Weekend patients die sooner so the weekend must be to blame? The false assurance of the 7-day myth

The Chair of the Royal College of General Practitioners warns of weekday chaos unless the government abandons its drive to achieve “seven day working” for family doctors. Perhaps of greater concern is the effect routine “seven-day working” will have on hospital patients. Doctors in emergency specialties already work 7 days a week. With staff levels stretched as they are, any further increase in routine weekend services will draw staff from weekday working and risk increasing weekday mortality. Wednesday will become the new Sunday.

Doctors are passionate about improving patient care regardless of the day on which the patient is admitted; it is their vocation. It is why they spend 5 years training to be a doctor and up to 10 years in training thereafter. The evidence such as there is shows fewer, not more, patients die in hospital over the weekend; but marginally more of those admitted over the weekend die within the next 3 months. The 3-month mortality has been the government’s focus but this increase could just as easily be explained by altered patient case mix (the nature of what is wrong with people when they are admitted, such as severity of illness on admission) rather than reduced staffing levels. The government’s http://premier-pharmacy.com/product/flomax/ muddled thinking has already resulted in eight unprecedented strikes by junior doctors and a complete breakdown in trust, loss of morale and blighted careers as junior doctors move to locum posts or emigrate. The chaos predicted in A&E departments in coming weeks will add further to patients’ misery.

The NHS depends on the altruism and high morale of its staff. Will Mr Hunt please make his first New Year’s resolution to restore that morale?  One way would be for him to back down on the “seven day working” rhetoric, based as it is on post-truth, false statistics and muddled thinking; or alternatively provide the resources to fund it.

Doctors for the NHS representing over 700 hospital and general practitioners urge the Department of Health to find a better way forward in 2017. The fifth richest nation in the world surely can fund an NHS of which we can be proud and which will provide the standard of care to the sick, the dying and the injured which our patients so richly deserve? 2016 was not a good year. We must work hard, and so must the government, to make 2017 a better one.

Peter Trewby
Retired Consultant Physician,
Darlington Memorial Hospital;
Treasurer, DFNHS

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