Risk of dying on NHS ward higher at weekends

David Stout, deputy chief executive of the NHS Confederation.
David Stout, deputy chief executive of the NHS Confederation.
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PATIENTS are more likely to die if they are admitted to hospital at weekends, a new review of NHS treatment confirms today.

Researchers examined all 14.2 million admissions to hospitals in England in 2009-10 and 187,000 patient deaths within 30 days of being admitted.

They found patients were 16 per cent more likely to die if they were admitted on a Sunday than a Wednesday and 11 per cent more likely to die if they were admitted on a Saturday.

The findings follow a report in November which found patients needing emergency care were almost 10 per cent more likely to die if they were admitted on weekends and were less likely to receive prompt treatment.

Published in the Journal of the Royal Society of Medicine, the latest study found higher death rates if patients went into hospital on a weekend.

For every 100 deaths following admissions on a Wednesday, 116 occur for admissions on a Sunday.

The results are consistent with similar findings in 250 not-for-profit hospitals in the United States but are likely to lead to further calls for seven-day-a-week hospital care in the NHS concentrated in a smaller number of centres.

The study authors said: “Admission on Tuesday through Friday was associated with the lowest risk of in-hospital death, while admission on Sunday was associated with the highest risk.”

Lead researcher Prof Domenico Pagano, from the University Hospital Birmingham Foundation Trust, said several reasons could be behind the findings, including that patients who are seriously ill can find themselves admitted on weekends.

If they were less ill, they would have had their admissions postponed until a weekday.

Prof Pagano said reduced staffing and fewer senior doctors on duty as well as poor access to tests could also have an effect.

“It may be that reorganised services providing seven-day access to all aspects of care could improve outcomes for higher risk patients currently admitted at the weekend,” he added.

NHS Confederation deputy chief executive David Stout said one solution involved concentrating expertise and delivering services from a smaller range of sites.

“Patients should never have to worry about what is the ‘right’ time to visit their local hospital. We need to make sure we are getting the quality of hospital care to a consistently high level 24 hours a day, seven days a week,” he said.

In November, the Hospital Guide, from Dr Foster Intelligence, found that around one in eight trusts had higher-than-expected death rates at weekends. It said hospitals with the fewest senior doctors on duty have the highest death rates overall. In a “handful” of NHS trusts, the death rate rose by 20 per cent or more at weekends.

The Department of Health is looking at ways the NHS could provide more services at the weekend, including carrying out more tests and consultant cover. It is expected trusts could be paid extra for extending weekend working, while GPs could be handed incentives to strike deals with hospitals which deliver care at weekends.