‘Weekend effect’ called into question again Believing patients are more likely to die after being admitted to hospital on a Saturday or Sunday – the so-called […]

Believing patients are more likely to die after being admitted to hospital on a Saturday or Sunday – the so-called weekend effect – is a “major oversimplification” of a complex issue, according to two new studies published in The Lancet.

The first paper found no association between weekend senior doctor staffing levels and mortality. Experts compared senior doctors’ involvement in emergency admissions at 115 NHS trusts on a Sunday in June two years ago and again on a Wednesday, three days later.

The days were selected as they are associated with the highest and lowest mortality rates. June was chosen as it has no public holidays and is unaffected by winter pressures.

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The authors did find the mortality risk among patients admitted at weekends was higher than on weekdays, carrying an increased risk of 10 per cent. But when they plotted mortality risk against senior doctor staffing levels, there was no evidence of an association between the two.

The “weekend effect” overshadows a much more complex pattern of weekly changes in quality of care, which are unlikely to be addressed by simply increasing the availability of hospital doctors on Saturdays and Sundays, the researchers said.

“To say that lower staffing is the cause for increased mortality is far too simplistic and not supported by the evidence,” lead author Professor Julian Bion, of the University of Birmingham, said.

“Policy makers should be extremely cautious when attributing the weekend effect directly to the lack of consultants at the weekend.”

The second paper, led by experts from King’s College London and University College London, looked at weekend stroke care.

There was no difference in 30-day survival for patients admitted during the day at the weekend, compared with during the week, and only very weak evidence that survival was worse for patients admitted overnight compared with those admitted during the day.

Lead author Benjamin Bray, from the Royal College of Physicians’ Clinical Effectiveness and Evaluation Unit and UCL, said: “Our study shows that the ‘weekend effect’ is a major oversimplification of the true extent and nature of variations in the quality of care that occur in everyday practice. Our findings apply to stroke care in particular but are likely to be reflected in many other areas of health care.”

The studies follow similar University of Manchester research last week which said death rates following hospital admissions at the weekend are higher only because fewer patients are admitted at the weekend and they tend to be sicker, skewing the figures.

They will add to evidence against Health Secretary Jeremy Hunt’s insistence on the existence of a “weekend effect” due to lower staffing levels, one of the key factors behind the Government’s push for a seven-day NHS which has led to the dispute with junior doctors.

A Department of Health spokesman said: “Once again, we are being presented with clear evidence of variation in care across the week – one study showing that on Sundays some hospitals have half the number of staff in key specialties than they do on Wednesday, and the other showing that care for stroke patients varies according to when they are admitted for treatment.

“This ‘weekend effect’ is the established consensus of the medical and scientific community and the Government makes no apology for tackling the variety of factors that contribute to this, including staffing levels and access to diagnostics, to create a safer seven-day NHS.”