Warning: having surgery at the end of the week could seriously damage your health

Partner Marcus Weatherby highlights some alarming research suggesting – amongst other things – that NHS patients undergoing surgery on Fridays are 44% more likely to die than those having operations earlier in the week…

marcus_weatherbyThis week Paul Aylin, a clinical reader in epidemiology and public health at Imperial College, London, published research confirming what has been a well known secret for some time. If you go into hospital at the weekend you are more likely to be the victim of a ‘medical accident.’

For years those of us carrying out clinical negligence work have routinely checked whether a surgical procedure was performed at the weekend for exactly these reasons. Expert evidence has always confirmed this, albeit anecdotally.

However, more surprising is the hard data thrown up by the research. Apparently the study showed that, as a patient, you’re 44% more likely to die if you have surgery on a Friday. Those who have operations towards the end of the week, whose post operative care overlapped with the weekend, were also likely to have a higher mortality rate.

It was previously thought that perhaps the higher rates reflected difficult surgery carried out at the weekend. But this research suggested that even allowing for that, mortality rates were significantly higher.

Professor Sir Bruce Keogh, NHS England Medical Director, agrees that something needs to be done to work out what increases the risks.

Previous studies have suggested that paying staff to work at weekends is expensive, and so hospitals cut costs by reducing staff levels then. Some do so more than others. Patients die as a result.

Working out how consultant-led work can continue at the weekend should not be beyond the wit of medical administrators. Working weekends may always be the unpopular option amongst consultants, but the nature of the profession and the job means that a consistent standard has to be met 7 days a week, not 5 out of 7.

Apparently Safer Clinical Systems are looking at ways to ‘eradicate this by increasing system reliability at key junctures.’

How about just putting on the same standard of staffing at weekends as there is during the week?  The research suggests it would save lives. Our experience of clinical negligence claims suggests it would be cost-effective as well.

 

Current Controversies, Marcus Weatherby, Medical Negligence,
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