So in the latest political gambit it seems Jeremy Hunt's vision of the NHS is far from what he already understands. This weekend has seen my fellow colleagues around the country posting #ImInWorkJeremy to prove the NHS is staffed with doctors at weekend. So here's my letter to you Mr Hunt...
Dear Mr Hunt,
Your vision of a 7-day NHS is something all doctors want. However, the message you've portrayed to the media and what the public percieve of us is truly damaging to the huge efforts and personal individual investments we doctor put not just into our career, but personal life too - all for the sake of doing the greater good the general population.
I would first like you to clarify where you received your statistics and how you have concluded what you claim.
The study by Freemantle et al (http://jrs.sagepub.com/content/105/2/74.full) states that patients admitted as emergency on a Sunday vs. Wednesday has a hazard ration of 1.16. HOWEVER, and this the big BUT, the same paper quotes "being an inpatient in hospital on Sunday, regardless of the day of admission, was associated with a lower risk of death (on that day) than Wednesday ....Similarly, Saturday was associated with reduced risk of in-hospital death compared with Wednesday..."
The above image sums up well the false claim you have made. Patients admitted on a weekend day have a higher risk of subsequent mortality, but this will not be because of lack of doctors. We already see the day of death is higher during the week. Therefore your publicly announced argument is a political LIE.
More likely is that social care services and GP services are unavailable at weekend, so the ill patient who has been struggling all week finally gives up and ends up in A+E at the weekend. They are self-selected as sicker patients.
May I add, elective admissions generally do not occur at weekends except for minor day case procedures and local anaesthetic cases. However, with government targets, many Trusts run Waiting List Initiatives (which I hope you are aware of) where surgeons, nurses and ward nurses are paid extra to run additional sessions in order to save a waiting list breach. However, often the staff of these sessions are occasionally with locum surgeons and nurses. Again, this self-selects a substandard care.
Further, if you were to be unwell anywhere in this country, you will go to an A+E department and you will be in the vicinity of an A+E Consultant. Followed by your specialty Consultant. Consultants, Registrars and Junior doctors staff a hospital day and night. Doctors includng Consultant already work weekends! However, services are spread thinner, granted.
I ask you this, how do you intend to construct the new Doctors Contracts to comply with European Working Time directive? If you want more doctors at weekends, will you pull staff from during the week?
I would first like you to clarify where you received your statistics and how you have concluded what you claim.
The study by Freemantle et al (http://jrs.sagepub.com/content/105/2/74.full) states that patients admitted as emergency on a Sunday vs. Wednesday has a hazard ration of 1.16. HOWEVER, and this the big BUT, the same paper quotes "being an inpatient in hospital on Sunday, regardless of the day of admission, was associated with a lower risk of death (on that day) than Wednesday ....Similarly, Saturday was associated with reduced risk of in-hospital death compared with Wednesday..."
The above image sums up well the false claim you have made. Patients admitted on a weekend day have a higher risk of subsequent mortality, but this will not be because of lack of doctors. We already see the day of death is higher during the week. Therefore your publicly announced argument is a political LIE.
More likely is that social care services and GP services are unavailable at weekend, so the ill patient who has been struggling all week finally gives up and ends up in A+E at the weekend. They are self-selected as sicker patients.
May I add, elective admissions generally do not occur at weekends except for minor day case procedures and local anaesthetic cases. However, with government targets, many Trusts run Waiting List Initiatives (which I hope you are aware of) where surgeons, nurses and ward nurses are paid extra to run additional sessions in order to save a waiting list breach. However, often the staff of these sessions are occasionally with locum surgeons and nurses. Again, this self-selects a substandard care.
Further, if you were to be unwell anywhere in this country, you will go to an A+E department and you will be in the vicinity of an A+E Consultant. Followed by your specialty Consultant. Consultants, Registrars and Junior doctors staff a hospital day and night. Doctors includng Consultant already work weekends! However, services are spread thinner, granted.
I ask you this, how do you intend to construct the new Doctors Contracts to comply with European Working Time directive? If you want more doctors at weekends, will you pull staff from during the week?
Additionally, do you realise physiotherapists, occupational therapists, pharmacists, specialist lab technicians, porters, cleaners, radiographers all run reduced/no services at weekends. They are all NON-doctors who are essential to running of a hospital during a normal day, facilitating care and discharge. Social Service do not operate at weekends either. Ploughing more doctors into a weekend will NOT make the hospitals run more efficiently or reduce mortality without the rest of the NHS services fully running at weekends too.
Finally, I will end this by asking you closed questions:
- Will you make a national apology for the misinterpretation of the statistics you have stated?
- Will you make a national apology to doctors for further destroying there ever so reducing morale under govermentment schemes?
- Will you state a plan on how you will run a 7-day NHS with which the ESSENTIAL allied health professionals and social services are available and fully functional at weekends?
Your kind regards,
Mr Steth
