SENIOR doctors in Scotland are to discuss how to implement a full seven-day-a-week service for patients in the NHS amid increasing concerns that patients admitted at weekends and on public holidays are more likely to die.

A symposium being held by the Royal College of Physicians and Surgeons of Glasgow (RCPSG) next month will consider the implications of extending the service rather than simply offering emergency cover at weekends.

The Scottish Government told the Sunday Herald that it believes "serious consideration" should be given to extending services to provide "seamless seven-day care".

There is increasing debate over extending the current five-day full service in the NHS, with several studies in recent years suggesting that patients admitted to hospital outwith the standard working week have higher death rates.

The medical director of the NHS in England, Sir Bruce Keogh, also recently called for senior doctors to be routinely on the wards every day of the week.

He said: "We must ask why, in many hospitals, expensive diagnostic machines and pathology laboratories are under-used, operating theatres lie fallow and clinics remain empty [at weekends].

"Yet access to specialist care is dogged by waiting lists and general practitioners and patients must wait for diagnostic results."

Dr Frank Dunn, president of the RCPSG, said the symposium, on May 28, would examine the pros and cons of extending the normal weekday service to weekends. He suggested the focus should initially be on improving care for acute admissions, before considering whether planned appointments should be available every day of the week.

"First of all, we could make sure that acute care is standardised throughout the working week; what specialties would need a consultant in more hours than at present or what radiology investigations would need to be available at the weekend.

"The next stage down the line would be to see if there is any merit moving towards elective work at the weekends," he said.

However, he pointed out that there were issues around holding routine clinics at weekends, with the extra resource implications exacerbated by European directives which limit the number of hours that staff can work in a week.

He added that it was not just a "doctor issue", as different services would need to be available to support their work.

He said: "Health workers, like everyone else, have commitments outwith their hospital and while they are all very willing to do emergency work, it would be a big step.

"So I think we should do this in stages; look first of all at the emergency situation, and then after that look at perhaps what we can do to look at weekend clinics and so on."

Dunn said research in other countries in Europe, such as Spain, also showed that patients were more at risk at the weekends when staffing levels were reduced.

He said the aim of the meeting is to produce a report to inform different agencies about the issue, including a working group which has been set up by the Scottish Government to examine a full seven-day service.

One of the speakers at the conference is consultant Professor Chris Isles, who was part of a research team which carried out a two-year study in Dumfries and Galloway.

It found patients admitted as emergencies on a public holiday were 48% more likely to die within seven days and 27% more likely to die within a month than those admitted on other days of the week.

Isles said: "Consultant physicians in Dumfries spend as much time on the admissions unit during public holiday as they do on normal days and weekends, but it is also true that fewer consultants and fewer junior doctors cover other medical wards during holiday periods.

"Therefore we might speculate that higher mortality among patients admitted on a public holiday reflects a cumulative lack of services and/or cumulative lack of doctors during these three to four-day periods."

ISLES said that more research was needed to establish other factors which could be influencing the results, such as sicker patients who had potentially put off seeking medical advice being admitted during public holidays.

But he supported the idea of having a seven-day service in the NHS, with the exception of routine outpatient clinics.

He added: "Intuitively, if you were organising a health service, you wouldn't have a five-day health service, you would have a seven-day service.

"It is illogical that you have fewer doctors and fewer services around on certain days of the week."

Consultant orthopaedic surgeon Ian Ritchie, president of the Royal College of Surgeons of Edinburgh, said the college "strongly supported" the principle of high-quality care for patients being available 24 hours a day, seven days a week.

He added that the implications of providing this service would have "far-reaching consequences for the way that clinicians will work in future".

A Scottish Government spokeswoman said: "While seven-day working is already a reality in some areas of NHS Scotland, we should give serious consideration as to what scope there is to extend the coverage of our services to provide patients with seamless seven-day care.

"Any move towards that would need to be conducted in partnership with professional and staff interests and through service redesign, rather than staff merely working longer hours."

She added: "We therefore welcome the fact that the Royal College is having this debate and look forward to discussing their conclusions with them."