Patient safety

17.10.12

Higher death rate on weekends in NHS hospitals

Patients are on average 10% more likely to die during the weekends than in the week, new research suggests. It is estimated that 3,000 weekend deaths from 12 key conditions are preventable each year.

Dr Foster Intelligence, which analyses NHS data, conducted an in-depth review comparing death rates at weekdays and weekends.

It reviewed 337,385 weekday admissions with 100,590 weekend admissions, concentrating on 12 of the biggest conditions where death rates are higher at weekends than at weekdays.

Of these conditions, risk of death from admissions caused by thickening of arteries (e.g. heart attacks), rose from 20% at weekdays to 28% at weekends. Abdominal aneurysm risks rose from 27% to 37%, while pancreatic cancer patients had a 25% risk during the week compared to a 34% risk at weekends.

This rise in weekend death rates has been attributed to a lack of experienced senior doctors present in hospitals during weekends. Dr Mark Temple, acute care fellow at the Royal College of Physicians, has advised a review of senior doctors’ working hours over the weekend.

But Dr Temple also pointed to other contributing factors which could account for the relative ratio of death rates, such as at-home and hospice patients being admitted to hospitals during weekends.

Professor Ross Naylor, the president of the Vascular Society of Great Britain and Ireland, raised issues concerning consultant working hours. He told the Telegraph: “I work in a unit with seven consultants and seven-day working is quite straightforward for us.

“But there are about 120 units providing vascular surgery, and you can’t provide that level of care in those with two or three consultants. It’s not just about the surgeon, of course, it’s the whole team.”

Sir Bruce Keogh, medical director of the NHS, addressed this issue: “Urgency is often crucial when dealing with illnesses affecting the heart and vascular system and it should be the norm that these patients are seen promptly by an appropriately experienced clinician, including at the weekend.”

Sir Bruce concluded by announcing a review of consultant working hours: “We are working with hospitals and professional organisations like the Royal College of Physicians to make this a reality.”

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