Staff shortages and weekend admissions increase DEATH risk of emergency surgery patients

The latest data has revealed hospitals with the highest staffing levels had the lowest death rates

 

PATIENTS undergoing emergency surgery face a great death risk if they are treated in an hospital that lacks doctors, nurses and critical care beds, a major study has found.

 

The ground-breaking research - carried out over five years and involving almost 300,000 cases of emergency surgery at 156 NHS trusts - found that hospitals with the highest staffing levels had the lowest death rates and were better at coping with SICKER patients.

Moreover, 14 NHS trusts were found to have significantly higher than expected death rates. 

Patients being treated by NHS trusts with the least amount of doctors and nursers per bed were seven per cent more likely to die, the researchers warned.

As well as having lower mortality rates, better staffed hospitals were able to keep patients alive - even when the patients were sicker before surgery and more likely to suffer complications.

 



High-achieving hospitals were also equipped with almost two-thirds more critical care beds



 

In trusts that performed better than expected and higher numbers of staff, patients had a greater number of pre-existing medical conditions.

They were also 27 per cent more likely to suffer complications during treatment.

Despite these complications - thanks to more staff and equipment - these trusts had 60 per cent fewer deaths than trusts performing less well than expected.

Trusts that came out on top had almost 50 per cent MORE doctors of any grade per bed and quarter more nurses.

These high-achieving hospitals were also equipped with almost two-thirds more critical care beds and a third more operating theatres per bed.

 



NHS trusts with lower death rates had more critical care beds and operating theatres



 

The research also discovered that patients admitted on weekends were more 11 per cent likely to die, compared to those who went in to hospital on a weekday. 

It is thought that more on-duty staff allowed for greater ability to identify and manage complications that may arise during risky surgery.

On top of more staff, researchers found that NHS trusts with lower death rates had more critical care beds and operating theatres.

The study will add to the row over staffing levels in NHS hospitals, particularly at weekends, after previous studies suggested higher death rates for people admitted on Saturdays and Sundays.

Previous research has also suggested that a lack of consultants on wards contributes to higher death rates.

 

The study will add to the row over staffing levels in NHS hospitals

 

The new study, published in the British Journal of Anaesthesia, looked at patients admitted to hospitals in England for emergency surgery for bowel problems, peptic ulcers, removal of the appendix, hernia repair and pancreatitis.

Senior author Dr Peter Holt, reader in vascular surgery at the St George's Vascular Institute in London, said: "This is the first analysis on this scale for emergency general surgical admissions examining the associations between the numbers of senior doctors, junior doctors and nurses per hospital bed and patient survival rates.

"Although we have not demonstrated causation, we believe the findings should form an important part of the debate over disparities in staffing levels and resource provision between NHS trusts."

Report author Mike Grocott, professor of anaesthesia and critical care at the University of Southampton, said: "Our study has identified a striking association between staffing levels, clinical experience and patient outcomes. This raises important questions about how emergency surgery is delivered within hospitals and across the NHS as a whole."