Research finds no association between weekend staffing levels and patient mortality

New research involving researchers from our University has found no association between weekend senior doctor staffing levels and mortality, questioning whether increasing senior doctor weekend working would impact mortality rates.

The ‘weekend effect’ – that patients admitted to hospital over the weekend are at an increased risk of death – 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.

Researchers from the High-intensity Specialist Led Acute Care (HiSLAC) project led by the University of Birmingham and involving researchers from the University of Leicester, collected data on senior doctor input into emergency admissions at 115 NHS trusts at two time points – Sunday 15 June and Wednesday 18 June 2014, and compared this with weekend admission mortality rates average over one year.

There were substantially fewer senior doctors present and providing emergency care on Sunday (1667) compared to Wednesday (6105). This was partly offset by the fact that doctors spent on average 40% more time caring for emergency admissions on Sunday (5.74 hours) compared to Wednesday (3.97 hours).

Once the number of admissions per hospital was taken into account, the findings show that emergency admissions on a Sunday collectively receive on average less than half the input of senior doctors compared to patients admitted on Wednesday (21.90 total specialist hours per ten emergency admissions on Sunday; compared to 42.73 hours on Wednesday).

The researchers then looked at mortality data for all 115 trusts and compared this to staffing levels at each trust. Across all trusts, there was a slight increase in the risk of death associated with weekend admission (10% relative risk increase). However, there was no evidence to suggest that increased mortality was linked to senior doctor staffing levels.

Co-author of the study Dr Carolyn Tarrant (pictured) from our SAPPHIRE Group said: “As part of the HiSLAC project we are now exploring the differences in care for patients admitted to hospital at the weekend as compared to during the week, by conducting observations in 20 hospitals across England.”