Dr Foster: weekend A&E admissions '10pc more likely to die'

The guide said one in eight hospital trusts had higher than expected death rates on Saturdays and Sundays.

It echoes the findings of the first research for the Department of Health on the issue, revealed by HSJ today, that patients admitted on Sundays are 16 per cent more likely to die than those admitted on Wednesdays.

The DH research, based on a full year’s admissions data, found patients admitted on Sundays were 16 per cent more likely to die than those admitted on Wednesdays. Those admitted on Saturdays were 11 per cent more likely to die. There is also slightly higher risk for those admitted on Mondays. A similar pattern was seen in data from US hospitals.

The Dr Foster guide said that in a “handful” of trusts, the mortality rate was found to have risen 20 per cent or more at weekends. The overall death rate for emergency admissions rose from 7.4 per cent during the week to 8.1 per cent at weekends, a 9.5 per cent increase.

The report identified 18 trusts - 12 per cent of the total - where mortality rates were found to be higher than expected at weekends.

There were nine trusts where out-of-hours mortality “may be a particular problem” as it was within the expected range during the week but rose on Saturdays and Sundays.

NHS medical director Sir Bruce Keogh is writing to NHS medical directors to say the admissions analysis, which he commissioned earlier this year, and the Dr Foster report, contribute to “a growing body of evidence suggesting where there is a lack of access to clinical services and senior leadership… patients do not always experience parity of access to the optimum treatment or diagnostic test, which can contribute to less favourable outcomes”.

He called for a debate about how to address the problem, which was likely to include more weekend working.

Sir Bruce told HSJ: “The rest of the world has moved on. Twenty years ago nobody worked at the weekend – you couldn’t go to the supermarket. Now you can. What you can’t do is get regular, consistent access to healthcare services.”

NHS Confederation deputy chief executive David Stout said that despite over a decade of sustained improvements in hospitals some “really knotty challenges” remained.

“We see inconsistent care between hospitals and inconsistent quality over the course of a week,” he said.

“A big part of the answer is to change the way we deliver services, bringing them closer to home where possible and moving them further away when they need to be in order to provide the safest and best possible care.”