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by GK Strategy 19th July, 2016

Seven day NHS: will May continue the uphill battle?

The Conservative’s grand plans for a seven-day NHS service took a further battering today as more compelling criticism surfaced on the Government’s capacity to deliver its bold manifesto pledge.

Professor Bion of Birmingham University, who is leading on a major NHS-funded research project on introducing more services at weekends, has called a seven-day service “unachievable” for at least another 20 years as a result of persistent underfunding and understaffing as per the current funding settlement, despite the additional pledged £10bn for 2015-2021.

The supposed extent of the increase to NHS funding across the course of this Parliament was questioned further today in a damning report from the House of Commons Health Select Committee. Sleight of hand and creative accounting have been at play to boost NHS England’s budget according to the Committee’s report into the impact of the 2015 spending review. As such, the Health Select Committee determine claims on NHS funding over this Parliament have been grossly exaggerated, and is closer to £4.5bn rather that the double digit figures being deployed by the Department.

Funding issues aside, the other lever at play to make seven-day services a reality is the workforce. NHS England’s Chief Executive Simon Stevens authored an article in this morning’s Telegraph stating that foreign NHS workers must be given assurance by the Government that they are still welcome in this country, echoing public sentiments from a number trust Chief Executives following the Brexit vote. However, with the number of EU workers in the NHS equivalent to the existing vacancy gap, the scale and scope of the problem remains vast and the solutions uncertain.

And so it appears there is not the money nor staff available to make seven-day services a reality for this Government. Seven-day services is very much Cameron’s baby – it was the theme of his first speech as Prime Minister of a majority government in May of last year, and became a flagship policy of his Government. The junior doctors’ contract dispute – which so severely impact the public’s perception of the NHS in the hands of the Tories – was rooted in delivering seven-day services.

The risk for the Government on moving away from seven-day services will be that it was mandated on the premise it would enhance patient safety and care on weekends. Moving away from this stance will signal one of two shifts in position for the Government, both equally unfavourable; conceding that it misrepresented data on weekend mortality to inform and drive this work, or that it no longer deems weekend mortality rates a priority.

The NHS is and always has been a politically sensitive issue. However, while the general public favour seven-day services, they are level-headed about its practicalities, with 83 per cent stating it should not be pursued if it impacts the availability of services on week days, suggesting the public has overriding priorities beyond seven-day services for the future of the NHS. The ultimate decision in the direction for the NHS lies under the new leadership of Theresa May, and whether she will be bold enough to abandon the pledge and re-direct efforts and critical funding elsewhere.

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