NHS Hospital Doctors calling radio show confirming how much higher the risks are for seriously patients in hospital at weekends...

[justbogoffnow]

Probably no surprise to many, but hospital doctors ringing in to a London radio station, discussing how bad things are in hospitals at the weekends. Eg a junior doctor covering 6 wards, 25 beds in each, 4 months into 3 years as a junior doctor. Just one of a string of experiences recounted, essentially not enough doctors on at weekends. More senior doctors saying the same and it's getting worse.

I don't know how it varies across the country, but my own experiences as a patient have always made me keep everything crossed that I never become very ill and end up in hospital over a weekend again. Not talking about ICU here (enough doctors and 1:1 patient to nurse ratio when a close relative was in ICU last year). Not sure about maternity wards (nearly 10 years since I was in-patient).

Caught a lot of the show, but not sure if any nurses rang in.

Anyone else notice a huge difference in care received during a weekend compared to weekday?

Any nurses and doctors on here think care is severely compromised at weekends?

Has it always been like this? Doctors mentioned the European working directive causing problems, but equally prefer not doing the hours that were prevalent before, although they do still do additional unpaid hours. Llike many things in life I'm sure it's more complex.

Only me?

Just bumping as I've woken up for some reason and was thinking about this!

I am not surprised.

Going back to 100hr weeks is probably not the way but can anyone explain why there isn't a 5-in-7 shift pattern for daytimes? And why hospital hierarchies think no seriously ill patient (in hospital ffs) should have expert medical help available at night?

I had my baby in June 2011. 40 hour labour with EMCS for failure to progress at 9cm....

After I had an infection which caused my scar to come open at 4 weeks post op and took 11 weeks to close. Eventually, I was referred back to a consultant at the hospital. We were talking through the infection and healing time and the likelihood of needing another c-section in future. He said there at been an investigation into the high number of infections post sections from this particular hospital the year before. The only finding was 78% of instances had been in emergency sections carried out at weekend. When I asked why that would make a difference he said "Bank Staff."

Scary figure soultrain but doesn't surprise me in the least .

I just don't get it, human brings can't do needing intervention or being very ill 'to order' during the normal working week.

All the doctors who rang in used the same word 'firefighting'. That's all they could do at weekends.

Er beings not brings!

The department that my DH works in always has consultant cover. However it is reduced over the weekends compared to the week. This doesn't mean that there aren't doctors (consultants or senior registrars) to cover just less of them than in the week. They are however short of the number of doctors needed due to cutbacks in funding so there are delays on procedures and they are constantly doing 'cover' rotas to fill in the gaps and do extra hours to ensure there are doctors to look after patients.

Not surprised. When in hospital with DS recently for a relatively long stay, he could not be discharged at the weekend as the busy London hospital only had one paediatrician for all kids wards and A&E.

A child died on the Saturday and quite understandably, the doctor was mainly with child/family or covering A&E than on the wards. But there was no-one else to do anything else until Monday, when more doctors were available.

So even though DS was better, we used an NHS bed and resources for two days longer than necessary. Which seems a bit crazy as it took all of three minutes to discharge him and free everything up.

I discharged my mum myself on a Friday evening from big teaching hospital .
Had to sign a disclaimer and it was scary ,but right decision ( fortunately ) .

Proper weekend cover would be very expensive though. There is no point having more doctors/surgeons without the back up of support staff. So hospitals would also need more lab staff, xray staff, phlebotomists, admin staff/theatre staff/porters etc.

A good friend of mine is a consultant surgeon who regularly works on a weekend. She gets very frustrated because they don't have enough operating theatres for weekend trauma. This also seems to be the case during the week as well, but then they have the option of cancelling elective patients.
I'm not sure how this problem can be solved.

It might be a bigger upfront cost, but is it actually more expensive when you look at the bigger picture (people stuck in hospital unnecessarily, far increased rates of problems for weekend patients, etc)?
"How much is a life worth?" is a calculation the NHS has to do, I suppose, but I find it hard seeing people justify cost as being a reason why it is OK for more people to die.

Also couldn't some of the support people work 5-in-7 too?

Its not just cost to the nhs though is it? The support staff are likely to have children and so they'll need child care. For many people, the weekends are the only time they see their family. Imagine your typical support worker, maybe earning 20k a year happily married to mr retail staff, also earning 20k. Where are they going to find child are on a weekend, especially on a rolling shift so unpredictable days. One of them is likely to have to give up their job. There's always going to be too many reasons why they can't adopt a working pattern that covers weekends with more than basic cover.

And that's more important than people's lives?

Maybe in your world. Not in mine.

No, it isn't more important I think we'd find that people would be unable to work weekends which could make the situation even worse because then there'd be no staff during the week as well.
Also when you've sorted out weekends, then rates would be worse overnight so we'd have to make people work 24hours a day, 7 days a week. It's just not practical without huge changes to people's lives.

Ok. I've found the solution. I googled and found a report that suggests 12 hour working days are the way to go. People supposedly like them because they only have to work three times a week to earn a weeks wage. It seems to be a trial based on nurses but maybe it would work for support staff too.

Link is Arms.evidence?nhs.uk/resources/Qipp/29491/attachment