The Academy of Royal Medical Colleges (AoRMC) has called for a fuller seven-day service within the NHS to create a "transformational shift" in care delivery, boosting efficiency and, ultimately, saving some much needed funds.

It claims that the majority of patients in hospital over a bank holiday or on the weekend would benefit from a daily consultant review, which could lead to earlier patient discharge freeing up hospital beds and improving the effectiveness of the patient pathway.

The majority of specialities surveyed called for diagnostic radiology services including ultrasound, CT, MRI and access to an expert radiology opinion over seven days, as well as support services such as physiotherapy, pharmacy, operation theatres, and administrative and clerical support.

In around 11% of hospital patients, discharge is delayed because of non-medical factors, and so "early weekday engagement and advance discharge planning between hospital and community based staff" would boost the ability to transfer care from hospital at the weekend, the report notes.

However, the Academy, which represents 20 medical Royal Colleges and Faculties, does stress that strong links between hospitals and community care are essential in order to fully protect frail, elderly and vulnerable patients.

It also concedes that its proposals will likely need extra consultant appointments and workforce reorganisation, as well as extra funding, but argues that morbidity and overall costs will be reduced over time.

Last year a study by UK researchers concluded that patients admitted on a Sunday had a 16% higher risk of dying than those admitted mid-week, while earlier this year an analysis found that patients having non-emergency operations on a Friday are 44% more likely to die than those having surgery on a Monday.

"It is not acceptable that over weekends and bank holidays, patients receive a lower standard of care than they would during the week," said Professor Norman Williams, Steering Group Chair and President of the Royal College of Surgeons.

Necessary cost

He says that hospital services must now be reshaped to "strengthen the quality of care given to patients regardless of when they are admitted", and while "ensuring that key staff and facilities are available to provide this support will come at a cost," this is "crucial for the full benefit of seven day consultant-led care to be realised".

Speaking at a Westminster Health Forum meeting in London earlier this this week, Chris Roseveare, Chair, Sub-Committee on 7 Day Provision, AoRMC and President, Society for Acute Medicine, said that "most patients would benefit from a daily consultant review," and warned "we cannot duck this issue, we must move it forward".

Noting that a 24-hour society is already upon us, the General Medical Council's Niall Dickson said that access to hospital services must be appropriate, "it doesn't mean we operate everything for everybody for 24 hours a day".

"Saying that, for patients who are sick there is no out-of-hours and we haven't done well in recognising that", he noted.