In 2015, Jeremy Hunt, secretary of state for health, during a joint interview with Dr Mark Porter, British Medical Association (BMA) president, on Radio 4 suggested that the tragedy of the Mid Staffs event indicated that the NHS was in need of a radical change to prevent such an event occurring again by ensuring that newly appointed consultants were not given the ‘opt out’ of weekend cover. Effectively making the NHS a Monday to Friday service in some departments, with ‘tragic consequences’ that had resulted in approximately 6,000 preventable deaths year on year since 2003.
Hunt also stated that he was supported by Dr Mark Porter in this endeavour, although Dr Porter suggested that the Government proposals were too simplistic and requested a more robust level of information on two points. Firstly, where is the extra funding going to come from and secondly, how will the NHS ensure that mid-week services were not going to be compromised.
The BMA argues that in order to improve care at the weekends the community services should be able to offer support services such as diagnostic and pathology while not forgetting the crucial role of care in the community to allow patients to be discharged. Mr Hunt has suggested that 5,000 more GP’s and practice nurses will be recruited to facilitate seven-day week GP services. The issue that many are concerned with, according to a survey carried out by the BMA, is how the NHS is going to afford seven-day services in the first place. The central concern raised by some of the junior doctors is that Mr Hunt has refused to negotiate 22 out of the 23 points that the BMA has brought to the discussions. They have even gone as far to say that the Government is not listening and are almost rail roading the BMA and its members into a new contract that’s unsafe.
Additionally, rather than giving junior doctors an 11% pay increase they are actually cutting their pay by up to 40% by extending the margin between ‘flat pay’ criteria.
The issue here does not only lie with Medics, regardless of seniority, but also nursing staff, with services being placed in jeopardy due to the cuts of senior nurse roles. This has seen a reduction in senior posts by 3% since 2010 and the temporary inclusion of nurses to the ‘shortage occupation list’ which will allow nurses from outside the European Economic Area (EEA) to have their applications prioritised. The former Royal College of Nursing president, Dr Peter Carter, suggested that nursing staff as a whole, along with senior expert nurses, are a huge part of the solution to the realisation of delivering seven day care. Ultimately, the question has to be about the funding and where it is going to come from.
It is clear that the NHS is unable to continue to function in its current format. The influx of refugees into the UK means that the population requiring medical care is going to increase year on year. Nurses, midwives, physiotherapists and dieticians already provide a seven day service – from CVA’s, MI’s to babies and fractures – none of which have ever happened between 9 and 5pm.
The BMA have suggested that the Government are simply giving with one hand only to take away with the other. The fact remains that change can be a difficult process and resistance is a natural reaction. However the central point to all this is the patients whom we care for seven days a week. Lest we forget that there is no ‘I’ in the word ‘team’ – good communication from all levels enhance the durability of the team in the first place, encourages growth, provides stability of professional values and ultimately enhances the patient experience that has got to be worth change as difficult as it may be.