New study questions weekend death rates in hospital

A NEW study from the University of Manchester has found that fewer patients in England die after being admitted to NHS hospitals at the weekend compared to during the week, which is contrary to the prevailing government view.

The study conducted by Centre for Health Economics concluded that the death rate following hospital admissions at the weekend is higher only because the number of patients admitted is lower than during the week and tends to be those more seriously ill.

Publication of this research in the Journal of Health Services Research and Policy is significant in that NHS plans to extend hospital seven-day services are based on research showing that the rate of mortality is higher amongst patients admitted to hospital at the weekend compared to those admitted during the week. It has been assumed that this is due to reduced availability of senior staff and diagnostic services in hospitals at weekends.

Previous studies considered the overall number of patients admitted to hospital but the Manchester researchers also looked at patients attending A&E departments between April 2013 and February 2014. It found that similar numbers of patients attended A&E each day at weekends and weekdays but hospital A&E departments admitted seven per cent fewer patients at the weekend and these tended to be "sicker patients". Looking at deaths in hospital within 30 days of admission the study demonstrated that the mortality rate was significantly higher at weekends amongst direct admissions due to the proportionately greater reduction in admissions relative to deaths.

Professor Matt Sutton, who led the research, said: "Hospitals apply a higher severity threshold when choosing which patients to admit to hospital at weekends – patients with non-serious illnesses are not admitted, so those who are admitted at the weekend are on average sicker than during the week and more likely to die regardless of the quality of care they receive.

"As a result, the figures comparing death rates at weekends and weekdays are skewed. The NHS has rushed to fix a perceived problem that further research shows does not exist."

Dr Mark Porter, BMA chair of council, commented: "This huge and robust study confirms what doctors have been saying all along: there is a lack of evidence showing that the “weekend effect” is caused by the absence of senior doctors. It is a far more complicated picture than the one the government has tried to portray."