'˜Weekend effect' on hospital mortality is over-simplified, say academics

THE 'weekend effect' on hospital mortality rates - one of the key factors behind the Government's push for a seven-day NHS - is a 'major oversimplification' of a complex issue, academics have said.
Junior Doctors on the picket line outside the LGI. PIC: Tony JohnsonJunior Doctors on the picket line outside the LGI. PIC: Tony Johnson
Junior Doctors on the picket line outside the LGI. PIC: Tony Johnson

Two new studies published in The Lancet journal suggest the concept, which suggests the mortality rate for patients admitted to hospital at weekends is higher than those admitted Monday to Friday, is over-simplified.

The first paper, led by the University of Birmingham, found no association between weekend senior doctor staffing levels and mortality, while the second, led by experts from King’s College London and University College London, looked specifically at weekend stroke care, and found no difference in 30-day survival for patients admitted during the day at the weekend compared with during the week.

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On Monday, embattled Health Secretary Jeremy Hunt faced a grilling from MPs in the Health Select Committee over the weekend effect and his push for a seven day NHS - one of the Government’s key aims that has led to the dispute with junior doctors.

He told the committee: “I am not an academic but I think the mistake for a health secretary is to look at the overwhelming amount of evidence there is of a weekend effect and decide to get off the hook and disputing the methodologies.”

But the chairman of the British Medical Association, Dr Mark Porter said the past week had seen a “flurry” of studies which “confirm what doctors have been saying all along” - that there is a lack of evidence showing that the weekend effect is linked to medical staffing levels.

Dr Porter said: “These academics are the latest in a long line of health professionals and leading experts to challenge the Government on its misleading use of figures,” he said. “It is a far more complicated picture than the one the Government has tried to portray. The Health Secretary should be very careful with his narrative and pay attention to proper investment and joint working with healthcare staff, rather than obsessing about medical employment contracts.”

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An NHS England spokesman said: “These latest studies don’t alter the wider issue that sick patients rightly should expect to be seen by a consultant within a few hours, have prompt access to tests and treatments and receive joined-up care, whatever day of the week they fall ill, as recommended by the Academy of Medical Royal Colleges.”

Meanwhile, MPs in the Public Accounts Committee have warned that staffing gaps in the NHS could lead to “shortcomings” in quality of care for patients and longer waiting times.

A new report from the committee found that in 2014 there was a shortfall of around 5.9 per cent of clinical staff working in the NHS - equating to a gap of around 50,000 staff.

The MPs add that “no coherent attempt” has been made to assess staffing implications on the Government’s pledge for a seven-day NHS.