According to The Guardian and Channel 4 News reports, a confidential Department of Health study has identified multiple risks to patients from the Government's planned expansion to deliver NHS services seven days a week by 2020.

This has already led to significant dispute between the Government and health workers over resourcing, most obviously in the context of the junior doctors' strikes. The Department of Health has now highlighted 13 separate areas of risks. These include that there are insufficient staff, particularly GPs and hospital doctors, and that the increased funding the Government has announced to date cannot cover the extra costs the NHS faces. It also has concerns about the lack of detailed costings, inadequate risk assessment and limited data to support the policy.

The President of the Royal College of Physicians, Professor Jane Dacre, warns that the drive to expand medical services at weekends is unrealistic. She highlights that the NHS struggles to deliver care five days a week on its current resources and already faces a shortage of doctors that is getting worse. There are simply not enough qualified staff to provide a seven-day service.

Separately, an independent think-tank, the Nuffield Trust, has warned that the spending increase the Government has announced to date for the NHS will only help it cope with the increase in demand on existing services. It will not enable the NHS to cover the increase in staff needed to deliver the additional services wanted by the Government.

Andrew Clayton, a member of the Penningtons Manches clinical negligence team, comments: "There is no doubt that there is an unacceptable variation in the quality of NHS care at different times of the week, with weekends a particular concern. Delivering consistent, high quality care seven days a week is laudable, but it needs to be properly focused and adequately resourced if it is to deliver its aim of improved patient safety.

"These reports suggest there has been inadequate assessment of the impact of extended NHS services on GPs, hospitals and emergency and urgent care providers. There is little point expanding NHS care if patient safety concerns are not addressed. More needs to be done to determine the costs and resources needed to deliver improved patient safety consistently every day of the week."