Plans to drive 7-day services across the NHS

NHS England's Medical Director Professor Sir Bruce Keogh set out plans to drive 7-day services across the NHS, starting with urgent care and supporting diagnostics. His forum on NHS service, seven days a week, suggested that there was significant variation in outcomes for patients admitted to hospitals out of hours.

A 2012 study suggested that the increased risk of mortality was as high as 16% on a Sunday, based on analysis of 14 million hospital admissions in 2009/10: 'There is increasing evidence that mortality rates for patients admitted to hospitals on both sides of the Atlantic are higher at weekends; our junior doctors feel clinically exposed and unsupported at weekends; and hospital chief executives are worried about clinical cover. It seems inefficient that in many hospitals expensive diagnostic machines and laboratory equipment are underused at weekends, operating theatres lie fallow and clinics remain empty. This, while access to specialist care is dogged by waiting lists and GPs and patients wait for diagnostic results.'

Later, government representatives used the 16% figure to justify its proposals to change doctors' contracts. However, doctors criticised the use of this evidence to support 7-day services in the the NHS, highlighting that the 2012 study showed association, not causation.