7 Day Services

Geoff Payne

Medical Director

South Central

NHS | Presentation to [XXXX Company] | [Type Date] 2

“ At the end of last year, the research company Dr Foster found mortality rates rose by 10%

at weekends. Other studies have shown similar correlations.

” BBC News, Health

Five day service model not meeting

patient needs or expectations.

3

Fewer people are admitted to hospital as an emergency

at the weekend but… chances of dying are noticeably

higher

100

200

300

400

500

600

700

800

900

MON TUE WED THU FRI SAT SUN

Dis

ch

arg

es (

000's

)

3.4%

3.5%

3.6%

3.7%

3.8%

3.9%

4.0%

4.1%

Emerency admissions

Percentage who are discharged dead

DH analysis of HES data 2010/11

National figures, England 2010/11

Variation in diagnostic services

National self-assessment tool Standared 5 and 6

Standard Mortality rates - Elective Admissions

“The NHS will move towards

routine services being available

seven days a week. This is

essential to offer a much more

patient-focused service and also

offers the opportunity to improve

clinical outcomes”

Ten Clinical Standards describing

minimum standards of care patients

should expect to receive seven days a

week.

“NHS England is the only healthcare system in the world that is trying to sort out the issue of 7 Day services. Individual hospitals have done some work on it, but never a national health service.

The NHS is owned by the people, so it must serve the people and serve them when they need it. With ill-health, that has to be across the entire week.

I believe there are compelling arguments for introducing 7 Day services, not least of all when we consider the mortality rates at weekends compared with the number of deaths during the working week”

Sir Bruce Keogh,

National Medical Director NHS England

Time for Change

“This change will

be difficult - but it

is the right thing

to do.”

Sir Bruce Keogh,

National Medical Director NHS England

Time for Change

The 10 Clinical Standards

Patient

Experience

Time to first

consultant

review

MDT

Review

Shift

Handovers

Transfer to

community

and Primary

and social

care

Mental

Health

Quality

Improvement Diagnostics

On-going

review

Intervention

/Key services

The Standards, 1-5 1. Patient-focused care

2. All admissions seen by a suitable consultant within 14 hours of admission, or

within 6 hours between 0800-2000 except:

patients who are very ill, where it should be 1 hour.

3. 14 hour review by a Multidisciplinary Team inc. Physio, Pharmacist, (and OT if a medical patient)

4. Handovers by competent decision maker

5. Hospital inpatients must have scheduled seven-day access to diagnostic services

The Standards, 6-8 6. Hospital inpatients must have timely 24 hour access, seven days a week, to consultant-directed interventions

7. Where a mental health need is identified following an acute admission the patient must be assessed by psychiatric liaison within the appropriate timescales, 24 hours a day, seven days a week:

1 hour- Emergency, 14 hours Urgent

8. Once transferred from the acute area of the hospital to a general ward patients should be reviewed during a consultant-delivered ward round at least once every 24 hours, seven days a week, unless “not necessary”

The Standards, 9-10

9. Support services, both in the hospital and in primary, community and mental health settings must be available seven days a week

10. All those involved in the delivery of acute care must participate in the review of patient outcomes to drive care quality improvement. The duties, working hours and supervision of trainees in all healthcare professions must be consistent with the delivery of high-quality, safe patient care, seven days a week.

The “When”

Working together to support seven day

services

NHSIQ Seven Day Services Team

• Help with the ‘how to’ – support health

communities, foster collaboration, build momentum, spread change

• Gathering intelligence – understand context, content and culture, impact

• Making connections - Learn, Share, Connect, Curate knowledge, Advise

• Building large scale transformational change capability and capacity – ‘hands on’ facilitation, coach, ‘honest broker’, clinical and public champions

• Shape future policy – identify national, regional, local barriers and challenges

Experienced dedicated team from across the health and

care economy

1. Diagnostics: Spreading

evidence-based models

2. Drive for spread:

Engaging all healthcare

communities in moving

towards services that meet the

clinical standards and

identifying the top interventions

3. Designing new models of

seven day services

Sharing the learning across the Country

• Integrated approach – alignment of plans

• Where do we start? – the baseline – do we really understand services offered?

• Mixed awareness of the clinical standards

• Identify those standards that will have the biggest impact

• Consistent themes, finance, workforce

• Culture & leadership across the local health community

• 7 day working v 7 day services

• Won the moral argument – this is the right thing -

Have you completed your 7DS self-assessment?

• On-line self- assessment tool to measure progress

• Enables you to baseline your current level of service provision as a local health community

• Find out how your are progressing towards meeting the clinical standards and service provision

• Coming soon:

Review your progress and benchmark yourself against others and reports

To access the Seven Day Self Assessment tool, register http://www.7daysat.nhs.uk/

7 Day Self Assessment Tool (7DSAT)

Online Self-Assessment Tool

Multiple Users

Easy to Register

Baseline current service provision

Covers Local Health Economy (LHE) provision

Brings data together

Links to useful information

sources

FAQs

Access Support

Measure progress of services &

Clinical Standards

Coming Soon:

Benchmark yourself against others

http://www.7daysat.nhs.uk/

Benchmark your progress - coming soon

Practical benefits of 7DS Guys & St Thomas’ respiratory physiotherapy

Practical benefits of 7DS Guys & St Thomas’ respiratory physiotherapy

The weekend effect! - Easy Metric