UK: Patients are 15% more likely to die in hospitals during weekends

NHS patients are twice as likely to die after being admitted to hospital at weekends, according to new research. There are significant differences in mortality even when a greater number of emergencies are taken into account.

About 11,000 more patients a year die within 30 days of going into hospital if they are admitted for treatment between Friday and Monday, compared to those who arrive on a Tuesday, Wednesday or Thursday.

The analysis of 14 million patients admitted to hospitals in England found that people admitted at the weekend were 15% more likely to die than those admitted on a Wednesday. Patients with cancer, heart problems or after a stroke were particularly at risk, having a "noticeably increased risk of death" along with cancer patients taken in on a Friday or Monday.

Sicker patients, less staff

Experts believe that reduced levels of staffing and backup services could be blamed for "weekend effect" of higher deaths. However, patients who go into hospitals at the weekend are likely to be sicker. A study of heart attack patients presented to cardiologists by the ACALM Study Unit found those who were admitted on Saturdays had death rates 20% higher than those who arrived at hospital during the week.

Prof Sir Bruce Keogh, NHS medical director, one of the authors of the study, said it revealed an "inconvenient truth" which could no longer be ignored. "The idea that patients are being harmed because of the way we organise our services is quite simply beyond what any of us can regard as acceptable," he said. "The moral and social case for action is simply unassailable."

"Change always brings practical difficulties that must be tackled, but we cannot duck the facts," said Prof Keogh. It is my job here to point out an inconvenient truth – doctors are trying their best but I have to think about the way that we can redesign services to address this issue."

Staffing reform needed

The research by University Hospital Birmingham NHS Foundation Trusts and University College London, examined the effect of hospital admission day on death rates across NHS England hospitals for 2013-2014. The research said: "Appropriate support services in hospitals are usually reduced from late Friday through the weekend, leading to disruption on Monday morning. This could go some way towards explaining our findings."

The Royal College of Surgeons said patients needed better access to senior staff and key tests at weekends. Its president, Clare Marx, said in a Telegraph report: "Patients that need treating at the weekend are less likely to be seen by the right mix of junior and senior staff and experience reduced access to diagnostics.

"Many doctors and NHS staff already work at nights and weekends and they should be valued and thanked for continuing to provide care during those unsocial hours. However, the evidence shows that this is not currently standard practice even in high-risk emergency care. This has to change."