When seven is heaven: Funding and resources for seven-day services

Seven-day services have emerged as one of the key priorities in the NHS and it’s easy to understand why. There is a clear opportunity to improve clinical outcomes for patients by providing seamless care across the whole week.

 

This could have a positive impact on many areas of work for CSP members, including delayed transfers of care and rehabilitation. But there are risks attached to rolling it out across the country and we addressed these in a detailed submission to the NHS pay review body (PRB) to inform the consultation it is carrying out.

 

We believe any new seven-day services should feature four characteristics. They should focus on improving the quality of care for patients in terms of their outcomes and their experience. They should be based on the principles of integrated service delivery. They should be properly funded and resourced. And they should maintain quality employment for  those involved..

 

Asking the PRB to look at the issue, the government stated that the shift to seven-day services should be made within existing budgets. Our fear is that against such a difficult financial backdrop, employers will simply seek to stretch the five-day service over the whole week. It is hard to see how this can be achieved without cutting either services or the pay of the staff delivering them. So what should employers do?

 

In our submission, we set out a good practice case study involving a trust that was looking to extend service provision for two musculoskeletal streams, acute and rehabilitation. It launched an extensive consultation that included discussions at staff meetings and focus groups involving clinicians, union reps and team leads. Management supplied full financial information, including how many additional staff could be afforded and the skill mix required, and presented detailed costings for several options that the focus groups could discuss.

 

The options were debated and narrowed down to three, which were then taken back to staff who were asked to vote for their preferred option. Following further discussions with union reps, a final proposal was made and a 30-day consultation launched. No fundamental changes were made to job roles and no-one was expected to work outside their specialism. With full agreement, the changes were made but only once sufficient staff were in place.

 

Let that be the template for action: quality services and quality jobs are inextricably linked. Any employer considering introducing seven-day services must work closely with trade unions and professional bodies. While the Westminster government remains focused on delivering seven-day services at the expense of the workforce, the Welsh Government  evidence to the PRB stated: ‘We want seven day services to improve and make NHS health care more prudent rather than simply expand it.’