Millions of patients will benefit from ground-breaking plans for 7-day access to both their GPs and hospitals, the Prime Minister has announced.
David Cameron has revealed details of a new, voluntary contract for GPs to deliver 7-day care for all patients by 2020. He has also unveiled proposals to deliver 7-day hospital services across half the country by 2018. These are the next steps in making England the first country in the world to provide a truly 7-day health service, underpinned by a strong economy and £10 billion of investment in the NHS. The plans are a key part of the government’s commitment to deliver security, stability and opportunity for the British people.
The government reports it has listened to GP leaders who say that the time has come for a new, voluntary contract option for general practice, integrated with community nurses and other health and care professionals, to provide more seamless, person-centred care for patients. That approach is embedded at the heart of NHS England’s Five Year Forward View.
The new contract will be funded with money from within the £10 billion of additional investment on the back of a strong economy and that will be set out in the Spending Review. It will aim to provide more money for primary care, more control for GPs over the way they work and more time to care for patients, and services 7 days a week. It will remove the bureaucratic box-ticking of the 2004 GP contract – freeing up GP time to provide the quality of care that they and their patients want. Micro-management of GPs’ work through the Quality and Outcomes Framework and other sorts of old-fashioned bureaucracy will be scrapped, giving doctors far greater professional control.
The government is also committing £750 million over the next 3 years to fund improvements in premises, technology and modern ways of working, such as supporting federations and larger practices in providing 7-day services through a flexible range of face-to-face, telephone, email and Skype consultations.
A number of hospitals and NHS staff are already delivering 7-day care. For instance, in Chesterfield, scans and tests can continue at the weekend,; in Northumbria, there are consultant-led services for emergency patients 7 days a week; Wigan runs a lung disease service 7 days a week to help keep patients well at home.
But the government believes there remains far too much variation and it is now guaranteeing, by the end of this Parliament, that patients who need to be in hospital will receive the same high quality assessment, diagnosis and treatment as on any other day of the week. By 2017, a quarter of the population who have urgent or emergency hospital care needs will have access to the same level of consultant assessment and review, diagnostic tests and consultant-led interventions 7 days a week.
The government is now giving the NHS the concrete objective of achieving 50% population coverage to those standards by 2018, and complete coverage by 2020. As part of its new ‘patient guarantee’, the Prime Minister announced that the government intends to make it a requirement in its new mandate to NHS England that they and clinical commissioning groups should ensure that every patient has access to 7-day services by 2020. It will be setting out clear milestones for delivery in the coming months and believes that by improving access to primary care, pressure on A&E and other emergency services within the NHS will be relieved.
David Cameron says: “Our plans for a truly 7-day NHS will transform services for millions of patients. It will offer hardworking taxpayers and families the security of the care they need at a time that is convenient to them. I want to pay tribute to the fantastic work of GPs and indeed all NHS staff across the country.”
New GP contract
The government wants GP practices to work together so that they have the scale to provide additional services that people value so much. The new voluntary contract will enable GPs to continue to work in local neighbourhood surgeries and health centres, with all the traditional benefits of family practice, but they will be able to join forces with neighbouring GPs to form federations and networks of practices – allowing them to deliver better integrated care and work more closely alongside community nurses, hospital specialists, pharmacists and other health and care professionals.
This will help to break down old-fashioned boundaries between GPs and hospitals, between physical and mental health, between health and social care – and enable the NHS to work better with local communities to keep people healthy and avoid unnecessary hospital admissions.
The new contract will be offered to GPs on a phased basis, starting with those groups of GPs that are most ready to work in this new way and building on the success of the pioneering Prime Minister’s Challenge Fund for GP access and the NHS vanguards. In addition, the government’s £750 million GP access fund will be subject to a bidding process, with applications to be received by the end of the year and the first schemes approved in 2016.
7-day services in hospitals
The plans will mean a dramatic improvement in standards of patient care at weekends. In the first phase, at least a quarter of the population will, by 2017, have access to services which meet the key 7-day clinical standards recommended by Prof Sir Bruce Keogh, the NHS Medical Director and supported by the Academy of Medical Royal Colleges.
Whatever day of the week it is, if patients are admitted to hospital in an emergency, they will be seen and have a thorough assessment by a suitable consultant as soon as possible and no more than 14 hours after arrival, over and above other treatment. If they are in a high dependency ward, they will be seen and reviewed by a consultant twice daily. If they are on a general ward, they will be reviewed during a consultant-delivered ward round at least once every 24 hours, 7 days a week. Now, only 10% of hospitals report that they meet this standard in all their clinical specialities measured in the baseline – falling as low as 33% of patients in geriatric medicine.
Whatever day of the week it is, inpatients will get the full range of diagnostic tests, such as x-ray, ultrasound, and MRI – and then will be given the results without delay. And they will get quick access to any urgent consultant-led treatment they need. Now, just over 10% of hospitals across England report that they provide all 14 of the diagnostic services 7 days – though all the evidence shows that in tackling diseases like cancer, early diagnosis and treatment are the key factors in improving survival rates. Currently there is only 52% availability over 7 days for echocardiography results.
