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Emergency care rules fail to curb ‘weekend effect’ hospital deaths

Introducing priority standards for emergency care in hospitals in England has failed to curb excess deaths at weekends, say researchers who call for the rules to be reviewed before they become mandatory

Introducing four priority standards for emergency care in hospitals in England has failed to curb excess deaths on Saturdays and Sundays, the first study of its kind has shown.


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The standards were introduced in 2015 to tackle the so-called ‘weekend effect’ of increased mortality rates and apply to up to 14 specialties.

They focus on the speed and frequency with which patients are seen by senior doctors and their access to diagnostic tests and treatment on seven days of the week.

235,146

of the 501,561 deaths in England in 2016-17 occurred in hospitals

Source: Public Health England

University of Manchester researchers reviewed the performance of 123 hospital trusts using data on deaths within 30 days of admission against the standards set in 2015, as well as weekend death rates for the three years to 2015-16.

Analysis of the figures showed that adoption of the four clinical standards was not associated with numbers of excess deaths among patients admitted on Saturdays and Sundays.

The researchers say the lack of associations could be for three reasons: poor quality data, the standards do not reduce excess weekend deaths, or the weekend effect may be the wrong measure to judge the benefits of seven-day services.

They recommend the standards be reviewed before adoption becomes mandatory in 2020.


Meacock R, Sutton M (2017) Elevated mortality among weekend hospital admissions is not associated with adoption of seven day clinical standards. Emergency Medicine Journal. doi: 10.1136/emermed-2017-206740

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