Seven day working will require investment in staff, says BMA

Seven day working among doctors will require investment in staff and resources, the BMA has said.

Delegates at the association’s Annual Representative Meeting voted unanimously in favour of a motion that recognised that many doctors “already provide seven day emergency services.” The motion said that delivering seven day routine and elective services “is not feasible within the current NHS budget constraints leading to reduced clinical services Monday to Friday and/or closure of hospitals.”

The conference also voted in favour of a motion that said that “provision of seven day healthcare requires investment in medical staff and supporting resources and not merely the reorganisation of services.” The motion added that any contract negotiations on seven day working “must take account of infrastructure and support services, compensation for antisocial hours, and family friendly working.”

Earlier this year Paul Flynn, chairman of the BMA’s Consultants Committee, said that the consultant workforce would have to expand significantly to provide cover seven days a week.1

Presenting the motion, Reinhard Heun, of the West Midlands division of the BMA, said that the motion was not about objecting to seven day services. “It’s about clarifying which conditions must be [met] to make sure that it is workable for patients and doctors,” Heun said. “It stresses the need for necessary investment and safeguards. If we and the public want seven day routine services that go beyond the current provisions, then there is a need for investment.”

Trevor Pickersgill, deputy chairman of the BMA’s Welsh Consultants Committee, spoke in favour of the motion. “The government do not get it. We do this already,” Pickersgill said. “I’d be happy to do clinics on a weekend, maybe occasionally, with appropriate pay, not just because I’m a professional. But I would like to know which bit of my Monday to Friday work, which keeps me there for probably 50 hours, they want me to do in lieu of that.

“I want there to be phlebotomy, I want there to be support nurses, I want there to be secretaries, I want there to be administrators, I want there to be typists, I want there to be people to show people where to go, [and] I want there to be radiographers to do routine tests that I want done on a routine patient,” Pickersgill added.

Also speaking in support of the motion, Krishna Kasaraneni, chairman of the GP trainee subcommittee of the BMA’s General Practitioners Committee, said that primary and secondary care lacked the resources and the workforce to provide seven day services. “GPs, consultants, junior doctors, and SAS (staff, associate specialist, and specialty grade) doctors already work 24 hours a day, seven days a week providing urgent emergency care for our patients,” he said. “When we talk about seven day services as something to aspire to, it already happens.”

He added, “The NHS does not have an endless supply of doctors or an endless pot of money. Therefore, GPs and secondary care need significant investment to complement each other’s work before any instance of routine care seven days a week is to be considered. If not, it will lead to closure of not only hospitals but also GP practices.”