{"id":35105,"date":"2015-09-04T12:12:41","date_gmt":"2015-09-04T11:12:41","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=35105"},"modified":"2015-09-04T15:31:42","modified_gmt":"2015-09-04T14:31:42","slug":"abi-rimmer-seven-day-services-lack-definition","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2015\/09\/04\/abi-rimmer-seven-day-services-lack-definition\/","title":{"rendered":"Abi Rimmer: Seven day services lack definition"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2015\/09\/abi_rimmer2.jpeg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-35116\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2015\/09\/abi_rimmer2-150x150.jpeg\" alt=\"abi_rimmer2\" width=\"150\" height=\"150\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2015\/09\/abi_rimmer2-150x150.jpeg 150w, https:\/\/blogs.bmj.com\/bmj\/files\/2015\/09\/abi_rimmer2-300x300.jpeg 300w, https:\/\/blogs.bmj.com\/bmj\/files\/2015\/09\/abi_rimmer2.jpeg 400w\" sizes=\"auto, (max-width: 150px) 100vw, 150px\" \/><\/a>What exactly are \u201cseven day services?\u201d This is something that I have been wondering ever since David Cameron announced in March that the NHS would run a seven day service by 2020. And, despite all the rhetoric from Cameron and health secretary Jeremy Hunt, the government doesn\u2019t seem to have a clear definition of what seven day services are going to involve.<\/p>\n<p>Without a clear definition, it will be impossible to measure whether we have \u201cseven day services.\u201d Lots of the doctors already work at evenings and weekends, so we need to understand how these new plans will be different from the services already offered by the NHS.<!--more--><\/p>\n<p>To find out what the government meant by \u201cseven day services,\u201d I sent Freedom of Information requests to NHS England and the Department of Health, to see if they had been talking to David Cameron about how seven day services would be defined. I wanted to get a better picture of what these services would look like.<\/p>\n<p>My request for a definition of \u201cseven day services\u201d from the Department of Health <a href=\"http:\/\/careers.bmj.com\/careers\/advice\/Health_department_refuses_to_release_correspondence_defining_seven_day_working_\">was refused on the grounds<\/a> that the information we were asking for \u201crelates to the formulation or development of government policy.\u201d\u00a0<a href=\"http:\/\/careers.bmj.com\/careers\/advice\/BMA_urges_government_to_define_%25E2%2580%259Cseven_day_services%25E2%2580%259D_\">This is important because the public need to know<\/a> what Cameron is promising them and doctors need to know what they are being signed up to offering.<\/p>\n<p>My request to NHS England specifically referred to correspondence between Bruce Keogh and David Cameron about the definition of seven day services. In response to our request, <a href=\"http:\/\/www.bmj.com\/content\/351\/bmj.h4637\">NHS England said there had been no correspondence on this topic<\/a>.<\/p>\n<p>The fact that Cameron had not formally consulted Keogh is interesting because, for the past two years, Keogh has been leading NHS England\u2019s work on seven day services. <a href=\"http:\/\/www.england.nhs.uk\/wp-content\/uploads\/2013\/12\/brd-dec-13.pdf\">He chaired the NHS Services, Seven Days a Week Forum<\/a>, which was established to consider how NHS services can be improved to provide \u201ca more responsive and patient centred service across the seven day week.\u201d As its first piece of work, the forum was asked by NHS England to focus on urgent and emergency care services and their supporting diagnostic services. As a result, the forum produced a report called \u201c<a href=\"http:\/\/www.england.nhs.uk\/wp-content\/uploads\/2013\/12\/forum-summary-report.pdf\">NHS Services, Seven Days a Week Forum, Summary of Initial Findings<\/a>,\u201d which included 10 clinical standards for seven day services.<\/p>\n<p>After that report was completed, NHS England asked the forum to do another piece of work, setting out proposals for the \u201c<a href=\"http:\/\/www.england.nhs.uk\/ourwork\/qual-clin-lead\/7-day-week\/\">creation of a fully integrated service delivering high quality treatment and care seven days a week.<\/a>\u201d This report was due to be published in the autumn of 2014. But when I searched for this report I couldn\u2019t find it. So I sent an FOI to NHS England asking them for a copy of the final report produced by the NHS Services, Seven Days a Week Forum established by Sir Bruce Keogh.<\/p>\n<p>In response to my FOI request, NHS England told me that, \u201cthe latest report from the NHS Services, Seven Days a Week Forum was published in December 2013 [and] is available with supporting information, case studies, and evidence.\u201d And they provided the link to the \u201c<em>NHS Services, Seven Days a Week Forum, Summary of Initial Findings<\/em>\u201d report. I then went back to them, because to me \u201cinitial findings\u201d implied that there was more work to be done.<\/p>\n<p>In response to this FOI request, NHS England told me that the proposal for the forum to report again in Autumn 2014 had been overtaken by \u201cthe publication of the \u201c<em>NHS Five Year Forward View<\/em> in October 2014.\u201d It said the <em>Five Year Forward View<\/em> \u201csets out how the NHS will tackle variations in the quality of care, including when patients are able to access services.\u201d<\/p>\n<p><a href=\"https:\/\/www.england.nhs.uk\/wp-content\/uploads\/2014\/10\/5yfv-web.pdf\">The Five Year Forward View document is 38 pages long<\/a>. Seven day services are mentioned twice. In the report it says that to \u201creduce variations in when patients receive care\u201d the NHS \u201cwill develop a framework for how seven day services can be implemented affordably and sustainably, recognising that different solutions will be needed in different localities.\u201d It also says that over the next five years the NHS will ensure that hospital patients have \u201caccess to seven day services where this makes a clinical difference to outcomes.\u201d That is it. There is no further detail of how this will be achieved, or what might be meant by seven day services.<\/p>\n<p>Hunt has said that he expects &#8220;<a href=\"https:\/\/www.gov.uk\/government\/speeches\/making-healthcare-more-human-centred-and-not-system-centred\">the majority of hospital doctors to be on seven day contracts<\/a>&#8221; by 2020. But the government is refusing to tell doctors what a seven day contract might look like.<\/p>\n<p>Hunt has also said he thinks that the NHS as a whole can be judged on how it manages care across the weekend. He has described the NHS&#8217;s approach to seven day services as a &#8220;<a href=\"https:\/\/www.gov.uk\/government\/speeches\/making-healthcare-more-human-centred-and-not-system-centred\">litmus test of our commitment&#8221; to making healthcare &#8220;more human-centred and not system-centred<\/a>.&#8221; And, at the very same time, the government is refusing to tell NHS staff what it means by seven day services.<\/p>\n<p>Doctors, and all other NHS staff, are in a situation where the government will lambast them for failing to deliver seven day services, while refusing to tell them what it wants them to deliver.<\/p>\n<p>The government is steadily building patient expectation, telling the public they will soon be able to access NHS services seven days a week. The government should be held to account for this promise. My worry is that, when patients do not get the seven day care they have been led to expect, it will be doctors, not politicians, who get the blame.<\/p>\n<p><em>\u00a0<strong>Abi Rimmer<\/strong>\u00a0is BMJ Careers news reporter.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>What exactly are \u201cseven day services?\u201d This is something that I have been wondering ever since David Cameron announced in March that the NHS would run a seven day service [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2015\/09\/04\/abi-rimmer-seven-day-services-lack-definition\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[236],"tags":[],"class_list":["post-35105","post","type-post","status-publish","format-standard","hentry","category-nhs"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - 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