have operating theatres that echo, laboratories which remain largely empty and highly expensive diagnostic kit going unused at weekends.”
He cited patients who suffered a stroke on a Friday being left hooked up to feeding tubes, anxious and uncomfortable on nil by mouth, waiting until Monday when services to test their ability to swallow would reopen.
He said progress on improving weekend care was patchy, particularly slow in rural areas, and that only a minority of NHS trusts had managed to establish seven day services. He partly blamed the current premium pay system, where introducing such services was unaffordable if consultants could boost basic pay by a third and junior staff receive up to twice their standard rate for working weekends.
“We have mounting evidence from places that are trying to implement this that premium rates of pay are an issue. I will be asking the pay review bodies to look at that.”
