The Weekend Effect: a Summing-Up of the Evidence (Department of Health / BBC News / NHS Employers / BMJ / Journal of Health Services Research and Policy)

Summary

Debates have arisen recently about possible “spin” and politically-motivated distortion in interpretation of the “weekend effect” and the benefits to patients of seven-day working. The Department of Health has produced an impartial presentation of the research. This includes a brief description of seven reports which have examined the association between weekend hospital admissions and poorer patient outcomes, such as higher mortality rates:

  1. Freemantle [et al] (2015).
  2. Ruiz [et al] (2015), Global Comparators Project.
  3. East Midlands Clinical Senate (2014), Seven-Day Services Project.
  4. NHS Services, 7 Days a Week Forum (2013).
  5. Freemantle [et al] (2012).
  6. AoMRC (2012).
  7. Aylin [et al] (2010).
  8. Professor Sir John Temple (2010).

“A range of potential causal links for the weekend effect have been identified; one of these is the availability of staff and services at weekends. It remains unclear how many deaths are avoidable”.

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Reference

Research into ‘the weekend effect’ on patient outcomes and mortality. London [Online]: Department of Health, October 30th 2015.

New “Manchester Study”: A Higher Bar for Admissions at Weekends?

A fresh re-interpretation of HES weekend-related mortality data, using an alternative methodology:

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Reference

Pym, H. (2016). Hospital death data – the row heats up. London: BBC Health News, May 7th 2016.

This relates to:

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Reference

Meacock, R. Anselmi, L. [and] Kristensen, SR. [et al] (2016). Higher mortality rates amongst emergency patients admitted to hospital at weekends reflect a lower probability of admission. Journal of Health Services Research and Policy. May 6th 2016. [Epub ahead of print].

Maternity Services and Neonatal Weekend Effect

Researchers at Imperial College London have discovered that babies born in hospitals in England at the weekends have a small but significantly higher chance of dying than those born on weekdays:

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Reference

Triggle, N. (2015). Babies born at weekends ‘have higher death risk’. London: BBC Health News, November 25th 2015.

and:

Snowden, JM. [and] Caughey, AB. (2015). Is there a weekend effect in obstetrics? BMJ. November 24th 2015; 351: h6192.

This relates to:

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Reference

Palmer, WL. Bottle, A. [and] Aylin, P. (2015). Association between day of delivery and obstetric outcomes: observational study. BMJ. November 24th 2015; 351: h5774.

Miscellaneous News and Comment

Possibly of incidental interest:

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Reference

Fallon, N. (2016). Margaret Gleeson inquest: Weekend staffing ‘affects care’. London: BBC Health News / BBC North West Tonight, June 20th 2016.

Junior Doctor’s Dispute: First Draft of History

The Irresistible Force and the Immovable Object: Compromise In Sight?

Another overture to compromise:

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Reference

Triggle, N. (2015). Jeremy Hunt makes pay offer in junior doctor row. London: BBC Health News, November 4th 2015.

This relates to:

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Reference

Junior doctors’ contract offer. London: Department of Health, November 4th 2015.

There is also an Executive Summary.

See also:

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Reference

Junior doctors’ contract offer. London: NHS Employers, November 4th 2015.

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Reference

Sir Bruce Keogh on junior consultant contract debate. London: NHS England, November 4th 2015.

This relates to:

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Reference

Junior doctors’ contract: the new offer. London: NHS Employers, November 4th 2015.

Rebuffed again?

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Reference

Triggle, N. (2015). BMA refuses to re-enter contract talks. London: BBC Health News, November 4th 2015.

Further discussion:

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Reference

Pym, H. (2015). A 1970s-style walkout by doctors – could it happen this year? London: BBC Health News, November 4th 2015.

Stuff their mouths with gold… ? (Aneurin Bevan)

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Reference

Triggle, N. (2015). NHS v ministers: A case of deja vu? London: BBC Health News, November 12th 2015.

When brinksmanship goes over the brink:

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Reference

Triggle, N. (2015). Junior doctors row: 98% vote in favour of strikes. London: BBC Health News, November 19th 2015.

Further analysis of the numbers involved:

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Reference

Triggle, N. (2015). Junior doctors row: what you need to know. London: BBC Health News, November 19th 2015.

Entrenched Positions or Ruthless Bargaining?

More heat than light… here follows an even-handed journalistic background history in the form of BMJ commentary / news articles on the cultural / political context:

O’Dowd, A. (2015). Hunt pledges that no junior doctor working within legal hours will face pay cut. BMJ. October 29th 2015; 351: h5814.

Kmietowicz, Z. (2015). Seven in 10 junior doctors will leave NHS if new contract is imposed, survey finds. BMJ. October 22nd 2015; 351: h5642.

Rimmer, A. [and] Kmietowicz, Z. (2015). BMJ editor writes to Hunt over misuse of weekend mortality data. BMJ. October 21st 2015; 351: h5624.

Rimmer, A. (2015). Junior doctors: it’s not about the money. BMJ. October 21st 2015; 351: h5591.

Rimmer, A. (2015). “Yes” vote predicted for junior doctors’ ballot on industrial action. BMJ. October 20th 2015; 351: h5610.

Limb, M. (2015). Thousands of junior doctors march against new contract. BMJ. October 19th 2015; 351: h5572.

Rimmer, A. (2015). Former Tory health minister posts message of support for junior doctors. BMJ. October 16th 2015; 351: h5553.

Rimmer A. (2015). BMA is encouraged by Hunt’s reassurances on junior doctors’ contract but seeks clarification. BMJ. October 9th 2015; 351: h5424.

Iacobucci, G. (2015). Health secretary accuses BMA of “utter irresponsibility” over junior doctors’ contract. BMJ. October 7th 2015; 351: h5377.

Iacobucci, G. (2015). Junior doctors’ dispute goes beyond pay, Tory MP says. BMJ. October 6th; 351: h5363.

Iacobucci, G. (2015). Junior doctors’ dispute is result of financial mismanagement, Labour says. BMJ. September 30th 2015; 351: h5244.

Moberly, T. (2015). Junior doctors pledge to continue action unless Hunt improves offer. BMJ. September 29th 2015; 351: h5212.

Moberly, T. (2015). Problems with the junior doctors’ contract: how did we get here? BMJ. September 29th 2015; 351: h5183.

Moberly, T. (2015). Junior doctors to be balloted on industrial action. BMJ. September 29th 2015; 351: h5168.

McCartney, M. (2015). Margaret McCartney: Stand with junior doctors. BMJ. September 24th 2015; 351: h5132.

Moberly, T. (2015). Nine royal colleges warn government about damaging effects of new junior doctors’ contract. BMJ. September 24th 2015; 351: h5086.

Bagenal, J. Moberly, T. [and] Godlee, F. (2015). Problems with the new junior doctor contract. BMJ. September 23rd 2015; 351: h5077.

Moberly, T. (2015). Royal colleges express concern over junior doctors’ contract as petition calls for strike. BMJ. September 22nd 2015; 351: h5044.

O’Dowd, A. (2015). MPs criticise Hunt for unclear plans on seven day NHS and “attacks” on NHS staff, but others praise him. BMJ. September 15th 2015; 351: h4948.

Limb, M. (2015). Full seven day NHS service is unachievable in near future, conference hears. BMJ. September 11th 2015; 351: h4903.

Crump, H. (2015). Seven day working: why the health secretary’s proposal is not as simple as it sounds. BMJ. September 5th 2015; 351: h4473.

McKee, M. (2015). Is the UK government right that seven day working in hospitals would save 6000 lives a year? BMJ. September 5th 2015; 351: h4723.

Rimmer, A. (2015). Cameron had no formal correspondence with Keogh before promising a seven day NHS. BMJ. August 28th 2015; 351: h4637.

Rimmer, A. (2015). Consultants will have seven day rotas by 2020, government says in response to open letter. BMJ. August 20th 2015; 351: h4548.

Rimmer, A. (2015). Junior doctors will not re-enter contract negotiations with government. BMJ. August 14th 2015; 351: h4447.

Christie, B. (2015). Seven day NHS is possible only with more resources, say surgeons. BMJ. August 4th 2015; 351: h4232.

Barer, D. (2015). Basing seven day working policy on evidence not political expediency. BMJ. July 29th 2015; 351: h4061.

Newbold, M. (2015). Skirmish over seven day working. BMJ. July 29th 2015; 351: h4082.

McCartney M. (2015). Margaret McCartney: The zombie statistic behind the push for seven day working. BMJ. July 6th 2015; 351: h3575.

Wise, J. (2015). Junior doctors to ask lawyers if the NHS is in breach of human rights legislation. BMJ. May 19th 2015; 350: h2712.

March 2016: Update on NHS Seven Day Services

Possibly of interest on consultants and the seven-day services topic:

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Reference

Triggle, N. (2016). NHS consultants: Employers ‘close to 7-day contract offer’. London: BBC Health News, March 11th 2016.

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Reference

Triggle, N. (2016). Not enough doctors for 7-day NHS, says Royal College head. London: BBC Health News, March 15th 2016.

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Reference

Triggle, N. (2016). Will consultants take the scalpel to Hunt? London: BBC Health News, March 18th 2016.

Weekend Handover / Surgical Handover

On the Weekend Out Of Hours Surgical Handover (WOOSH) form:

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Reference

Boyer, M. Tappenden, J. [and] Peter, M. (2016). Improving Weekend Out Of hours Surgical Handover (WOOSH). BMJ Quality Improvement Reports. April 4th 2016;5(1). pii: u209552.w4190.

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Dementia and Elderly Care News. Wolverhampton Medical Institute: WMI. (jh)
This entry was posted in Acute Hospitals, Commissioning, Department of Health, For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), For Social Workers (mostly), In the News, Integrated Care, Local Interest, Management of Condition, National, NHS, NHS Employers, NHS England, Non-Pharmacological Treatments, Quick Insights, Statistics, UK, Universal Interest and tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , . Bookmark the permalink.

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