Seven day working - a parent's view

There is now general recognition that the NHS needs to get to grips with seven day working. This has been reflected in the NHS Commissioning Board Planning Guidance, Everyone Counts: Planning for Patients 2013/14. It says that 'the NHS will move to providing seven days a week access to routine healthcare services'.

But what will this mean from a patient perspective? It should mean access to the right professionals, tests, therapies and treatments at the time you need them. And this should apply to community care and acute inpatient hospital care. From a personal perspective, I think this will be great and would have made such a difference for my son, Ben.  

Ben, who is now 5 years old, had Guillain-Barré syndrome just before he was 2 years old. He had lower limb paralysis which went undiagnosed in primary care for a week. We visited the GP twice within the space of four days.

The first time, the doctor focused on Ben’s bottom – he had had a rectal prolapse. The second time, we talked about Ben’s apparent refusal to walk and we were told to wait a few more days before worrying. As Ben was not in pain at this point, this felt okay, especially as I desperately wanted my son to be well. But as the days went on, Ben’s pain increased considerably. My husband and I became increasingly worried and we decided to take him to hospital.

At A&E, it was clear from the reactions of the team that Ben was seriously ill. We were immediately admitted and the next day, during the afternoon, we were transferred to a tertiary hospital.

Ben had a series of urgent tests that evening, including an MRI scan under general anaesthetic. By then, the hospital was really quiet and it felt like the staff had had to open up the radiology unit just for us. As we arrived from the ward, the lights were off and the doors locked. The consultant had to search for someone to open them. This feeling that people were staying late and doing things differently to normal heightened my anxiety about Ben’s wellbeing, making me really concerned about the potential for something to go wrong.

While Ben was under anaesthetic, there was nowhere really to wait within the hospital – the hospital café was closed and everything was quite and empty. But it had been a long day, and my husband and I needed something to do to fill the time and something to eat. So we had to leave the hospital to find a place to eat nearby. It felt strange leaving him in the hands of strangers at such a critical time. To those around us, my husband and I looked like a couple out for the night. But all we could think about was our extremely ill and vulnerable child.

Fortunately, the imaging was enough evidence to confirm the diagnosis and for intravenous immunoglobulin treatment to begin that night. Over the weekend, nothing much happened. We were visited by the consultant and saw nurses regularly. We waited for signs that the treatment had started to work (which it didn’t).

In a way, we welcomed this lack of action. Things had been so frantic in the run up to getting the diagnosis and starting treatment that it was almost nice to have some 'time off'. But I now know it may have been better for Ben’s recovery if the pace had been maintained and physiotherapy had started immediately, rather than waiting until Monday for the service to be available to Ben. 

Three years on, Ben is now much better – he can walk independently and enjoys going to the playground with his friends. He has had surgery to correct his right foot position and has regular hospital check-ups and physiotherapy. When I asked him about how hospitals can improve, he suggested an increase in the availability of Angry Birds.

From my point of view, I would prefer the focus to be on the fundamental shifts needed in how people work in order to achieve seven day working. I know it won’t be easy, but I also know from personal experience how important having services available when you need them is (I am so pleased they could open up the radiology unit and the staff did stay late). And I also know that it would be better (in terms of experience and physiological safety and outcomes for patients) for this to be planned and well thought through to meet local population needs.

So I hope that by sharing  examples of how services are changing (like our Flow Cost Quality work), and by sharing patients’ stories, the next time I need an MRI on a Friday evening, the lights will already be on.

Zoe is a Public Affairs Manager at the Health Foundation