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DH civil servants fear seven-day NHS will cause ‘workforce overload’

Department of Health civil servants have warned the Government that its seven-day NHS plans may cause ‘workforce overload’, including due to a lack of GPs.

A DH risk register from late July, obtained by the Guardian and Channel 4 News, lists 13 major risks with the planned seven-day NHS rollout – a flagship Tory manifesto commitment ahead of last year’s general election.

Senior civil servants fear that the NHS does not have enough staff or money to fulfil the commitment by 2020, with a lack of GPs, hospital consultants and other health professionals cited as a factor that may mean the full service ‘cannot be delivered’.

It comes as NHS England is currently in talks with GP Access pilot areas about continuing seven-day routine appointment at a cost of £6 per head of population.

The risk register further says the plans could be scuppered because NHS staff, particularly doctors, do not ‘believe in the case for change’.

According to the Guardian article, other concerns include the policy failing to improve the quality of hospital care at weekends and reduce death rates among those admitted for treatment as an emergency on Saturday or Sunday; concern that Brexit could hamper plans, ‘particularly with regards to workforce and finances’ because the NHS employs 55,000 staff from around the EU; and a risk that ‘patients do not report any difference/improvement in their experience [of] out of hours and at the weekend’.

BMA chair Dr Mark Porter said the risk register showed that the Government pledge for a seven-day NHS was ‘nothing more than a headline-grabbing soundbite set to win votes rather than improve care for patients’.

He said: ‘To see in black and white that the Government has disregarded its own risk assessment’s warnings about the lack of staffing and funding needed to deliver further seven-day services, is both alarming and incredibly disappointing.

‘If the Government wants to make more services available across seven days, then it needs to urgently address how it will staff and fund them rather than continue to mislead the public and brand doctors – who already work round the clock, seven-days a week – as a roadblock to their plans.’

Labour’s shadow health secretary Diane Abbott said: ‘This is a scandal. The Government is undermining the NHS with plans it knew to be unworkable.

‘I will be writing to Jeremy Hunt to ask him to explain how why has contravened his civil servants advice and to ascertain whether he has misled Parliament.’

It comes as BMA’s Junior Doctors Committee recently announced it will consider further industrial action over their imposed new contract.

Health secretary Jeremy Hunt has repeated that there is currently a higher risk of dying when admitted to hospital on the weekend, the so-called ‘weekend effect’, as justification for changing junior doctor terms, even though a host of medical studies claimed these claims were an oversimplification.

But a DH spokesperson said the risk register was ‘entirely routine’ and ‘by definition’ listed ‘worst-case scenarios’.

They added: ‘We are confident our programme for a safer seven-day NHS is on track, and will deliver real benefits for patients.

‘Over the past six years eight independent studies have set out the evidence for a “weekend effect” — unacceptable variation in care across the week. This Government is the first to tackle this, with a commitment to a safer, seven- day NHS for patients and £10 billion to fund the NHS’s own plan for the future, alongside thousands of extra doctors and nurses on our wards.’