Posted by: ayrshirehealth | October 14, 2015

Seven Day Working – Part 1 by @andrew_AMD


  1. I work a 7 day week unpaid as a blogger, activist and campaigner in mental health matters. I am now a pensioner, basic monies, while still giving carer support, unpaid, to two sons who are on Disabled Living Allowance due to mental disorder diagnoses/labels.

    I can understand this rant but it’s not doing anything for me, in terms of capturing my interest. Maybe others will identify with it. I don’t know. Just like this Associate Medical Director blogger.

    The difference being that he is getting paid and I ain’t. If he disnae have the answers then we’re all up the creek without a paddle.

    Just saying.

    • I have worked in the health service for over 30 years and have allways questioned why some departments are closed at weekends with an on call service provided as back up, and thousands of pounds worth of equipment lying un used all weekend and in some cases from 5pm untill weekdays, this is a mindset that most are programed to work in, and our politicians decide the funding based on that very same mindset. whilst I appreciate the stance taken by Chrys on a personal basis, the bigger picture is not wages persay but overall funding and managing of that funding in a more targeted way, beter care in the community can clear bed blocking, more flexible consulting hours by GPs can avoid unnessasary A+E visits, the soloutions are there if someone is prepared to step outside the bubble and look, its time for a radical reform not only of the service but of the people who provide that service. Rant over.
      S Donlon

  2. I love these can-do attitude folks. I’d like to think I’m one too. I think that seven days of equal effort would indeed improve patient care. I am old. So old that when I was at school O Grade arithmetic still existed. I do hope that there is no expectation that we work seven days a week but rather any five of seven? Were I younger I might wonder whether I’d be able to get “weekend” quality time with my kids on my wednesdays and thursdays off, i.e. will the schools be on seven days a week too? The point being that weekends ARE different in our society. Arithmetic also comes in when adding all the wages up for the new staff required to fill all these hours – I doubt NHS A&A could afford to pay the parking wardens for the weekends let alone the rest of us. It is far more realistic to look to better systems to make weekends safer for patients. That should be do-able but will still need a willingness to change among senior as well as junior staff. My last arithmetic query is over the 11000 lives to be saved. Stats like this can mean almost anything, or nothing and in this usage looks like a moral bludgeon to a staff doing its best with too many patients each. Now that’s arithmetic.

    It’s where we must end up? Frankly I don’t know.

    Steven Lawrie

  3. Ok. So.
    There is no doubt that Monday-Friday 8-5pm are drastically different from weekends and holidays in our acute hospitals, GP surgeries, IJB hubs, pharmacies, community hospitals…etc. It’s great to shout #iminworkjeremy but just stand in the car parks and the difference is obvious. The solution however, is much less clear.
    Our patients and carers need more. We need more. As you say, Monday’s would be much less stressful if we had true and equal 7 day working. But here’s the problem. It will cost. And cost lots. We can’t even afford 5 day care it seems. And if our acute hospital demographic continues the way it has, the people needing our services will be even more complex and they will need complex community provision when they are ready to leave. Jeremy Hunt and his allies have chosen to shine a light on the medics as the obstacles to a 7 day NHS. Those of us with any knowledge of who our patients are know that medics are but a small link in a very long chain. Our frailer and older patients need all the links to be connected for a successful outcome. That means Drs, nurses (the only link that does actually provide a 7 day service in ED and in the wards), technicians, AHPs, pharmacists and of course, the elephant in the room….social care and its decision makers. Integration helps but will it really change entrenched working patterns?
    All that we can realistically offer within current resources is an equal service across 7 days. The hard sell would be that this would be a reduced service across 7 days because there simply isn’t enough money and there aren’t enough of us (and by ‘us’ I mean all of us in health and social care) to extend all that we currently provide 5 days to 7 days a week.
    And I’m not sure that the public, politicians or indeed healthcare professionals would be willing to buy this.

    • Absolutely agree that 7 day working needs to be adopted by everyone who has a role to play in caring for and supporting our frailer and older people. Delighted to say North Ayrshire Health and Social Care Partnership already provide a seven-day-per-week Care at Home service that does just that and helps individuals to return home from hospital at weekends, just as we do during the week. We are looking to build on this by piloting 7 day working in our equipment store to ensure anyone who needs an aid or piece of equipment to stay at home or return home can access it without delay. Developing services in this way is vital to ensuring we fully meet the needs of local people.

  4. Great blog Andrew. I respect your courage in saying.. you don’t know the answer.
    I am sure no one person will have the answer … surely collectivley we can come up with some ideas and workable solutions.

  5. The cynical view would be you want your cake AND you want to eat it!

    Its not a difficult argument – in fact its quite simple. If we want our health service to deliver over 7 days then we need to fight for it and make the difficult choices as a society that currently we seem unable to make.
    I don’t care to try and count how many times we’ve all agreed that “working differently” is required and that currently how we do things is unsustainable. I get that. What I can’t get is that we are still stuck going round in circles on this and with little sign of a solution in sight.

    If we truly want it then I suspect something has to give at the moment and that might mean paying for it. Are we willing to pay for it? Tax rise anyone?


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