The Nuffield Trust’s “London Quality Standards” report evaluates recently introduced standards to improve acute and emergency care in London hospitals. London-wide experiments with Seven Day Services Standards are soon to feature in STPs elsewhere in the UK. These standards specify various minimum requirements, including regular consultant review during out-of-hours and at the weekends.
This study found little evidence of benefits for patients. Threats to impose weekend working standards might be counter-productive, say the authors.
“We saw some deficiencies in hospitals’ ability to manage complex changes, and evidence of a deep disconnect between frontline staff and top managers. The use of reconfiguration as a ‘stick’ to drive the standards de-motivated staff, and eventually came to be seen as an empty threat”.
Vaughan, L. Machaqueiro, S. Gaskins, M. and Imison, C. (2017). The London Quality Standards: a case study in changing clinical care. London: Nuffield Trust, February 15th 2017.