Weekend staffing problems in NHS trusts could lead to higher fatality rates

The Dr Foster Hospital Guide 2012 has once again been investigating the worrying issue of high mortality rates in NHS trusts all over the country, and they have published their results with regards to weekend staffing levels. While some have performed well in the past year, others – such as The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust – have raised concerns over the quality of care in their hospitals at the weekends.

There is an undeniable relationship between the HSMR (Hospital Standardised Mortality Ratio) and the ways hospitals are staffed at the weekends. In the 2011 guide, it was discovered that this mortality rate decreased when there was a bigger number of senior doctors working at the weekends, and they decided to investigate how it had changed in 2012 by looking at 105 different trusts.

There was some good news with several trusts showing an increase in senior staff members since 2010/11. The following hospitals have at least 2 additional senior staff members per bed:

• Croydon Health Services

• Dartford and Gravesham

• Great Western Hospitals

• Imperial College Healthcare

Isle of Wight

• Sandwell and West Birmingham Hospitals

• Rotherham

• West Middlesex University Hospital

• Wirral University Teaching Hospital

The bad news is that five NHS trusts didn’t perform so well. The following hospitals had a Hospital Standardised Mortality Ratio that was higher than expected during the weekends (compared to the within expected or lower than categories during week days):

• Buckinghamshire Hospitals

• Mid Yorkshire Hospitals

• Oxford University Hospitals

• Royal Cornwall Hospitals

• The Royal Bournemouth and Christchurch Hospitals

The reasons for these poor results are wide ranging, with staffing levels of senior doctors being just one explanation. The mortality rates could also be related to patients being inappropriately admitted due to lack of social care or community services, as well as many procedures such as scans and other medical tests not being frequently available on Saturdays and Sundays. The Dr Foster Hospital Guide will continue to monitor the relationship between weekend mortalities and the number of senior staff on the wards in the future.

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