Presentation made by James Thallon, Medical Director South East, NHS England. Improving access to seven day services event, Crawley 17 March 2105.

1. 7 Day Services
James Thallon,
Medical Director
(South East)

2. 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. 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
Discharges(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

4. Variation in diagnostic services
National self-assessment tool Standared 5 and 6

5. Standard Mortality rates Elective Admissions

6. “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.

7. “This change will
be difficult - but it
is the right thing
to do.”
Sir Bruce Keogh,
National Medical Director NHS England
Time for Change

8. 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

9. The Standards, 1-5
1. Patient-focused care
2. All admissions seen by a suitable consultant within 14
hrs 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

10. 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”

11. 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.

12. The “When”

13. Working together to support seven day
services

14. 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

15. 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

16. 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 re 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 -

17. 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/

18. 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/

19. Benchmark your progress - coming soon

20. The weekend effect! - Easy Metric