London hospitals: Hundreds die 'due to weekend staffing'

"Stark" differences in consultant hours at weekends were identified

Hundreds of people die every year in London due to a lack of hospital consultants available at weekends, according to NHS London.

A report from the strategic health authority showed there were more than 500 avoidable deaths in emergency care in the capital every year.

It found: "Reduced service provision at weekends is associated with this higher mortality rate."

Under the review, NHS trusts were asked to rate themselves on key indicators.

The report, Acute medicine and emergency general surgery - case for change, was compiled for NHS London in the spring.

It focused on the care adult patients receive on a general ward after being admitted for emergency treatment.

'Inadequate access'

The review found: "If the weekend mortality rate in London was the same as the weekday rate, there would be around 520 fewer deaths."

It identified "stark" differences in consultant hours across the capital's hospitals at evenings and weekends.

Across London, consultant emergency general surgeons were on site for an average of four hours a day at the weekend, compared with 10 in the week.

The report said: "In London there is significant variation in the number of hours that a consultant is expected to be on site.

"There is inadequate access in almost a third of London's hospitals to an emergency theatre - this is detrimental to patient outcomes and can increase mortality and morbidity," it warned.

But John Appleby from The King's Fund, a charity which shapes NHS policy, said the reasons behind figures were much more complex than consultant cover alone.

However, he said: "Patients are entitled to expect high quality care whatever day of the week, or time that they are admitted and that includes safe levels of appropriate staffing."

Safety 'priority'

While the Hillingdon Hospital and Croydon Health Services expected an on-call consultant emergency general surgeon to be on site for 12 and nine hours a day, respectively, over the weekend, King's College and Newham University hospitals had cover for only two hours.

A Newham University Hospital spokeswoman said: "Patient safety is the highest priority at Newham University Hospital NHS Trust.

"Daily ward rounds are led by a consultant including at weekends.

"The trust provides 24-hour consultant on-call cover over the weekend to ensure that all patients have a consultant-led and delivered service as part of their care."

A King's College hospital spokeswoman said: "It is important to clarify that the figures quoted in the report apply to general surgery only and do not include patients who are seen within our major trauma centre, which includes our emergency department.

"Patients with life-threatening injuries are seen by the on-call major trauma consultant, who is resident in the hospital at all times.

"In addition to having a consultant general surgeon resident on site between 08:00 BST until 20:00 BST Monday to Friday, we also currently have a consultant general surgeon who is resident between 07:30 BST and 17:30 BST Saturdays and Sundays.

"At all other times there is, of course, a consultant general surgeon on call for the hospital who will arrive within 30 minutes of being called by the resident specialist registrar."