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High weekend hospital death rates due to ‘multiple factors’ - not doctor availability

Staff shortages at all levels, overcrowding, sicker patients and diagnostic test results delays are among the reasons cited by doctors for the increase in hospital death rates at weekends, a survey by healthcare intelligence provider Binley’s has found.

The survey, which was conducted via Binley’s online HCP community, OnMedica, and asked more than 1,230 primary and secondary care doctors in England to cite the most important factor in weekend hospital death rates, suggests that a wide range of issues could be to blame.

Twenty percent of respondents stated either overcrowding
due to a rise in unplanned admissions, or a slower turnaround in diagnostic test results. Thirteen percent said lighter or reduced rostering of nursing staff and 11 percent lack of consultants reviewing sick patients.

Thirty seven percent of respondents believed ‘other’ factors were primarily to blame, with comments including:

"Increased overall demand on services (both acute and chronic) with a massive under-availability of manpower resources.”

"Evidence suggests that patients admitted are sicker. Little evidence that failure in clinical care is the main cause.”

"It’s multifactorial - reduced background support and reduced clinical staffing at all levels both in hospital and in the community.”

"It’s a lack of junior and middle grades that is the problem; there is only a skeletal medical staff. My ITU has four trainee doctors in the day but only one out-of-hours and at weekends. Consultants are not on the wards much more during the week - they are in theatre or clinics mainly.”

Seventy-five percent of doctors did not think hospital death rates would be reduced by consultants performing routine work at weekends, 11 percent thought it would improve the situation and 14 percent did not know.

When asked to cite the most important action that needed to be taken to reduce hospital death rates at weekends, 23 percent of respondents said an increase in community services to support terminally ill patients wishing to die at home.

This was closely followed by faster access to diagnostic testing (22 percent) and then an increase in the number of ward sisters and senior nurses working at weekends (15 percent).

Only eight per cent of respondents thought that increasing the number of consultants at weekends was the most important action that needed to be taken to reduce hospital death rates at weekends and even fewer (six percent) cited increasing the number of ancillary staff at weekends.

Twenty six percent of respondents selected ‘other reasons’, with comments including ‘stop underfunding the NHS’; ‘routine ward rounds (not necessarily consultant led) to identify patients who are not doing well earlier and help to discharge patients who are ready to go, thus reducing the bed crisis’, and ‘improve access to primary care and other supporting services’.

Sarah Eglington, healthcare intelligence director of Binley’s, said: "Our research suggests that weekend hospital death statistics may arise from a combination of factors, ranging from the type of patient who typically uses out-of-hours services to access to diagnostic services and clinical staffing at all levels.

"If it is to reduce weekend death rates in hospitals, the Government must engage with clinicians in order to understand the myriad of challenges faced by hospitals and other supporting NHS services, and create a comprehensive and integrated strategy to tackle them.”

Press contact:
For more information, please contact: Andrew Baud and Catherine McNulty, Tala +44 020 3397 3383 / 07775 715775

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