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Comment on BMJ study on scheduling of elective surgery at weekends

28 May 2013

Commenting on the BMJ study asking the question: should we rethink the scheduling of elective surgery at the weekend? Professor Antony Narula, RCS council member and Consultant ENT surgeon, said:

‘The BMJ study is an important piece of research which contributes to the debate around how to improve survival rates following surgery.

It is not acceptable that there should be such a wide variation in the mortality rates following elective surgery according to the day of the week the operation takes place.

It has long been recognised that the 48-hour period after surgery is critical to a patient’s chances of recovery and today’s study rightly suggests that this is an area which needs further research. If operations are carried out on a Friday, the patient will recover over a weekend when less clinical support is generally available within a hospital.    

This reinforces the importance of patients being seen on a daily basis by consultants, and also the need for full clinical support being available seven days a week in hospital to provide the best treatment.

The study outlines five complex procedures that normally require intensive care facilities and are not usually carried out at weekends. The procedures highlighted are high-risk and we believe that further analysis of how hospitals are working is essential to understand the reasons for them taking place at weekends.

Many of the issues raised in the study are explained at length in The Academy of Medical Royal Colleges, publication Seven Day Consultant Present Care’which outlines the Medical Colleges’ commitment to delivering daily high quality care to patients.  Professor Norman Williams, President of the Royal College of Surgeons, is now chairing an expert group which is taking forward specific proposals to improve the care at weekends and evenings.

If detailed analysis of this data confirms the initial findings, the implications of the Working Time Regulations in fragmenting medical and surgical teams and creating multiple patient handovers, needs to be considered.’


Notes to Editor:

The Royal College of Surgeons of England is committed to enabling surgeons to achieve and maintain the highest standards of surgical practice and patient care. Registered charity number: 212808. For more information, please contact the RCS press office on:

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