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Emergency services study appears to contradict need for seven-day NHS

Major new study of NHS trusts in England reveals fewer people die in emergency hospital admissions at weekends.

There are no more deaths following hospital admissions at weekends with fewer patients admitted than during the week, a study has revealed.

Researchers from the University of Manchester and University of York claim that those who are admitted may be sicker, leading to the so-called ‘weekend effect’ of higher death rates at weekends.

The government has used previous studies, which have documented higher weekend mortality rates, to support moves for a seven-day NHS.

The study covered 140 non-specialist acute hospital trusts in England analysing 12,670,788 accident and emergency attendances and 4,656,586 emergency admissions between April 2013 and February 2014.

Researchers also compared weekday and weekend emergency attendances and admissions to hospital, and deaths in any hospital within 30 days of attendance or admission.

Similar numbers of patients attended emergency services on weekends and weekdays.

There were also similar numbers of deaths among patients attending emergency services on weekend days compared with weekdays.

University of York professor of health policy Tim Doran said: ‘The previous studies demonstrated that the odds of dying are greater following a weekend admission, but they were unable to explain why. The assumption made by the Department of Health is that quality of care is responsible, but the authors of those papers were clear that quality of care was one of several possible explanations.

‘Severity of illness is another key explanation. In common with the previous papers, we were unable to directly measure severity of illness, but the finding of reduced numbers of admissions at weekends suggests that hospitals are being more selective about who they admit at weekends, and it is extremely unlikely that they would choose not to admit the sickest patients.’

Unite chair of doctors David Wrigley said: ‘Once again we see more independent evidence that casts serious doubt on the claims by Jeremy Hunt that the NHS is not safe at weekends.

‘It's time for Mr Hunt to stop and listen to NHS staff and support them working in these difficult circumstances.’

A DH spokesperson said: 'This study actually adds to the evidence of variation in care across the week, because it indicates there is a higher level of sickness required for patients to actually be admitted at the weekend.

‘No one seriously disputes the established consensus from eight studies in the past five years that the “weekend effect” exists, and the government makes no apology for acting on our ambition to create a safer seven-day NHS.’

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