Dr Foster recently published its latest annual hospital guide, the main focus of which was on weekend staffing in A&E departments. The report has identified the fact that ‘being admitted to hospital at weekends is risky’.
It goes on to state that ‘patients are less likely to get treated promptly and more likely to die. The chances of survival are better in hospitals that have more senior doctors on site’. However, alarmingly, it also found that some hospitals with A&E departments have very few senior doctors working in the hospital at weekends or overnight. The findings of the Dr Foster report support the Royal College of Physicians (RCP) 2010 recommendation that any hospital admitting acutely ill patients should have a consultant physician on-site for at least 12 hours per day, seven days a week. No other duties should be scheduled during this time. In addition, all medical wards should have at least one daily visit from a consultant; in most hospitals this will involve more than one physician. Appropriate time off in-lieu should be allowed for these additional hours. Commenting on the report, Inside your hospital, Sir Richard Thompson, president of the Royal College of Physicians, said: “At last we have data that clearly links higher numbers of senior doctors in hospitals at the weekend with lower mortality rates. Over the past 10 years, the number of doctors in the NHS has steadily increased and it is therefore not surprising that mortality rates have fallen. We must ensure that consultant numbers continue to increase to allow higher levels of staffing at the weekend in all hospitals. The 2011 Dr Foster report also echoes the Royal College of Surgeons (RCS) view on areas such as improving consultant-led cover at weekends, uptake of new technology and concentrating operating in high volume units where outcomes are better. Professor Norman Williams, president of the Royal College of Surgeons, said: “Surgeons are leading the way in producing detailed audits in areas such as cardiac surgery, vascular care, bowel cancer treatment and obesity operations which are helping reduce variation between hospitals and drive up standards. It is heartening that this study acknowledges that patient safety and hospital mortality is continuing to improve across the NHS. By pulling all this together into a report designed for patients, Dr Foster is making a positive contribution to the public debate about our health service.” “Mortality rates in the NHS are going down, but hospitals with high rates and poor outcomes in the evenings and at weekends must investigate to see where performance may be falling short and look to those with the best rates to see how they can improve,” said NHS medical director Professor Sir Bruce Keogh. “By working together and sharing best practice, hospitals can improve services for patients. I will be asking the NHS medical directors to look closely at weekend services to ensure patients admitted at weekends receive the same standards of care as those during the week. This problem is not unique to the NHS, it confronts all health systems in the world, but I am confident the NHS is well placed to address these issues.”
