British Medical Report Finds Surgery Has Greater Death Risk Later In Week

By Helen MacGregor

Medical law experts today described an NHS report as ‘sadly familiar’ after it revealed that patients who undergo pre-planned surgery towards the end of the week are more likely to die and called for an urgent review of care to be carried out.

The study by the Imperial College in London found that death rates for elective surgery patients are lowest on Mondays and increase for each subsequent day of the week.

The odds of death were 44% higher for patients who had planned operations on a Friday than on a Monday, the study published by the British Medical Journal (BMJ) found.

A figure from Imperial College attributed in part to less availability of ‘staff, resources and diagnostic services’.

Lisa Jordan, head of the Medical Law and Patient Rights team at Irwin Mitchell, said: “The findings of the study carried out by Imperial College are unacceptable and show that urgent action is needed to improve surgery and aftercare for patients on a weekend.

“This is a sadly familiar issue as a number of our cases reflect the findings of the report. Patients or their families instruct us to help find answers about why their care was substandard, which we often discover was a result of lack of staff and resources over a weekend.”

Researchers gathered data from all non-emergency surgery undertaken by the NHS in England in 2008-2011. Looking at 4 million operations they found more than 27,000 deaths within a month of surgery, putting the average risk of death at 0.67%.

They found an 82% increased risk if an operation was carried out at the weekend compared to a Monday but stressed that the vast majority of elective procedures are carried out during the working week.

Lead author Dr Paul Aylin, from the School of Public Health at Imperial, said: “Unlike previous studies, we included both deaths in hospital and deaths after discharge, so this eliminates a potential bias of counting only in-hospital deaths. We tried to account for the possibility that different types of patients might have operations at the end of the week, but our adjustment made little difference.

"This leaves us with the possibility that the differences in mortality rates are due to poorer quality of care at the weekend, perhaps because of less availability of staff, resources and diagnostic services."

But leading medical law experts say that it is now vital that the findings of the study are acted upon.

“Steps must be taken immediately to improve this to ensure patients are given the thorough care they deserve irrespective of the day of the week they have surgery or require after care services”, Lisa Jordan from Irwin Mitchell said.

“The NHS’ top priority must be to provide consistent care on every day of the week which would boost patient safety and reduce the number of adverse incidents.”

Read more about Irwin Mitchell's expertise relating to surgery claims