Out of hours patients face increased risk of dying

More than half a million patients are admitted to a London hospital as an emergency every year, but new figures show that patients admitted at the weekend have a significantly increased risk of dying, compared to those admitted on a weekday.

The findings are highlighted in a report, published by NHS London and London Health Programmes, which sets out the need for change in hospital care for emergency patients. Evidence put forward by leading clinicians suggests that increasing the number of hours hospital consultants are available at weekends and improving access to diagnostic scans could save more than 500 lives every year in London. Dr Andy Mitchell, medical director at NHS London, said: “The reasons for differences in mortality rates during the week compared to the weekend are complex. However, we know that one of most important factors in improving outcomes for patients is to be assessed by an experienced consultant as quickly as possible. In some cases this happens, but our review found that many hospitals in London had insufficient consultant cover, particularly at weekends. “We want patients in London to have access to the same services 24 hours a day, seven days a week. Continuing to give patients poorer care at the weekend is not an option. Every avoidable death is one too many. This is not a Londonspecific problem but we are leading the way to find a solution. The improvements we have achieved with stroke and cardiac care should be extended to all patients, no matter what their underlying condition.” A panel of GPs, physicians, surgeons and nurses has developed new commissioning standards to provide high-quality and safe hospital care across every day of the week, including weekends. This follows an extensive review of the quality of care inpatients receive in hospital and discussions with patient groups. These standards include the need for all emergency patients to be seen and assessed by a consultant within 12 hours of being admitted to hospital and for patients to have access to diagnostic scans within one hour, 24-hours a day, if they are in a critical condition. Professor Matt Thompson, professor of vascular surgery at St George’s Healthcare NHS Trust and clinical director for the review, said: “This is not about money or understaffing – we believe there are enough consultants working within the NHS in London, but current working practices leave some hospitals with insufficient consultant cover, particularly at weekends. One answer may be to bring consultants together in the right places – like centralised services in London for heart attacks and stroke which is already saving hundreds of lives every year in London. However, it will be up to clinicians and commissioning groups to decide, in discussion with patient groups, how services should be improved. “Carrying on as we are is not an option; patients deserve better than to hope the right consultant is available if they are admitted on a weekend. We have to make the NHS in London work better as a system for patients.”

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