By continuing to use the site you agree to our Privacy & Cookies policy

UK hospital death rate higher for weekend admissions

People are more likely to die if they are admitted to hospital at weekends, a large-scale review of NHS data has reiterated.

Patients are 16% more likely to die if they are admitted on a Sunday than a Wednesday, and 11% more likely to die if they are admitted on a Saturday.

For every 100 deaths following admissions on a Wednesday, 116 occur for admissions on a Sunday - a “significant increased risk”, the researchers said.

It follows a report in November which found patients needing emergency care are almost 10% more likely to die if they are admitted on weekends and are less likely to receive prompt treatment.

The new analysis covered all admissions - more than 14.2 million - to NHS hospitals in England during 2009/10, including both emergency and planned admissions.

It looked at more than 187,300 patient deaths within 30 days of being admitted to hospital.

The researchers found higher death rates if patients went in on a weekend but a slightly lower death rate if people were already in hospital on a weekend.

Being already in hospital on a Sunday led to an 8% reduced risk of dying on that day compared to already being in hospital on a Wednesday.

The medical conditions resulting in the biggest number of in-hospital deaths included pneumonia, congestive heart failure, heart attack, septicaemia, acute renal failure, urinary tract infections and neck or hip fracture.

The experts, including from University College London and the Universities of Birmingham and East Anglia, wrote in the Journal of the Royal Society of Medicine (JRSM): “We identified a significantly higher risk of subsequent in-hospital death during the 30-day follow-up period associated with admission during the weekend (Saturday or Sunday), compared to mid-week days.

“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.

“Admission on Saturday was associated with a marked increased mortality (death) risk and admission on Monday was associated with a less, but statistically significant, increased risk.”

Lead researcher Professor Domenico Pagano, from the University Hospital Birmingham Foundation Trust, added: “These results offer conclusive evidence that confirms previous reports of increased 30-day mortality risk for patients admitted to hospital with emergency conditions at the weekend compared with the rest of the week.”

He said several reasons may 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 week day.

Prof Pagano also said reduced staffing and fewer senior doctors on duty as well as poor access to diagnostic tests on weekends could have an effect. The Department of Health is looking at ways the NHS could provide more services at the weekend, including more tests and consultant cover.

While this will not be imposed, tools such as providing financial incentives for trusts to promote weekend working and incentives for GPs to strike deals with hospitals which deliver care at weekends could be introduced.

As well as publishing data on outcomes for patients, hospitals may be rewarded a small bonus percentage of their income for offering care at weekends.

 

Readers' comments (18)

  • I suspect that the outcomes would be even worse if they looked at Friday night admissions...

    Unsuitable or offensive?

  • this is appalling. at the risk of stating the obvious, the day of the week or the time of day should have no bearing whatsoever on the treatment a patient receives or their survival rate. patients admitted in an emergency do not choose the date, day or time. such an idea is totally irrational and flawed!

    Unsuitable or offensive?

  • Seeing as a lot of hospital services are closed or run on skeleton crew during the weekend, this isn't in the least bit surprising. Calling in someone from home in an emergency always takes time, and time is crucial with medical care. The more prompt a service can be called upon the better.
    Also, the whole "wait & see how it is on Monday" attitude is rife through the NHS. Investigation that would be undertaken immediately in the week are sat on at the weekend. It's time this ended & services are made 24/7.

    Unsuitable or offensive?

  • Melanie Hill | 3-Feb-2012 3:18 pm

    Excellent comment. I wrote the one above yours but two more things now come to mind:

    when I worked in Switzerland in a city university hospital all staff had to live within a certain radius of the hospital so that they were available in an emergency when needed. This was in the statute and was a condition of the employment contract;

    those who took up a career in healthcare have to be prepared to make some sacrifices with their time and that includes being available when needed 24/24 (obviously excluding pre planned holidays when away) no matter what their level. this is the price we all pay. we get off duty and are only disturbed in exceptional circumstances if there is a staff shortage but also have to expect some call duties and availability during unsocial hours.

    Unsuitable or offensive?

  • michael stone

    Anonymous | 3-Feb-2012 12:36 pm

    It is a fair few years since I was inside a hospital, but are you someone who works in one - in the mid 1990s hospitals seemed to almost empty of doctors at weekends !

    By the way, i heard comment about this on R4 this morning, and the outcomes are apparently worse even for planned weekend admissions, not just for weekend emergencies.

    Unsuitable or offensive?

  • Not shocked I work on a ward were during the week there are docs present 9-5 - after 5 and at weekends on call system. Why will patients be at their worst between 9-5, the whole hospital should be open 24/7. Not rocket science.

    Unsuitable or offensive?

  • I am afraid this situation will only get worse with Chief Execs up and down the country trying to make massive savings. When Cameron promised frontline services would not be affected he was either lying or living in cloud cuckoo land.

    Unsuitable or offensive?

  • Sarah Stanley | 4-Feb-2012 12:09 pm

    how will GP commissioning affect this?

    will NICE still be the decider or will GPs have the power to override their decisions?

    will it give GPs more choice or will it limit availability of drugs and treatment even more?

    Unsuitable or offensive?

  • Ms Stanley

    sorry got my webpages mixed up and stupidly answered your comment without scrolling back to the top of the page. My answer was because I thought i was on the page about prostate cancer drugs being too expensive and your comment was about that. Silly me but perhaps you would have some comments on my questions above as well. I think you can see how the problem could also relate to your remark about the situation getting worse, etc.!

    As for your comment above I am sad to agree although I thought the cut backs were to be more to the effect of getting rid of some of the administration and their high salaries in favour of staff more fit for the purpose of actually caring for patients in the NHS.

    Unsuitable or offensive?

  • Anonymous | 3-Feb-2012 3:33 pm

    "those who took up a career in healthcare have to be prepared to make some sacrifices with their time and that includes being available when needed 24/24 (obviously excluding pre planned holidays when away) no matter what their level. this is the price we all pay. we get off duty and are only disturbed in exceptional circumstances if there is a staff shortage but also have to expect some call duties and availability during unsocial hours. "

    No thank you!! The NHS already abuses the good nature of its staff. The price we all pay, and have been paying for years, is too high. Why do people think that we should be slaves to our jobs? We have families and lives of our own. Nursing should not expect to own our rights to a decent life.

    Unsuitable or offensive?

  • This is not just about consultant having the weekends off, but also about the culture of the NHS support departments. Traditionally, their contracts were written up as Mon-Fri 9-5 = no routine medical records staff, x ray, scanning, outpatients, Pharmacy, cardiology support staff etc

    Clearly, no point in bringing in the Consultants to diagnose if no 'diagnostic' facilities available and no diagnostic facilities, no formal diagnosis and no specific treatment.

    Also, will need more staff if these depts do go 24/7 - and this government is simply not going to cough up that sort of cash - cheaper to let the patients die.

    Unsuitable or offensive?

  • Anonymous | 4-Feb-2012 4:39 pm

    "No thank you!! The NHS already abuses the good nature of its staff. The price we all pay, and have been paying for years, is too high. Why do people think that we should be slaves to our jobs? We have families and lives of our own. Nursing should not expect to own our rights to a decent life."

    The NHS does abuse the good nature of it's staff, however, I always knew when I started nursing that I would be expected to work weekends, nights and holidays as healthcare provision needs to be 24 hours a day, 7 days a week. I don't agree with the awful internal rotation system where next week I have an Early, Night and Long Day in the same week though, more care should be given to planning rotas etc so staff can spend time with their families.

    Unsuitable or offensive?

  • I totally support the point about diagnostic services needing to be more available out of hours but I just cant imagine where the money is going to come from for that. Good point also about Consultants wasting thier time coming in if they cant access the treatment/ tests they need for their patients. IT ALL COMES DOWN TO MONEY!

    Unsuitable or offensive?

  • Anonymous | 4-Feb-2012 5:26 pm
    from
    Anonymous | 4-Feb-2012 4:39 pm

    I take your point. I knew when I entered nursing in 1980 that I would be expected to work unsocial hours, weekends, nights, etc. However, I have more than kept my end of the bargain; working many extra hours to cover emergencies, staffing cuts, missing breaks; on duty early and off duty late. We all know and experience this on a regular basis. I've spent years doing jobs which also required being on call. (something that most nurses know nothing about, thankfully).

    The one constant in all these years is this: The more you give, the more they will expect you to give; and when you outlive your usefulness, you will be thrown onto the heap. I've seen it happen too many times.

    So when someone actually advocates further advantage being taken of us as a solution to weekend issues in hospital, I have a problem with that. Let's not forget, which professionals are actually to be found in a hospital 24/7, 365 days a year? Yep. Nurses. It's time for the AHPs and Medics to did their bit. I'm fed up paying the price!

    Unsuitable or offensive?

  • From Anonymous | 3-Feb-2012 3:33 pm

    I was actually referring to the lack of availability of the consultants at weekends and out of hours in my comment although I didn't think it necessary to spell this out. My apologies if this was not clear.

    Obviously nurses already make more than their fair share of the sacrifice and their services cannot be stretched anymore without the provision of extra staff.

    Unsuitable or offensive?

  • I dread emergencies after 5 and weekends on my ward, having to use bleep system. As previously mentioned why do we have 3 doctors on ward between 9 - 5 and none after 5 and weekends. We should have a 24 hour service all year round surely the resulting faster discharges would help the bed situation.

    Unsuitable or offensive?

  • Anonymous | 4-Feb-2012 10:06 pm

    "The one constant in all these years is this: The more you give, the more they will expect you to give; and when you outlive your usefulness, you will be thrown onto the heap. I've seen it happen too many times."

    I completely see your point now, I agree with you there, it always seems to be the same people on the wards who turn up to cover sickness etc because they are the first ones rang because they are known to be the 'helpful' ones etc.

    Unsuitable or offensive?

  • michael stone

    It was 1995 - so things might be better now - but when my dad was in hospital and needed a prescription drug one Sunday, he told me the hospital had to get an outside GP to presribe it ! Coventry's main hospital, and our population is ca 300,000.

    Unsuitable or offensive?

Have your say

You must sign in to make a comment.

Related Jobs

Sign in to see the latest jobs relevant to you!

newsletterpromo