Hospital chiefs at West Hertfordshire Hospitals Trust plan staffing changes to address higher death rates at weekends

West Hertfordshire Hospitals NHS Trust operates hospitals in Hemel Hempstead, Watford and St Albans
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Bosses at west Hertfordshire hospitals are drawing-up plans to increase the number of junior doctors on duty at the weekends – as part of a continuing drive to ensure patients are no more likely to die at the weekend.

Nationally data has suggested that hospital patients are more likely to die at the weekend, than on a week day.

That ‘gap’ between weekend and weekday mortality rates was highlighted at a meeting of the West Hertfordshire Hospitals NHS Trust board on Thursday, September 2.

West Hertfordshire Hospitals NHS Trust operates hospitals in Hemel Hempstead, Watford and St AlbansWest Hertfordshire Hospitals NHS Trust operates hospitals in Hemel Hempstead, Watford and St Albans
West Hertfordshire Hospitals NHS Trust operates hospitals in Hemel Hempstead, Watford and St Albans

And, in a report to the board, the potential ‘failure to reduce the ‘gap’ between weekend and weekday mortality’ was identified as one of the risks facing the Trust.

Addressing the issue, the report stresses that hospital patients identified as being unstable do already receive a daily ‘consultant review’ over the weekend.

It points to measures such as seven-day working standards, clinical outreach services and sepsis screening.

And it highlights the Trust’s aim to increase the number of junior doctors on duty at the weekend by six.

Following the meeting, officials from the Trust have stressed that any increase in weekend mortality rates at the Trust is relatively low – compared to regional and national figures,

And they have outlined the steps that are already taken to provide care at the weekends.

“The latest national statistical data provided by an organisation called Dr Foster shows that our mortality rates compare extremely well across weekends and the weekday both regionally and also nationally,” said chief medical officer Mike van der Watt.

“The figures show that the trust has made good progress towards seven day working.

“We provide a cardiology, respiratory and gastroenterology seven day consultant cover walk-around for our urgent care patients which increases our specialist review of patients at the weekends.

“We have introduced an ITU outreach service which reviews whether our deteriorating patients would benefit from ITU care.

“Our consultants also carry out twice daily reviews of our more unwell or unstable patients.

“We are reviewing our weekend medical staffing levels and working to increase the number of junior doctors available at that time.”

According to data from March 2021, published by Dr Foster and supplied by the Trust, the overall ‘hospital standardised mortality rate’ – or HSMR – for the Trust was 102.5, compared to a national figure of 103.

The ‘weekday emergency’ HSMR for the Trust was reported as 100.8, compared to a national figure of 101.6.

And the ‘weekend emergency’ HSMR was 104.2, compared to 108.5 nationally.

HSMR is a ratio that compares the number of actual deaths recorded at a hospital with the rate that could be expected.