SpinningHugo wrote:WelshIan wrote:
I still don't understand your answer. What are they supposed to do with that hospital? They are already open 24/7.
I really do not appreciate this sort of condescension to a serious question.
Operating theatres? Equipment?
Clearly we aren't going to be doing standard operationa at 2 am but in commercial terms it makes no sense to have any difference between Sundays and Wednesdays.
You're quite right to be cross and I apologize. Long day.
Thanks for the apology, Hugo.
So you're basically talking about Cameron's 7-day NHS plan? That's likely going to cost more money, not save anything. NHS England did some research into costing this back in 2013, based on the experience of 8 Trusts:
https://www.england.nhs.uk/wp-content/u ... -7-day.pdf" onclick="window.open(this.href);return false;
The conclusions:
Costs of implementing seven day services, and current service levels, vary within these eight providers and may vary even more across the whole English NHS. Current services are at different levels. That suggests a local rather than a standard national approach to implementation is required.
• The range of costs for implementing seven day services at most providers, excluding London, is broadly 5% to 6% of relevant expenditure (i.e. the cost of emergency admissions excluding maternity) or up to 2% of total patient care income. In our view, caution should be used when attempting to use this information to construct a potential cost for the whole of the English NHS because of the relatively small sample size, the differences in London and the potential differences in nonfoundation trusts.
• It appears that the additional costs would be lower in London trusts than elsewhere, because of investments already made. Costs would tend to be higher in smaller district general hospitals. The practical problems of implementation, and recruitment, also tend to be worse at smaller trusts.
• There is evidence that seven day services at the front-end of the hospital can pay for themselves at some trusts, by reducing admissions and length of stay. But usual PBR rules have to be flexed locally to enable providers to share the financial benefit from reducing admissions.
• Seven day services for a hospital as a whole are unlikely to be cost-neutral (except at some London trusts) under the present configuration of services. It is fair to conclude from this small study that the move to seven day services does appear achievable, but it may be too expensive and unsustainable for all existing hospitals to move all their current range of services to a seven day basis.
• Costs could be reduced if current payments for working unsocial hours were reduced.
• In general PBR has not helped with creating seven day services and a set national tariff would not be a good tool to incentivise them. Emergency seven day services may be better paid for as a fixed ‘payment for capacity’, with adjustments for activity levels. The hard task is to find a fair and defensible way to set that payment level in a semi-commercial environment.
• In the trusts examined, any move to seven day services was led by the trusts not their commissioners. NHS England would need to take action to incentivise commissioners if it wants to implement seven day services quickly.