CONSULTANTS will have to work evenings and weekends at Scotland's newest hospital in a radical move to provide patients with better-quality care and a greater degree of safety.
Most specialists will have to cover shifts up to 10pm and weekends at the new £840 million South Glasgow Hospital when it opens on the site of the current Southern General in Glasgow in 2015.
Traditionally, the majority of consultants working in the NHS, who can earn more than £100,000 a year, have worked weekdays and been on call at weekends.
But in an interview to mark the "topping out" of the new building, which will be one of the biggest acute hospitals in the UK, Robert Calderwood, chief executive of NHS Greater Glasgow and Clyde, said discussions had begun about reorganising rotas.
He said "pockets" of the profession had already changed working patterns, with emergency and acute medicine specialists present in their departments late at night, seven days a week.
He said most consultants were still on call from home outside core weekday hours, but when the new hospital opens a range of them will be available on site between 8am and 10pm every day. This includes surgeons, orthopaedic and trauma specialists, other specialists, and radiology and laboratory staff.
He added: "All the people needed to assess your needs, agree a treatment plan and execute the plan will be there in this model as a minimum in the extended working day, seven days a week."
Noting that as many people fell ill on Saturdays and Sundays as they did midweek, he said it meant patients would "get the most appropriate, highest-quality care, the quickest we can provide it".
He said he envisaged planned appointments and treatments being available during evenings and on Saturdays at the hospital, adding that investment in technology meant its potential for treating patients had to be maximised. He also admitted the change would have a knock-on effect on the wider workforce.
He said: "My personal sense is the vast majority of staff understand why and they recognise the need. But everyone is an individual and everyone has commitments, and strives to get the work-life balance that they need. So I do not underestimate for some members of staff change will be seen as threatening, and we have to work with them to accommodate our needs and their needs."
He added that the board was working with universities to ensure future doctors and other healthcare professionals understood what was likely to be expected of them during their career. The intention is not to make medics and support staff work longer hours, but to spread them across rotas that cover the longer working day and week.
Last autumn, research by Dr Foster Intelligence found patients admitted for emergency treatment at weekends were almost 10% more likely to die than those admitted during the rest of the week. Staffing levels were viewed as a key factor, particularly the presence or absence of senior doctors.
A spokeswoman for the British Medical Association in Scotland, which represents doctors, said: "We recognise good patient care means hospital medicine cannot be a 9am to 5pm job. Consultants in many acute and emergency specialities already provide on-site cover at the evenings and at weekends and there are provisions within consultants' contracts that facilitate this.
"However, any proposals to move to a seven-day service for routine work such as outpatient clinics, elective operations, etc would have enormous resource implications, as it would require not only doctors but the entire healthcare team and the full range of essential support services such as diagnostics to be fully staffed seven days a week. In the current public-spending environment this would clearly be completely unaffordable."
Health Secretary Alex Neil is expected to take part in the topping out ceremony today at the new hospital.
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