“Dying for the weekend” – differences in quality of stroke treatment for patients admitted at the weekend

11 July 2012

In February 2012, I commented on the research published in the Journal of the Royal Society of Medicine which reported that patients admitted to hospital at the weekend were 16% more likely to die than patients admitted on weekdays.  On Monday, a study looking at the quality of treatment provided to stroke patients at weekends was published which adds further weight to the argument that hospital care at the weekends is poorer than that provided on weekdays.

The study, undertaken by the Dr Foster Unit, the National Audit Office and University College, reveals that performance against 5 out of 6 key measures of care provided to patients, who suffered a stroke between 1 April 2009 and 31 March 2010, was significantly lower on weekends as opposed to weekdays.  The authors concluded that there is strong evidence to suggest that stroke patients admitted at weekends are less likely to receive urgent treatments and that they have worse outcomes than patients admitted on weekdays.

The NHS “Act FAST” campaign highlights the importance of calling 999 immediately if the symptoms of stroke are observed and this is because earlier treatment of stroke leads to improved outcomes.  The National Institute for Health and Clinical Excellence (NICE) has set out a quality standard for strokes which includes brain imaging within 1 hour and immediate admission to a specialist acute stroke unit where they should be assessed for and receive thrombolysis if required. 

Stroke is the largest cause of adult disability in the UK and has a high cost to the NHS.  It can cause permanent brain damage and loss of function if not treated quickly and so urgent assessment and care is crucial. 

It is disturbing to see that, despite the potential consequences of delay in treating stroke being so well known, some patients are not receiving the appropriate care simply because they are unfortunate enough to suffer their stroke at the weekend.  Such a delay in providing the appropriate treatment, whether at the weekend or during the week, may constitute medical negligence.

Kingsley Napley’s clinical negligence team acts for children and adults who have sustained damage as a result of negligent medical treatment.  If you would like advice regarding a potential claim, please contact us on 020 7814 1200 or by email at clinnegenquiries@kingsleynapley.co.uk

Citations

Palmer WL, Bottle A, Davie C, Vincent CA, Aylin P. Dying for the Weekend: A Retrospective Cohort Study on the Association Between Day of Hospital Presentation and the Quality and Safety of Stroke Care. Arch Neurol.  Published online July 09, 2012. doi:10.1001/archneurol.2012.1030. http://archneur.jamanetwork.com/article.aspx?articleid=1212192

http://www.nhs.uk/actfast/pages/stroke.aspx

http://www.nice.org.uk/aboutnice/qualitystandards/stroke/strokequalitystandard.jsp

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