Studies raise doubts about link between weekend deaths at hospitals and staffing levels

Association between hospital doctor staffing levels at weekends and patient mortality has been ruled out, according to the results of two studies. 

Both studies, published in The Lancet (online, 10 May 2016), confirmed that any link between mortality rates and weekend admissions was a complex issue and it was too simplistic to suggest it was because of the number of doctors on duty. 

The subject has become a hot topic in the UK as the government is keen to see a move to the provision of seven-day health services. 

Researchers at the University of Birmingham compared the number of hours worked by senior consultants responsible for emergency admissions between 8am and 8pm on a Sunday and a Wednesday at 115 NHS trusts^[1]
. 

The team found fewer doctors were available on a Sunday (1,667) compared to a Wednesday (6,105), and emergency admissions received half the doctor input on Sunday compared to midweek. There was a 10% relative risk increase of death at weekends but further analysis showed this was not linked to doctor numbers. 

The second study focused on the 30-day survival rate of 74,307 stroke patients admitted to 199 hospitals in England and Wales between April 2013 and March 2014^[2]
. The researchers found no difference in 30-day survival of patients admitted during the day at the weekend, compared to during the week, and only “very weak” evidence that survival was linked to a day or night admission. 

The authors conclude 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.