Weekend patients at higher death risk

A new study has revealed that 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.

The 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 authors found 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.

This suggests a generalised "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, say the authors. Patients already in hospital over the weekend do not have an increased risk of death.

The authors caution that it is not possible to show that this excess number of deaths could have been prevented; adding that to do so would be "rash and misleading."

Nevertheless, they say 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 at weekends to improve quality of care and reduce deaths.

But an accompanying feature article by Helen Crump at the Nuffield Trust says 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.

She also warns that, 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 BMJ this week.