A&E patients 48% more likely to die on bank holidays

PATIENTS admitted to hospital as emergency cases on public holidays are significantly more likely to die than those admitted on other days of the week – including weekends – a major Scottish study has revealed.

The report found these patients were 48 per cent more likely to die within seven days and 27 per cent more likely to die within a month.

The two-year study was carried out by doctors in Dumfries and Galloway, who concluded the higher risk was due to a lack of doctors and the availability of NHS services during these holiday periods, which could last up to four consecutive days.

Patient groups last night urged health boards and the Scottish Government to ensure hospitals were adequately staffed at all times and called for more research to determine what steps are needed to save more lives.

Co-author Dr Sian Finlay, of Dumfries and Galloway Royal Infirmary’s medical unit, said: “If we assume patients with severe illnesses are no more likely to be admitted on any one day of the week than any other, then it becomes difficult to escape the view that a cumulative effect of lack of services and lack of
doctors on public holidays must have a part to play in the higher public holiday mortality.”

The team looked at seven-day and 30-day death rates among patients admitted as emergencies at the Royal Infirmary between January 2008 and December 2010. Just over 20,000 people were admitted, 77 per cent of whom were
admitted during the week and the rest at weekends.

The research team, including experts from the Robertson Centre for Bio­statistics at Glasgow University, worked out that 5.6 per cent of the admissions occurred on public holidays.

Their findings revealed that patients admitted at weekends were slightly older, less likely to have cancer and more likely to have a respiratory problem.

Patients admitted on public holidays were also more likely to have a respiratory problem, but otherwise there were no distinctive differences.

In all, 771 patients (3.8 per cent) died within seven days of admission, while 1,780 (8.9 per cent) died within 30 days. After taking account of factors likely to influence the results, death rates were only slightly higher at weekends. But they were significantly higher for public holiday admissions – on weekdays and weekends – than for other days.

The study said: “Some 5.8 per cent of patients died within seven days, compared with 3.7 per cent of those admitted on other days of the week, while 11.3 per cent died within 30 days, compared with 8.7 per cent of those admitted at other times.

“This means that patients admitted as medical emergencies on public holidays were 48 per cent more likely to die within seven days and 27 per cent more likely to do so within 30 days.”

The study is published in Emergency Medicine Journal

Margaret Watt, who chairs Scotland Patients’ Association, said: “We know there is a shortage of staff in the NHS in general. To hear this is even worse at public holidays is just not on. We need some joined-up thinking and working here to determine why the risks are higher at certain times and to work out what can be done.”

A Scottish Government spokesperson said: “Everyone in Scotland has the right to expect the highest-quality care, where and when they need it. Scotland is the first country in the world to implement a national patient safety programme across the whole healthcare system and has some of the safest hospitals in the world, with recent figures showing that acute hospital mortality is continuing to reduce over time.

“We expect all boards to ensure that they have appropriate clinical staffing levels to ensure quality of care.”