Study Casts Doubt On Hunt's Doctor Contracts

The Government's main argument for imposing a new junior doctors' contract has been shattered by new research showing A&E patients are no more likely to die at the weekend than on weekdays.

Experts at the University of Manchester found that although the death rate is higher at weekends it is because fewer patients are admitted to hospital on Saturdays and Sundays, skewing the figures.

Professor Matt Sutton, who led the research, said: "Patients with non-serious illnesses are not admitted, so those who are admitted at the weekend are on average sicker than during the week and more likely to die regardless of the quality of care they receive.

"The NHS has rushed to fix a perceived problem that further research shows does not exist."

Health Secretary Jeremy Hunt has used previous research suggesting that there's a "weekend effect" as a reason for rewriting contracts to make it cheaper for hospitals to rota more doctors on Saturdays and Sundays.

Doctors have argued that there is no evidence that the deaths are avoidable or that increasing staffing will reduce deaths.

The dispute over the contract has led to a series of strikes, including the first-ever full walkout from emergency care in the history of the NHS.

The researchers from the Centre for Health Economics at the University have now analysed all 12.5 million emergency admissions to English hospitals over an 11-month period.

Results published in the Journal of Health Services Research and Policy show that an average of 38,000 people a day attend A&E, with little variation through the week.

But doctors admit 7% fewer patients at the weekend.

GPs also refer 61% fewer patients as an emergency for direct admission to the wards at the weekend.

In both groups of patients deaths are up - between 5.5 and 21% - but the researchers say it's because only the sickest are admitted to hospital at weekends and they're more likely to die regardless of the care.

The British Medical Association said the research proved doctors were right to fight the contract.

Dr Johann Malawana, head of the BMA's junior doctors' committee, said: "Throughout this process doctors have been saying that the misrepresentation of data is completely inappropriate.

"Actually it's not related to staffing. There are other issues at play.

"The nature of patients presenting at weekends are different. And that means the government needs to look at its rhetoric and the way it is attacking the medical profession."

But the Department of Health said eight studies in the last five years had flagged up a 'weekend effect' and it made no apology for trying to create a safer seven-day NHS.

Speaking on Thursday night, Jeremy Hunt said: "Hospitals can't afford to roster enough doctors on a Saturday. There's about three times less medical cover at weekends.

"You can't choose which day of the week you are ill.

"That's why it's important we promise all NHS patients the same high quality care every day of the week."

NHS England said the results underlined the need for consultants to be present at weekends – but, significantly, not junior doctors.

A spokesperson said: "This analysis confirms the fundamental point that patients admitted to hospital at weekends are sicker, and need to have the right medical cover available, ensuring patients can see a senior doctor as soon as possible."

The government has agreed to a five-day truce next week so talks can resume, but only if they focus on the outstanding issues. Junior doctors are due to meet on Saturday to decide on their next move.