Patients admitted at weekends more likely to die at Dorset County Hospital new figures show

Figures from NHS digital show the difference in hospital mortality rates during the weekend and during the “midweek period – which runs from Tuesday to Thursday – between October 2016 and September 2017.

Meanwhile, Monday and Friday are classed as ‘transition’ days and do not count towards the final figure.

In the report, NHS bosses say that odds ratio greater than 1 mean that the odds of mortality within 30 days of admission for patients admitted at the weekend are higher than for midweek admissions.

This applies to DCH, which has an odds ratio of 1.10.

The data is based on number of measures, including mortality within 30 days of admission, emergency readmissions within seven days of discharge and length of stay following an emergency admission but does not show how much more likely a patient could die.

The local trend matches national figures, and it is widely accepted that there is a ‘weekend effect’ at hospitals, where death rates rise on Saturday and Sunday.

This is because of a number of possible explanations for the differing mortality rates including service provision inside and outside the hospital, patient behaviour and the variance of patients.

The figures, NHS Digital says, are a ‘smoke alarm’ which requires further investigation by the trust and should not immediately be interpreted as indicating bad performance.

But academics at the University of Manchester said that the increase in deaths at the weekend was only because fewer patients were admitted, and these patients tended to be sicker after undertaking an investigation.

Dr Rachel Meacock, from the university’s centre for health economics, said: “We found no association between Trusts’ performance in relation to any of the Department’s four standards and the death rates for patients admitted at weekends.

“This is not surprising given the lack of evidence linking mortality to consultant presence and service provision at weekends.”

“There is bias in the NHS results, because they are dividing a higher number of deaths by a lower number of admissions.”

The latest report itself gives a number of possible explanations for the differing mortality rates, including case-mix of patients “over and above that accounted for in the analysis”, patient behaviour and provision of services both in and outside of the hospital, including social care.

However, the British Medical Association (BMA) said that the data of weekend mortality is complex.

Dr Chaand Nagpaul, chairman of the British Medical Association, added: “Doctors are committed to providing the best possible treatment to patients when they fall ill and the BMA supports high quality consistent patient care across the week.

“We know that more seriously ill patients are likely to be admitted to hospital during these hours, so better evidence is needed before making any assumptions on how to address this seeming weekend effect.”

However, DCH hospital bosses rebuffed the figures with a spokesman for the hospital saying: “Patients can expect the highest standards of care at Dorset County Hospital, whatever day of the week they are admitted.

“These figures are complex and should be interpreted with caution. One factor is that patients admitted to hospital at weekends tend to be seriously ill.”