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Fewer people die in hospital at weekends contrary to government claims, study finds

Fewer people die in hospital at weekends than during the week, according to research.

The study contradicts claims by the health secretary, Jeremy Hunt, that more people admitted to hospital at the weekend die which has been used to justify the imposition of a new contract on junior doctors.

Hunt has repeatedly stated that junior doctors must routinely work at weekends because the higher death rate is linked to lower staffing levels.

A team from Manchester University addressed the question of why the death rate rises at the weekend among patients admitted to hospital as an emergency.

Their analysis looks at the numbers of people arriving in accident and emergency (A&E) as well as the numbers admitted to a bed.

It finds that there is indeed a “weekend effect”, because fewer people are admitted and they are the sickest patients, leading to a higher death rate than in the week.

In terms of actual numbers, the deaths are fewer.

Prof Matt Sutton, research lead, said: “Hospitals apply a higher severity threshold when choosing which patients to admit to hospital at weekends – patients with non-serious illnesses are not admitted, so those who are admitted at the weekend are on average sicker than during the week and more likely to die regardless of the quality of care they receive.”

“As a result, the figures comparing death rates at weekends and weekdays are skewed. The NHS has rushed to fix a perceived problem that further research shows does not exist.”

Hunt’s argument was bolstered by a study published in the British Medical Journal last September, one of the authors of which was NHS England’s medical director, Prof Sir Bruce Keogh. It looked only at patients admitted to hospital – not the numbers coming through A&E. It also found that the patients admitted at the weekend were sicker than in the week, but suggested that having more staff working could reduce the death rate.

The team from the University of Manchester’s Centre for Health Economics dispute that. They looked at all patients attending A&E departments between April 2013 and February 2014. They say the earlier study did not take into account the drop in the numbers. At the weekend, they have found, hospitals admitted 7% fewer patients.

Overall, says the study, published in the Journal of Health Services Research and Policy, patients attending A&E at the weekend are no more likely to die than patients attending A&E during the week.

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