Illness can happen to anybody at any time. The patient admitted in the weekends get limited access to the primary care than other week days. There is often poor involvement of senior medical consultant in the assessment and consequent management of acutely ill patients in these days.
Considering these facts, National Medical Director Bruce Keogh and responsible institution has established a seven day NHS service in 2013. During the establishment, NHS seven day service forum was focused on acute inpatient. The forum was established to provide consistent support services like diagnostic and scientific services with community, primary and social care. The NHS seven day services helps prevent unnecessary admission and support timely discharge of the patients.
Poor emergency service in the weekends has led an increased variation in outcomes of mortality rates, patient’s experience, re-admission rates and length of hospital stay. To decrease the variation in outcomes, the seven day service forum developed 10 clinical standards for patients care based on the evidence and recommendations from Royal colleges and expert bodies.
The 10 clinical standards are:
Medical practitioners must actively involve patients, their families and carers with all the detail information of treatment, investigations and on-going care while making shared decisions. All information including severe condition must be clearly informed to the patients regularly. This should be done every day of the week.
Patients admitted in emergency care must be seen with full clinical assessment by an appropriate medical consultant as soon as possible, at least within 14 hours of admission.
A Multi- disciplinary team must have a quick assessment to identify complex and on-going needs of all emergency inpatients. The decision for multi-disciplinary assessment should be overseen within 14 hours by a competent and estimation for discharge date should be placed along with complete medicines understanding within 24 hours.
The decision of shift handover must be controlled by an experienced senior. Handover should be done at a selected time and place, with the multi- professional involvement. Communication and documentation should be included in handover process and must be revealed in hospital policy.
Diagnostic services like x-ray, magnetic resonance imaging (MRI), echocardiography, endoscopy, bronchoscopy, ultrasound, computerized tomography (CT) and pathology must be accessible to hospital inpatients in all days of the week. The consultant directed diagnostic test results must be available seven days a week;
Patients admitted in the hospitals must have all time access to the appropriate specialized consultant on-site or in a properly agreed networked provisions with clear procedure, such as:
The patients who need mental health care must be assessed by psychiatric liaison within the appropriate period.
Consultant must review all the patients on the AMU, SAU, ICU and other high dependency areas twice daily. All acutely ill patients who are directly transferred or those with worsen condition should be seen twice daily by a consultant.
Support services must be available seven days a week in a hospital and in primary, community and mental health setting in order to ensure next steps in the patient’s care.
Medical practitioners who are involved in providing acute care must participate in the review of patient’s outcomes. Patient experience, patient safety and clinical effectiveness are the things which should be focused while evaluating patient outcomes. Trainees should be consistently checked for high quality healthcare service to the patient's.
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