Intended for healthcare professionals


Skirmish over seven day working

BMJ 2015; 351 doi: (Published 29 July 2015) Cite this as: BMJ 2015;351:h4082
  1. Mark Newbold, professor of health leadership
  1. 1Aston University, Birmingham, UK
  1. marknewbold51{at}

Would more effective leadership of the profession have avoided this debate?

Doctors have reacted with dismay and anger to the approach taken by the secretary of state for health, Jeremy Hunt, over seven day working and contract renegotiation,1 with many using social media to remind him that, actually, they regularly work at weekends.2

His challenge to the BMA on contract changes to support seven day working came during a speech that was mostly about a grand vision for the NHS.3 Indeed, it was almost an adjunct to his main message, which described the creation of a more “human” service in which power will shift from politician, doctor, and manager to the patient.

The vision he articulated includes much that will be welcomed by doctors and managers, including a move from access targets to broad quality metrics, fewer targets in return for greater transparency, and a learning culture with much more local autonomy. These all point to a cultural change that is long overdue.

Most will also support the increased use of technology to empower patients and the placing of safety and quality at the heart of the new regulator, while few will argue with his proposal to end the target based regime …

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