Abstract
The acute hospital system in the NHS is in crisis, with the rising demands of treating elderly comorbid patients and limited financial and workforce resources. An increase in the workforce trained in and delivering general medical services seven days per week has been proposed as a solution to this crisis. The current trainee and consultant workforce is unable to provide this increase because of imbalances between training and service delivery, the different demands of large and small hospitals and the need to simultaneously provide high-quality specialised services. The demographics of the NHS medical workforce are also changing, which will limit expansion. It is very unlikely that a generalist workforce can be achieved in less than 10 years without a clear governmental strategy and increased staffing levels, both of which seem unlikely at present.