NHS staff abandon ship on Fridays and weekends, expert warns

NHS hospitals are not being used to “full capacity” every day of the week, with some turning into the “Mary Celeste” on Fridays, a consultant has warned.

Dr Andrew Stein, a kidney specialist, said the NHS “will not function [or] hit any target” until it operates a seven-day service. The 2015 Tory manifesto pledged that by 2020 everyone could see a GP seven days a week from 8am to 8pm, and that hospitals would be “properly staffed, so that the quality of care is the same every day of the week”.

The Conservatives had also committed to ensuring anyone needing urgent care would have access to the same level of consultants, tests and interventions “whatever day of the week it is”.

But Dr Stein, who co-authored a 2013 NHS report that found patient outcomes were affected by the day of the week, said the health service still does not provide a full seven-day service.

“The NHS will not function, we will not hit any target… until we work seven days a week, which would seem to me to be appropriate for a developed country,” he told Radio 4’s Today programme.

The NHS is facing a record backlog of seven million patients waiting to start treatment and more than 460,000 waiting longer than six weeks for a key diagnostic test. NHS data also show patients are 25 per cent more likely to be stuck in hospital on weekends, compared with weekdays, despite being fit to leave.

Some 70 per cent of patients who no longer meet the criteria to remain were still in hospital on Sundays, on average, between December 2021 and October 2022, compared with 54 per cent who were not discharged on Wednesdays.

Referring to the backlogs, Dr Stein said: “Just getting more staff in and using more money doesn’t necessarily solve that problem because that’s an efficiency problem.”

Jeremy Hunt, the former health secretary and now Chancellor, led the push for a seven-day service, which resulted in the 2016 junior doctors’ strike. Mr Hunt said studies had shown a “weekend effect” in the NHS, with higher mortality rates for those admitted on Saturday and Sunday. A study in the British Medical Journal found up to 11,000 more people die every year after being admitted on the weekend, compared with the week day. Doctors and unions accused Mr Hunt at the time of “misusing statistics”. It comes as nurses voted for the first ever national strike, while junior doctors are expected to be balloted in the new year and other health workers could go out on strike before Christmas.

One former senior health source said it was not the right time to revive the seven-day service debate owing to the threat of mass industrial action across the NHS. “For people that were wavering, I think it would just put petrol on the fire,” they said.

NHS trusts are required to hit a series of clinical standards for a seven-day hospital service. For example, all emergency patients must be seen and have a clinical assessment within 14 hours of admission. But these data are not published routinely by the NHS. Until April 2020, NHS Digital published figures showing the odds of death within 30 days of admission for patients admitted at the weekend, compared with midweek. However, the Department of Health and Social Care stopped commissioning this data.

Previous analysis of UK hospitals found, on average, 86 consultants working on a Wednesday but only 12 on a Sunday, Dr Stein said. “In most hospitals in the UK it’s like the Mary Celeste on a Friday afternoon, people start heading to the carpark at 12 and by 2pm it’s all quiet and the hospital is not used to full capacity through the weekend.”

A Department of Health and Social Care spokesperson said: *”We expect trusts to provide high-quality care to patients seven days a week.”