Brexit will hamper introduction of seven day hospital services, expert warns.

The United Kingdom’s exit from the European Union would make it more difficult to bring in seven day services in hospitals, an expert has warned. Julian Bion, chief investigator of a research project looking at the provision of emergency, specialist led care at weekends, said it could take 20 years before seven day services were successfully introduced. Speaking at a Science Media Centre briefing in London on Monday 18 July, he said that seven day services were “unachievable with current funding, and post-Brexit it’s going to be even more difficult.” He added, “I would hazard a guess that we’re 20 years away from being able to achieve a seven day service given the current challenges, but I’d love to be wrong.” Bion, who is based at the University of Birmingham, said that future progress towards seven day services would be “predicated on . . . the challenges of Brexit and the impact on funding.” He added that although the “weekend effect”—the increased risk of death among patients who are admitted at the weekend rather than on a weekday—existed it was difficult to knowwhat caused it. “Unless you make a diagnosis, you don’t get the treatment right. The problem for politicians is they can’t wait 15 years for large research collaborations to give them those answers,” he said. “I do have sympathy for politicians, because they do have to make decisions sometimes in an evidence vacuum.” Rachel Meacock, a research fellow in health economics at the University ofManchester, said that she would like to see a pause in the introduction of seven day services until a better understanding of the weekend effect was reached. “We should be looking to improve care at the weekend, but we need to understand how we do that. [We could] just extend hospital services, but we have no idea what that will do to patients in the week,” she said. “If staffing is the key, and staffing and patient outcomes are linked, then we are likely to make outcomes for patients in the week worse.” Paul Aylin, professor of epidemiology and public health at Imperial College London, disagreed. He said, “I think if we look to examples of some specialties where there has been some reorganisation of care, for instance in stroke care . . . that hasn’t necessarily involved having more staff, it’s just involved reorganising the service.” He added, “It’s very complex, but it’s not simply a question of [stretching] out weekday staff over the weekend. There’s probably a need to be slightly more imaginative and look at other specialties where real improvements have been made to quality of care.”