Patients admitted to hospital at the weekend are likelier to be sicker and have a higher risk of death, compared with those admitted during the week, revealed a new study. This analysis was carried out as collaboration between University Hospital Birmingham NHS Foundation Trusts and University College London, and included Sir Bruce Keogh, National Medical Director of NHS England.
In the latest analysis, the study authors observed that around 11,000 more people die each year within 30 days of admission to hospital on Friday, Saturday, Sunday, or Monday compared with other days of the week. The authors said, "This suggests a generalized 'weekend effect' which can be partly explained by the reduced support services that start from late Friday through the weekend, leading to disruption on Monday morning."
However, the study suggested that patients already in hospital over the weekend do not have an increased risk of death. The authors cautioned that it is not possible to show that this excess number of deaths could have been prevented. They further added, "To do so would be rash and misleading. Nevertheless, the number is not otherwise ignorable and we need to determine exactly which services need to be improved at the weekend to tackle the increased risk of mortality."
The debate on seven day working was reignited following health secretary Jeremy Hunt's recent call for hospital doctors to work over the weekends to improve quality of care and reduce deaths. An accompanying feature article by Helen Crump at the Nuffield Trust said, "It is not clear how or to what extent investment in seven day services will reduce weekend deaths, and that the costs may outweigh any benefits. Unless overall staffing levels increase, ramping up services at the weekend will leave a gap in the hospital's weekday rota, with potentially serious consequences across other services."
The study is published in the British Medical Journal.