A health think tank has challenged the government's plan for a full seven-day service in England's NHS.
In a Scrubbing Up column for the BBC News, Nigel Edwards, chief executive of the Nuffield Trust says the hundreds of millions of pounds it will cost could be better spent elsewhere.
He said other areas for investment include improving out-of-hospital services and tackling sepsis.
The government says it is determined to improve care at weekends.
Plans for a seven-day NHS have provoked a bitter row between the government and doctors' representatives.
Ministers argue thousands of people die every year because there is not the same level of service at weekends as during the week.
The British Medical Association, which represents doctors, says the government has failed to set out what its policy means in practice, and what it will cost.
It points out that many doctors already work at weekends.
In an exclusive interview and article for the BBC's "Scrubbing Up" column, the Nuffield Trusts's chief executive, Nigel Edwards, says a seven day NHS is a good aspiration.
"Tough trade-offs"
But he argues the health service is in a world of "tough trade-offs", with many hospitals only managing to meet their current commitments by running up deficits.
He concludes the policy is likely to cost hundreds of millions of pounds, and suggests - in the current climate - there are better ways of spending the money.
In his column. he says: "NHS policy is largely made by middle-aged, middle-class men and women who commute long distances into London and Leeds."
Shouldn't we think of funding out-of-hospital services as a priority - as much as focusing yet again on hospitals, and making sure they can offer appointments over longer hours?
Nigel Edwards, Nuffield Trust
Mr Edwards added: "I think one compelling priority would be to try and shorten the time that patients stay in hospital.
"A seven-day-service helps a little with that but actually this is more about investing in community services and getting the decision-processes in hospitals a lot slicker. And we could do that, probably, more easily".
He says there may also be benefits from focusing on individual conditions.
"Another area would be sepsis, which has a very large toll of mortality, probably much more significant than seems to be associated with seven day working.
"Putting in some measures to spot that early and to intervene in a more effective way would have a big effect on people."
'Upfront costs'
Health Secretary Jeremy Hunt has defended the push for a seven-day NHS. He acknowledged there may be "upfront costs" of hundreds of millions of pounds, but he told the BBC there may also be similar levels of savings because of improved discharge from hospital.
He also argued the government was investing in other areas such as the new meningitis B vaccine, new cancer drugs and dementia.
We know that thousands of people die every year avoidably because we don't offer the same level of service at weekends as we do in the week
Jeremy Hunt, Health Secretary
And he insisted there was strong support in the health service for the seven-day plan.
"For doctors who are totally passionate that the NHS should offer the best and safest care anywhere in the world, the knowledge that thousands of people die every year because we don't offer the same level of service at weekend as we do in the weeks is something that really worries them."
The chief executive of the Sepsis Trust, Dr Ron Daniels, welcomed the proposed emphasis on tackling the problem, which kills an estimated 37,000 people every year in the UK.
"Reducing deaths from sepsis is not rocket science but there's been relatively little investment in dealing with the problem.
"A stronger approach to tackling sepsis would be the quickest win towards saving lives and would require much less investment than a move to full seven-day services in the NHS."
collect by...http://www.bbc.com
No comments:
Post a Comment