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Should the NHS work at weekends as it does in the week? Yes

BMJ 2013; 346 doi: (Published 21 February 2013) Cite this as: BMJ 2013;346:f621
  1. Bruce Keogh, NHS medical director
  1. 1Richmond House, London SW1A 2NS, UK
  1. Bruce.Keogh{at}

Some royal colleges recently advised that patients should get the same consultant led care at weekends as they do on weekdays. Bruce Keogh agrees that this would benefit patients, but Paul Flynn (doi:10.1136/bmj.f622) sees little justification for elective care at weekends and asks who’s going to pay

Initially conceived in 1940s America to respect Christian and Jewish practices, the weekend has been universally adopted in Western countries as protected personal time. In the UK challenges from high street retailers resulted in a change to the Sunday trading law in 1994. Since then, social behaviour has changed profoundly. Public expectations of service provision for customer convenience have resulted in the provision of routine services seven days a week in many industries—but not in healthcare.

This is a shame because extending the service would offer the opportunity to improve clinical outcomes with the added benefit of a much more patient focused service.

Weakness of current system

The NHS provides essential emergency care but not regular routine …

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