London's hospitals are failing to provide a safe level of out-of-hours emergency care which is costing the lives of at least 500 patients a year, a report has concluded.
Acutely ill or injured patients are not getting the care they need because too many junior doctors are covering too many emergency situations without the specialist expertise of consultants.
The report comes a day after the King's Fund, the health think-tank, called for a radical reorganisation of hospital services, to reduce capacity and improve safety. Experts said hospital closures were essential to improve quality in those that remain. Half of the 31 hospital emergency units in London are part of NHS trusts facing merger or closure of services.
The draft document, obtained by the Health Service Journal, was commissioned by NHS London from 26 experts and presented to a private meeting of the health authority last month. It says: "Our hospital emergency services are not as reliably safe as might be expected. The situation needs to improve."
There are more than half a million emergency admissions to hospitals in London a year, but the report found "stark variation" in the level of consultant cover in different hospitals which was linked to the number of deaths.
"Each year there are around 25,000 deaths in hospital following emergency admission. If the weekend mortality rate in London was the same as the weekday rate, there would be around 520 fewer deaths. Reduced service provision at weekends is associated with this higher mortality rate."
It adds: "The chance of death significantly increases if a patient is admitted out-of-hours compared to in hours. This large variation in standards at different times of the week cannot continue."
Where the same level of cover was provided at weekends as during the week there was no difference in the death rate. But as the report, Acute medicine and emergency general surgery – case for change observes, "patients have little choice over when and where they are treated in an emergency".Reuse content