day week' for senior doctors 15 December 2013 Last updated at 08:35 By Nick Triggle Health correspondent Hospitals in England will have to ensure senior doctors and key diagnostic tests are available seven days a week under new plans. The measures form part of a vision unveiled by NHS England to tackle the higher death rates at weekends. The changes, proposed by medical director Prof Sir Bruce Keogh, will be applied to urgent and emergency services over the next three years. But the cost and staffing implications have yet to be finalised. Five-day model Research suggests death rates are 16% higher for patients admitted on Sundays compared with those for patients admitted on Wednesdays. We have a system that is not built around the convenience of patients and is not compassionate to patients for part of the week End Quote Prof Sir Bruce Keogh Medical director, NHS England Sir Bruce said it was time to "undo more than 50 years of custom and practice that have failed to put the interests of patients first." His review said that, while some hospitals had started improving care at weekends, most still operated on a "five-day model," staffed largely by junior doctors and with little access to specialist equipment and tests on the weekend. Two things are key to this. One is the availability of diagnostic tests at the weekend...Then you need someone experienced to interpret those tests and to institute the right treatment," he told the Sunday Times. We have a system that is not built around the convenience of patients and is not compassionate to patients for part of the week. The proposals, which will be discussed by the board of NHS England this week, set out a series of new standards for hospitals. These include: All emergency admissions to be seen by a consultant within 14 hours Seven-day access to diagnostic tests, such as X-rays, ultrasound, MRI scans and pathology Patients in intensive care and other high dependency units to be reviewed by a consultant twice a day Weekend access to multi-disciplinary teams, which include expert nurses, physios and other support staff To encourage hospitals to follow the new standards a system of incentives, rewards and sanctions will be built into contracts by 2016-17. Sir Bruce warned hospitals could face multimillion-pound penalties if they failed to keep up their standards at weekends. He told the Sunday Times hospital trusts would be contractually-bound to run a full service seven days a week - with breaches costing them up to 2.5% of their annual income of up to £500m. Hospitals that refuse or fail to provide safe weekend care could also face losing their right to use junior doctors, he said. Sir Bruce said the changes would cost about 2% of the NHS's operating budget of £97bn. More efficient Nick Triggle Health correspondent Anyone who has been in hospital will be aware of the change of pace the weekend brings. Theatres lie empty, equipment is turned off and there are noticeably fewer staff around. It is, therefore, no surprise that many believe a truly seven-day service is long overdue. This review has provided a vision for what services could look like. But the big question now is how it can be implemented. The NHS is in the middle of its biggest savings drive in history and there remains much work to be done to get hospital consultants fully signed up. This promises to be just the start of a long process. The review also acknowledged that hospitals would need better support from community services, such as social care, if the seven-day ambition was to be achieved - so patients could safely be discharged when ready. A report on how care outside hospital needs to change will be produced in autumn 2014. That report may also include details of how the non-emergency work which hospitals do, such as hip and knee replacements, could be provided on a seven-day basis. In the meantime, the review team will concentrate on the cost and workforce implications. This is to be twinned with the work of the urgent and emergency care review, which last month recommended the creation of a two-tier A&E system. The review team believes those changes would help the NHS become more efficient, freeing up money to pay for these changes. Whole NHS system Sir Bruce said it was clear that patients "want us to act now to make seven-day services a reality in all parts of the NHS." He added: "This is not just about hospitals but the whole NHS system. One part cannot function efficiently at the weekend if other parts don't. Doctors firmly believe that patient outcome should not be affected by what day of the week they fall ill End Quote BMA spokeswoman Ahead of the publication of the review, Health Secretary Jeremy Hunt said: "Patients should be able to depend on the NHS every day - not just Monday to Friday." Dean Royles, of NHS Employers, which represents hospitals, said: "Seven-day working is probably the most important issue facing the NHS at the current time. A British Medical Association (BMA) spokeswoman said it supported high quality care seven day a week and "doctors firmly believe that patient outcome should not be affected by what day of the week they fall ill." But she said it is a "complicated problem which will not be easily resolved by one single 'quick fix"'. Dr Paul Flynn, chairman of the BMA's consultants' committee, said more money would be needed if the proposals were to be a success. "There are concerns that, without careful planning and careful management, this is not going to be possible for a lot of units without a big investment," he said. Shadow health secretary Andy Burnham said: "This idea is right in principle but, with the NHS in increasing financial distress, the government must set out clearly how it will be paid for."