NHS Junior Doctors Contracts: Explained

 

Junior doctors have been striking a bunch this year. The Department of Health was proposing to change the working conditions 53,000 NHS junior doctors. A lot of NHS staff flat out do not want these contract changes to go through. The latest is that negotiations have ceased, and the Department of Health plans to impose the contracts whether docs like it or not.

We already have a Seven Day NHS, so what is going to change?

David Cameron has announced that he will push on with his key promise to create a Seven Day NHS. But what does this actually mean for the National Health Service?

 

How does the NHS work now?

Seven Day NHS - A doctor shrugs and looks at the ceiling. From the hit show "Scrubs"

Seven Day NHS: Do we need it?

At the moment vital services in hospitals such as accident and emergency, ambulances and emergency surgery are available seven days a week. Some GP practices also run an out-of-hours service. SO BEFORE WE GO ON, THE NHS DOES ALREADY RUN FOR SEVEN DAYS.

But out-patient care (which is medical care which does not require an overnight stay), routine non-urgent surgery and GP visits are mostly ran on a Monday-Friday basis.

Hospitals have less senior doctors and staff in at the weekend. Recent research shows that death rates for patients admitted to hospitals over the weekend are 16% higher than if you come in during the week.

SO, 7.5 million people in the UK do have access to their GP seven-days a week and the newly elected Conservative Party want to increase this to include the whole country by 2020.

 

How will it work under  the new plans?

Seven Day NHS - a women sits in front of a computer. Her email pops up and she falls off her chair

Seven Day NHS: David Cameron thinks we need to use technology to reduce waste

Very simply: GP surgeries across the country would be open at the weekend. In hospitals all the routine services and care which is currently Monday-Friday only will be available over the weekend.

The government plans to hire 5,000 more GPs to help cover the extra hours.

They will continue streamlining the NHS to make sure it runs efficiently. For example: In the past GPs had to give a ten minute slot for each patient, even if the diagnosis didn’t need that amount of time.

The government removed this rule in 2013 allowing GPs more flexibility over how they organise their appointments.

 

Government ministers are also considering removing an “opt-out” agreement that means that hospital consultant doctors don’t have to perform “non-emergency” work during the weekend. They thing removing this would improve weekend care as it would mean patients wouldn’t have as long to wait for routine surgery.

David Cameron also wants to look at how people get seen. Patients should be able to get medical advice via Skype or email – cutting down on wasted time.

What’s next: tweeting what’s wrong with us perhaps? @theNHS #myheadhurts

 

What are the Pros and Cons?

Pros

– Hopefully fewer people dying, and equal quality of care whatever day you go to hospital.

– Reducing the chaos on Monday mornings when NHS staff struggle to keep up with a back-log of work from over the weekend. It would also mean better quality of life as people won’t have to wait for as long for routine or minor surgery.

– This is the first step towards a 24 hours health service – also improving people’s quality of life.

– Continuing to look at where the NHS isn’t working – and improving the service so that patients and staff can benefit.

 

Cons

Seven Day NHS - a monkey with a nurses hat on picks at the head of a second monkey

Seven Day NHS: Will the Nurses go on strike?

– The NHS costs money. Big money. And right now we don’t even know how much these new services will cost, let alone how it will be funded. Research in the past few years has shown the NHS will need an extra £30 billion to keep services at their present level. At the moment the Conservatives have promised to spend an extra £8 billion on the NHS from now until 2020. The other £22 billion will be found through efficiency saving.

– The NHS has been missing targets for a while now – last winter the Accident and Emergency targets were missed every week. 95% of patients are meant to be seen in four hours – but 63 out of 140 NHS trusts missed that target every week. So if even more hours of work are added in this could just lead to more missed targets.

-Workers are worried the new system will just lead to wage cuts as the government struggles to find the cash. The Royal College of Nurses has said it would consider strike action – something they have never done before.

– Some have accused the Prime Minister of political point scoring. In the run up to the election the “Seven Day NHS” was a big Conservative pledge. At the time senior doctors asked where the money was going to come from and asked why a fully costed plan had not been released. They said his plans were all talk designed to win votes. If so, it obviously worked.

 

What do Doctors think?

Quite a lot seem to think the government, especially Health Secretary Jeremy Hunt is portraying them as lazy. After Hunt announced that plans for a 7-day NHS will include weekend-working contracts the hashtag #I’mInWorkJeremy went viral online.

Hundreds of medical staff shared pictures of themselves at work. They also wrote messages about the pressure they face working in the NHS.

“Are you at work this weekend Jeremy? Because I am. Thank you for making out that we’re lazy, money-grabbing Doctors who don’t want to work long hours, especially at the weekend. Despite being employed part time (I have a 9 month old son at home), I’ll have worked over 60 hours this week. We, Jeremy, are the people skipping lunch so we can make sure our patients’ paperwork is done so they can go home on time. We’re the people missing family birthdays, our friends’ weddings, our children’s first steps, because we’re putting our patients’ needs first. We are the people that don’t see our own families anywhere near as much as we’d like to, because we’re busy taking care of yours.” – Laura Land, doctor from Telford

Being a politician, Hunt then tried to get involved. His #I’mInWork photo backfired when people noticed that the picture accidentally revealed confidential patient information. One NHS worker commented that if they had made the same mistake they would probably have been fired. Nice try, Jezza.

 

What the experts say:

Professor Chris Ham from health charity The King’s Fund says that a 7 day NHS is “the right thing to do” but that the £8 billion spending will  “be welcomed, but that will really help to keep existing services running, it won’t fund all the new commitments we’ve heard of during the election campaign, including seven-day working.”

Now several health service experts at the Royal College of GPs say that implementing the 7 day NHS is “unachievable”. Doesn’t sound too promising.

They say that adding more doctors will not solve the problem, as the NHS is already understaffed. They’ve also warned that bringing in a 7 day NHS without solving the other problems could risk destabilising other parts of the health service. Yikes!

 

Seven Day NHS Decoded: Cameron promised it, he’s now re-promised it – but we still don’t know how he’s going to make it happen.

Should the government concentrate on making the current NHS work properly before extending opening hours? The trouble is that Davis Cameron promised the 7 day NHS in his first speech after re-election. He’d look pretty silly if the government changes its mind now.

 

Seven Day NHS: British Prime Minister David Cameron puts a hand over his face

Seven Day NHS: Will David Cameron make it work?

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