The UK Prime Minister, David Cameron, recently reiterated his commitment towards a full seven-day NHS and stated that the expansion of weekend working would be dependent on staff working more flexibly, not longer hours. The issue of flexibility is an important point. Under the NHS pay scale Agenda for Change (AfC), a widespread NHS pay system, the standard working week for NHS staff on AfC contracts is 37.5 hours. This is about seven-day services and not seven-day working.
Therefore, delivering the extra hours of a comprehensive level of clinical pharmacy service is likely to require additional staffing resource. In fact, this was one of the messages that came out of the Healthcare Financial Management Association report into the financial implications of introducing seven-day services in NHS hospitals. To ignore this important factor in the implementation of seven-day services is likely to result in many services being spread too thinly over seven days and may impact on the level of patient care that is currently provided during the working week.
The Guild of Healthcare Pharmacists (GHP) supports the expansion of seven-day clinical services — if this improves patient safety. But we will not accept this if the services were to be pushed through at zero cost. The British Medical Association, the trade union and professional association for doctors and medical students in the UK, and the Royal College of Nursing, which represents nurses and nursing and shapes health policies, have already raised the issue of appropriate funding and the GHP would make the same call to the government. Some will claim the service expansion is not increasing the workload, merely spreading it over seven days rather than five. This view misses the point completely.
I would not suggest that all the services and duties undertaken during the week are replicated at weekends because this would not necessarily improve patient care. However, pharmacy managers need to look at what should be done at weekends (and by which grade of staff) to allow delivery of the clinical standards outlined in the ‘NHS services, seven days a week forum’ and build a case for the additional resource that is likely to be needed. Without such additional resources I would ask pharmacy managers to think carefully about whether or not services can be expanded safely.
Seven-day services are long overdue in the modern NHS; the key challenge will be implementing them in a sustainable way without compromising the existing levels of service.
The Conservative Party, claiming to be the real party for working people, should listen and address the concerns raised by healthcare professionals and their representative bodies and trade unions if the maximum benefits that can be achieved through implementing seven-day services are to be realised. Pushing the agenda through without addressing these concerns may not improve patient safety and outcomes and could lead to an unsatisfied and disengaged healthcare workforce.
Dave Thornton is immediate past-president of the Guild of Healthcare Pharmacists, which is part of the trade union Unite.