Thursday, 15 January 2015
Merger proposals for 7-day working
A high profile national goal for the NHS is so-called '7-day working' and all hospitals are thinking how to achieve it. Clearly it will be very expensive in an environment where all NHS Trusts are strapped for cash and many are in, or heading for, a deficit. Many studies have shown that quality of care in the NHS is much reduced at weekends and death rates are higher and so ensuring that care is as good at weekends as in the week is extremely important: that is what 7-day working seeks to achieve.
The Royal Surrey has studied its position and would find it extremely difficult to achieve 7-day working albeit there might be little choice in the medium term. Ashford and St Peters are in the same position. The assertion is that, by merging, 7-day working becomes a viable proposition. For example if RSCH has 2 consultants in a specialty getting than to accept that one of them must always be present in the hospital and doing ward rounds etc. on Saturdays and Sundays would be difficult if not impossible. To recruit further consultant resource would be expensive even if recruitment was practical. However if ASPH also had two consultants in that specialty and there was a merger, then a rota between 4 consultants becomes possible. Thus goes the argument.
It is important to understand what 7-day working means. Much of the merger documentation uses this term without explanation leading some with the impression that the whole hospital would work exactly the same every day of the week. That is no so. Outpatient Departments would not change. 7-day working refers to inpatients and essentially to consultants being available on one or other of the sites and doing ward rounds etc. (plus necessary support functions e.g. diagnostics). It also does not refer to all specialties. Merger documentation currently refers to stroke, GI (gastrointestinal) and interventional radiology although others might come on board.
Thus the merger benefits of 7-day working as currently described are limited but nonetheless very worthwhile. They might have to be realised anyway without a merger but with more difficulty and greater expense.