Seven-Day NHS: The Key Questions Answered

The Prime Minister has committed to making sure the NHS is fully staffed at weekends - creating a seven-day service. But that might not be as simple as it sounds.

:: What is the plan?

For decades the NHS has run only a basic service at weekends with potentially significant decisions on care being made by junior doctors.

Concerns about patient safety are the big driver for moving to a 'seven-day NHS' , with consultants working daytime hours on Saturday and Sunday.

That will have an impact on other staff too - diagnostic labs will need to be open and MRI scanners fired up to make sure consultants have key medical information to determine treatment.

And GPs too will be expected to open up at weekends, which should ease pressure on accident and emergency units.

:: Is there really demand for extra care at weekends?

People don't just fall ill Monday to Friday. Anyone who has been to A&E over the weekend will know how busy hospitals can be.

There is also the argument that hospitals should 'sweat their assets' more - MRI scanners are too expensive to stand idle.

And weekend access to GPs would certainly be convenient for commuters who find it difficult to see their doctor in normal working hours.

:: Does the current system of reduced staffing at weekends impact on patient safety?

Elderly patients often have multiple medical problems that can be difficult to untangle - and junior staff may not have the skills and experience.

It's been estimated that the lack of senior staff at the weekends results in 3,000 extra patient deaths a year.

Research published in the Royal Society of Medicine showed that patients admitted on a Sunday are 14% more likely to die over the following month than those admitted on a Wednesday.

Patients having surgery on a Saturday are 82% more likely to die than those having their operation on a Monday.

:: What is morale like among NHS staff currently? Could nurses really go on strike?

Morale is low, without question. Staff resent the below-inflation pay rises in recent years - an issue that has resulted in industrial action.

The Royal College of Nursing has threatened fresh action if the extra pay staff get for working weekends is stopped.

:: So how many extra staff does the NHS need and what will it cost?

There are no official figures for the whole country. But NHS England has looked at the impact of weekend working on some sample hospitals.

So a large city NHS Trust like Aintree University Hospital in Liverpool is calculated to need an extra 23 consultants to bring in weekend working - at a cost of £2.7m each year.

A smaller district general like Dorset County Hospital in Dorchester is likely to need an extra eight consultants at a cost of £1.1m.

And with 168 acute hospital trusts in England the NHS is likely to need well over a thousand extra consultants and perhaps £200m or more each year to cover weekend working.

:: What about GPs?

Some GPs are already piloting longer opening hours.

That doesn't mean every surgery will be open. They're grouping together, with a rota covering the weekend.

So GP care is available, but patients may have to travel slightly further.

:: Will £8bn a year be enough to fund such a significant overhaul of the NHS?

The £8bn pledged in the Conservative's manifesto would only just cover current services. NHS England says it needs the money to cover the extra demand from a growing - and older - population.

It is unclear how seven-day working will be paid for.

:: Where will the staff come from?

This is probably the biggest barrier to the plan.

The Royal College of GPs says the NHS needs an extra 8,000 family doctors, and the early calculations on hospital consultants suggest well over 1,000 will be needed.

But it takes 10 years to train a GP and 14 years to train a surgeon. So it looks impossible to achieve the numbers needed in the five years of the next parliament.