Oxford research challenges data behind proposals for a seven-day NHS

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Research that suggested NHS patients admitted on the weekend were more likely to die has been questioned by a new Oxford University study, which claims this ‘weekend effect’ is based on flawed data.

The original study authored by UCL Professor Nick Freemantle has been cited by Jeremy Hunt, as support for a seven-day NHS and a new contract for junior doctors.

However, the new findings claim that the difference between weekday and weekend mortality rates is based on errors in the recording of hospital admissions. They show that over a third of Monday to Friday admissions classified as a stroke were actually routine, low risk, procedures. Lead author Professor Peter Rothwell argues this applies to a ‘range of conditions’ and without the mistakes there is no ‘weekend effect’. This echoes similar conclusions by a Manchester university study last week.

This has been disputed by Professor Nick Freemantle, who has defended his findings, claiming that ‘coding errors were taken into account when they complied the research and they used other criteria to get around them.

Professor Rothwell, head of the Centre for the Prevention of Stroke and Dementia, told the BBC Radio 4 Today programme: “What you’d really need to do to study this – the basic due diligence – would be to make sure that there isn’t a difference in the coding of data between the weekend and weekday admissions, but nobody had done that.

“It turns out there are quite big differences between the accuracy of diagnostic coding for weekend admissions versus weekday admissions.”

He has also been critical of governmental handling of the current contract conflict with junior doctors who, after a number of strikes, have recently agreed to fresh talks. “Looking at where we are now, you could only describe it as a shambles,” he said. “We need to step back and work out whether there is a problem that needs solving. The high-quality data suggests there’s no problem to be solved.”

In response, Freemantle argued: “I really wish I could say he was right and that there isn’t a weekend problem, but unfortunately that isn’t the case”. He also stressed the limits of Rothwell’s findings stating: “Professor Rothwell’s study was only based on nine GP practices in Oxfordshire, which is not an enormous number.”

A spokesman for NHS England has also said: “This report about data collection covering one condition from nine GP practices in no way alters the wider issue that sick patients should rightly expect to be seen by a consultant within a few hours, have prompt access to tests and treatments and receive joined-up care, whatever day of the week they fall ill, as recommended by the Academy of Medical Royal Colleges.”

Jeremy Hunt has agreed to a five-day pause in the imposition of the new junior doctors contract and both sides have expressed optimism that talks could be successful. 

Image: Garry Knight