Doctor's union the British Medical Association seems to be siding against the notion of expanding the provision of routine national health services to seven days a week.

Only emergency care is currently available on the NHS at weekends, but the National Health Service Commissioning Board (NHSCB) revealed back in December that it is looking into the viability of providing more routine services over the weekend, to offer greater convenience to patients and slash waiting times.

The move follows research showing that patients admitted to hospital over the weekend were more likely to die; one study, published in the Journal of the Royal Society of Medicine, found that patients were in fact 16% more likely to die if admitted on a Sunday than those coming in mid-week.

The NHSCB's taskforce is not due to report its findings on expanding services until the Autumn, but the Department of Health has already voiced its support for the move.

"Offering easier access to hospital consultants, GPs and routine hospital services seven days a week will reduce delays and ensure that patients get seen and treated by experienced healthcare professionals," health minister Lord Howe has said.

According to Sir Bruce Keogh, England’s NHS medical director, service expansion would “offer the opportunity to improve clinical outcomes with the added benefit of a much more patient focused service”.

In a debate published in the British Medical Journal, he conceded that there will be "difficult problems to solve", particularly on the economic side, but argued that "the clinical, compassionate, and patient convenience arguments in favour of change are compelling".

"It would enable us to be truly patient centred for the whole of the week, rather than two thirds of it, and we could improve access, shorten diagnostic response times, shorten hospital stay, and improve training,” he stressed.

Against all logic?

But Paul Flynn, chairman of the BMA consultants committee and a consultant obstetrician and gynaecologist, is not convinced, arguing there is room for service improvement without offering a seven-day service.

"The systems of finance and organisational structures often stand in the way of delivering efficient healthcare," and “it flies in the face of all logic to reward a system that is not using its existing resources to best effect over five days by giving it the opportunity to mismanage them over seven," he said.

There are several ways to improve efficiency in the NHS, he argues, noting that “it is time the NHS listened to the doctors who can tell it how to solve these problems and stopped just throwing a longer working week at it.”

Flynn also pointed to the current "dire" financial position of many providers in the NHS, questioning who would pay for extending routine services. "It is inconceivable that they will be able to staff operating theatres and clinics seven days a week, let alone provide all the other resources that this activity will consume," he stressed.

However, a poll of GPs and secondary care doctors across the UK, conducted by last year, found that 59% agreed that hospitals should operate on a 24-hour, seven-day rolling weekly schedule, although a significant number voiced concerns over the cost and feasibility of such a move.