Hospitals have been told by national officials to focus on improving access to medical consultants and diagnostic services as part of efforts to improve care for NHS patients at weekends.

  • National bodies tell trusts to focus on four specific clinical standards for seven day services
  • Letter says standards have “most impact on reducing weekend mortality”
  • Trusts expected to report on seven day working progress from next month

Acute trusts have also been instructed to report data by the start of next month on how successfully they are meeting current expectations for seven day working.


Inpatients must have scheduled seven day access to X-rays and other diagnostics

The government has made improving care for patients at weekends a key priority for this Parliament.

A letter from NHS England, the NHS Trust Development Authority and Monitor sent to all hospital trusts at the end of last month, and seen by HSJ, directs them to focus on four out of the 10 clinical standards for seven day services set by NHS England in December 2013.

Trusts had been expected to meet at least five of the standards by next April and all 10 by April 2017, but had not been told to prioritise any above the others.

The four standards trusts have been told to focus on are:

  • Standard 2: All emergency admissions must be reviewed by a consultant as soon as possible, but at the latest within 14 hours from arrival at hospital.
  • Standard 5: Hospital inpatients must have scheduled seven day access to X-ray, ultrasound, CT, MRI and other diagnostics.
  • Standard 6: Hospital inpatients must have timely, 24 hour access, seven days a week to consultant directed interventions.
  • Standard 8: All high dependency patients must be seen and reviewed by a consultant twice daily, including all acutely ill patients or others who deteriorate.

The letter, signed by NHS England medical director Sir Bruce Keogh and Monitor and TDA medical directors Hugo Mascie-Taylor and Kathy Mclean, said the four standards had been chosen for “immediate focus” following discussion with the Academy of Medical Royal Colleges.

It said this was because they “have been identified as having the most impact on reducing weekend mortality”.

The letter said: “The clinical case for seven day services includes reducing variation in the mortality risk for patients admitted on weekdays and weekends, and ensuring that doctors in training are safely supervised on every day of the week.”

It said trusts should complete the NHS Improving Quality seven day service self-assessment tool by 5pm on 4 September.

Each organisation should identify a responsible officer for collecting and inputting the data, and one executive director responsible for reporting the organisation’s performance against the standards.

The letter said: “Once established in September, the baseline will help local and national teams to identify the main areas for quality improvement. Results of the survey will be published nationally and will provide a baseline against which the progress of implementation can be measured on a quarterly basis.”