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A Seven Day NHS – some suggestions from seven day manufacturing

February 13, 2016

Manufacturing companies have been working round the clock for decades. The bosses normally work Monday to Friday during the day, and the workers work shifts to cover either 5 days of 24 hours, or 7 days of 24 hours.

In the heated debate on the junior doctors hours and pay, it is clear that doctors believe that their core work times are like the bosses – Monday to Friday daytimes. Everything else is subject to overtime rates (time and a half, double time..)

However, if you want to go to a 24 – 7 NHS,  some doctors are going to have to start working like industrial workers.

There are two standard models in industry: the 5 day and the 7 day.

The 5 day model is 8 hour daily working, 3 shifts, 6-2, 2-10, 10-6, running from Monday morning to Saturday morning, and the worker changes the shift each week (for example 6-2 one week, 2-10 the next). There is flexibility within the system for workers to arrange between themselves to swap shifts, for example for someone to do permanent nights so allowing another to avoid a week of nights.

The 7 day model is 12 hours, 4 days on and 4 days off, rotating shifts. So for example, if you start on Wednesday 6am to 6pm, then you finish Saturday 6pm and start again Thursday 6pm to Friday 6am. This shift pattern is traditionally better paid than the Monday to Friday shifts, because the ‘overtime’ supplement is built into the pay. The other thing to say is that it needs more workers.

Regarding the current dispute, it is clear to me that the government won’t pay for a seven day NHS. If they were serious about their manifesto pledge, they would be making proposals – or imposing a contract – that required some doctors to work on a 24-7 shift rota as standard, not as overtime.

Pic 16.02.11 Doctors 7 day working proposal chart

A link to the BBC story that includes the graphic is here

One Comment leave one →
  1. Jane permalink
    February 14, 2016 8:11 pm

    My junior doctor son says:
    ‘It is a fair point actually. This is how it should be staffed if you wanted a constant 24 hour service. Otherwise you are admitting that the service in hours (9-5 Mon-Fri) is different from the service out of hours. But this is the one of the key points of the argument………the new contract will just spread the work force more thinly throughout the week rather than address the bigger picture of understaffing. If they want a full 24 hour service then need more staff!’

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