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Equality for all - delivering safe care seven days a week - case studies

01 January 2012 - NHS Improvement


NHS Improvement worked with clinical teams across health and social care to find examples of equality of treatment and outcome regardless of the day of the week.

This guide and case studies give examples of service delivery models that are being used across the NHS to deliver clinical services outside the standard working hours and across the weekend period, in many instances.

The service delivery models described respond to service, patient or carer demand and provide benefits for both patients,staff and carers. There are three emerging principles that could be used to categorise the models being adopted under the following headings:

1. Admission prevention
Services that are designed to care for patients in their usual place of residence during times of poor health or mental illness.

2. Early diagnosis and intervention
No delays in assessment, diagnostics and treatment leading to an earlier diagnosis and intervention.

3. Early supported discharge
Patients returning home once they are able to be supported in their own home by services.

Seven Day Services Case Studies

Acute care

Acute Medical Unit: Epsom General Hospital - Epsom and St Helier University Hospitals NHS Trust and Surrey County Council Adult Social Care

Cancer care

Extended radiotherapy service - Cambridge University Hospitals NHS Foundation Trust

Six day chemotherapy service - The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust

Cardiac care

A regional PPCI on-call rota agreed collaboratively between clinicians and managers - The Leeds Teaching Hospitals NHS Trust

Seven day acute cardiology service - Royal Berkshire NHS Foundation Trust

Seven day physiotherapy service for cardiothoracic patients - South Tees Hospitals NHS Foundation Trust

Integrated older peoples' services

Pan Gwent Frailty Programme: Supporting people at home through seven day rapid response and reablement - Aneurin Bevan Health Board, Wales

Community healthcare

Rapid Response Service - Birmingham Community Healthcare NHS Trust


Seven day working - extended endoscopy service - Royal Liverpool and Broadgreen University Hospitals NHS Trust

Seven day endoscopy service - Southampton General Hospital

Seven day consultant radiology service - Gloucester Hospitals NHS Trust

24 hour, seven day microbiology services - Royal Free Hampstead NHS Trust

Seven day radiology service - Salisbury NHS Foundation Trust

General medicine

A consultant led and delivered seven day services model across a geographically challenged Trust - Northumbria Healthcare NHS Foundation Trust

Working towards a seven day hospital service at Torbay Hospital - South Devon Healthcare NHS Foundation Trust - Torbay Hospital

Women's services

Obstetric and gynaecological physiotherapy services - The Ipswich Hospital NHS Trust

Leicester Fertility Centre - University Hospitals of Leicester NHS Trust

Extending the consultant's day in breast and gynaecological services - including theatres and wards - Winchester and Eastleigh Healthcare NHS Trust

Mental health services

Lancashire Intermediate Support Team - Lancashire Care NHS Foundation Trust

NHS Nottinghamshire and Nottinghamshire County Council Adult Social Care, Health and Public Protection (ASCHPP) - Nottinghamshire Healthcare NHS Trust


Rehabilitation seven days per week for elective orthopaedic patients - Golden Jubilee National Hospital, Scotland

Physiotherapist services contributing to reduced length of stay and increased patient outcomes - Northumbria Healthcare NHS Foundation Trust

Consultant led and delivered orthopaedic trauma service - Oxford Radcliffe Hospitals NHS Trust


Seven day residency pharmacist model - Oxford Radcliffe Hospitals NHS Trust


Seven day respiratory physiotherapy services improve quality, patient outcomes and contribute to reduced length of stay - Guys and St Thomas' NHS Foundation Trust

Introduction of a seven day respiratory surgical physiotherapy service and a new innovative role of physiotherapy assistant practitioner - South Tees Hospitals NHS Foundation Trust


Physiotherapy and occupational therapy seven day service for the stroke unit and community team - Newton Abbot Hospital, Torbay and Southern Devon Care Trust

A seven day service for the assessment and treatment of transient ischaemic attack (TIA) - University Hospitals of Leicester NHS Trust

Developing a 24/7 service on the acute stroke unit - University Hospital of North Staffordshire NHS Trust


Telemedicine supporting seven day services across a range of clinical specialties

Therapy services

Seven day therapy service - Heart of England NHS Foundation Trust

Introduction of a seven day physiotherapy service across ICU, HDU and surgery - South Tees Hospitals NHS Foundation Trust