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RCS calls for focus on urgent and emergency care in 7 day NHS debate

06 Sep 2015

The Royal College of Surgeons has today published a new policy paper on seven-day care in the NHS. The RCS has reviewed the evidence and believes the risk of death is higher for some groups of patients admitted to hospital at the weekend. In many hospitals the levels of staffing and access to diagnostics are worse for all patients including those requiring emergency treatment over the weekend periods.

President of the Royal College of Surgeons, Miss Clare Marx said:

“Multiple studies, including today’s study published in the British Medical Journal, show that patients admitted to hospital at weekends have worse outcomes. There are likely to be multiple reasons for this but it is not just related to the evidence that those patients tend to be sicker than those admitted during the week. It is also clear that patients that need treating at the weekend are less likely to be seen by the right mix of junior and senior staff and experience reduced access to diagnostics.

“Many doctors and NHS staff already work at nights and weekends and they should be valued and thanked for continuing to provide care during those unsocial hours. However the evidence shows that this is not currently standard practice even in high risk emergency care. This has to change. An example is the evidence of  a recent audit of patients needing emergency bowel surgery demonstrating that both consultant surgeons and anaesthetists were present for just 41% of operations after midnight. The same study showed that some of the sickest patients were undergoing their surgery at this time.

“Given finite NHS resources, the focus should be on reducing mortality and therefore improving urgent and emergency care and services for those patients already in hospital at the weekend. This is in line with NHS England’s standards on seven-day care. It must be stressed that this is not about making NHS staff work longer hours, but enabling a sufficient presence of appropriate staff across the entirety of the week.”

Note to editors

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.

The British Medical Journal article is authored by NHS England Medical Director Prof Bruce Keogh and others and is entitled ‘Analysis: Increased mortality associated with weekend hospital admission: a case for expanded seven day services?’. Please contact the BMJ for access to this article.

The emergency bowel surgery audit referred to is ‘The First Patient Report of the National Emergency Laparotomy Audit’ published on 30 June 2015.

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