A new study undermines one of Jeremy Hunt’s big arguments for changing junior doctor contracts

‘Extending services is not going to save any more lives’

The junior doctor’s strike is the protest of our generation. Last week, they staged the first full walk-out in NHS history; it was the latest in a series of industrial actions to protest against health secretary Jeremy Hunt’s plans for the NHS.

The top-line is that Hunt wants to create a “seven-day NHS” and in doing so, is proposing changes to junior doctors’ pay and working hours. They object, enough to walk out.

So perhaps they’ll be cheered to learn that today, one of Hunt’s chief claims has been contested by a huge new study.

Hunt has always pointed to data that those who go to A&E at the weekend are more likely to die. However, according to a new study by academics at Manchester and York universities, slightly fewer people die at the weekend and the reason that the mortality rate appears higher is because fewer people are admitted on Saturdays and Sundays.

The study examined more than 12.6 million visits to A&E and more than 4.6 million emergency admissions during the period from April 2013 to February 2014. The paper found that, “the average number of patients attending A&E on weekend days and dying within 30 days is similar to weekdays. The crude death rate following an A&E attendance is significantly lower at the weekend compared to during the week (0.99 per cent vs. 1.03 per cent). After adjusting for risk, attending A&E at the weekend is not associated with a significantly higher probability of mortality than attending during the week.”

Speaking off the back of the findings, one of study’s authors, Rachel Meacock, who is a research fellow in health economics at Manchester University, reasserted that “about the same number of people die [at weekends], but it’s just that you are dividing that by a lower number [of admissions]. It’s a simple fraction issue. It’s really obvious.”

Meacock thus contests that the creation of a seven-day NHS would reduce mortality at the weekends, arguing that “the policy got ahead of the evidence. I think the NHS has rushed to fix a problem it didn’t really understand. We don’t really need to be extending services, it’s not going to be saving any more lives.”

The Department of Health has argued back. “Disputes about precise methodology risk obscuring the established consensus of a weekend effect.

“Of course, we’ve always been clear that death rates are higher following admission at the weekends – this is in part because some patients are sicker, but even adjusting for that experts have been clear that other factors including staffing levels and diagnostic availability are part of the problem.

“Eight studies in the last five years show clear evidence of the weekend effect and the Government makes no apology for tackling the problem to create a safer seven-day NHS.”

The battle continues; one suspects that no amount of data will make either side see eye-to-eye.