Intended for healthcare professionals

Rapid response to:

Head To Head

Should the NHS work at weekends as it does in the week? No

BMJ 2013; 346 doi: https://doi.org/10.1136/bmj.f622 (Published 21 February 2013) Cite this as: BMJ 2013;346:f622

Rapid Response:

Re: Should the NHS work at weekends as it does in the week? No

I cannot vote yes to the question posed because I do not believe it is possible for the NHS to work at weekends exactly as it does on weekdays but I am sympathetic to attempts to provide more and better services at weekends. A considerable number of problems would need to be overcome to make this possible.

Foremost in my mind is the provision of training to young surgeons. The amount of contact time I have with my trainees is already sub-optimal, largely as a result of the European Working Time Directive. My trainees miss a quarter of the operating lists, clinics and ward rounds where training might take place because of rota commitments (and miss more because of various types of leave). If I were to work on Saturdays and/or Sundays and have compensatory days off on week days, it would be essential that my trainees should do the same. This might be intolerable for young surgeons with young families.

I am also concerned about continuity of care. Cover arrangements in hospitals at weekends are constructed on the assumption that only the consultant led team on duty will be around. This presents some problems but is arguably better than a system under which various consultant teams are absent on various days in the week when cover arrangements are not robust. My own stage in life and career is such that I would be willing to consider working at weekends and having time off in the week - my No vote does not indicate a Luddite attitude - but I would only accept it if it were also acceptable to trainees and adequate continuity of care could be guaranteed. I am not convinced that these requirements could be met.

Competing interests: I am a consultant surgeon and might be affected by changes in working practices for NHS hospital doctors

01 March 2013
Stephen Brearley
Consultant surgeon
none
Barts Health NHS Trust
Whipps Cross University Hospital, London E11 1NR