Babies delivered at the weekend are significantly more likely to die, study suggests


Babies delivered at the weekend are significantly more likely to die, study suggests

 

Babies born at the weekend are more likely to die or suffer injuries, than those born on a weekday, a new study suggests

Nearly 800 babies die each year because NHS hospitals are not performing consistently through the week, according to Imperial College London,

The alarming new figures appear to show the devastating toll of understaffed wards, with a lack of nurses, midwives and diagnostic specialists at the heart of the problem.

The new research comes after Jeremy Hunt, the Health Secretary, claimed that 11,000 deaths a year in NHS hospitals were related to low staffing levels at weekends and called for a ‘7 day NHS.’

“We are determined to tackle this so that every new baby and mother receives the high quality care they deserve, 24 hours a day, seven days a week”
Ben Gummer, Health minister

But Mr Hunt has faced a backlash from healthcare workers and medical staffing with weekends at the root of the current dispute between the Government and junior doctors who are threatening to strike.

Now researchers at Imperial have shown that fewer babies survive for a week if they are born between Friday and Monday. What’s more alarming is the number of stillborn babies and women suffering infections, rises at the weekend, even after allowing for birth weight, maternal age and pre existing health conditions.

 

Health Minister Ben Gummer said: “This is further evidence that standards of care are not uniform across the week. We are determined to tackle this so that every new baby and mother receives the high quality care they deserve, 24 hours a day, seven days a week.

 

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The finding, published in the British Medical Journal, was based on more than 1.3 million births which took place at NHS services between April 2010 and March 2012.

The study showed that the rate of perinatal (stillborn or within seven days) death on weekdays was 6.5 per thousand babies delivered. The rate of death across babies born on Saturday and Sunday rose to 7.1 per thousand.

 

Dr William Palmer, lead author and honorary research fellow from the School of Public Health, added: “The public should reasonably expect high quality care at all times, and this paper suggests that managers and clinicians in maternity care need to seek further assurance that their services are providing consistently good care throughout the week.

“We have been able to present a detailed and comprehensive assessment of the ‘weekend effect’ in this important area of healthcare.”

The research also found that mothers admitted at the weekend had slightly higher rates of infections compared to weekdays, 8.7 infections per thousand deliveries, compared to 8.2 per thousand.

 

Babies were also more likely to be injured during birth on Saturday’s and Sunday’s compared with weekdays with the rate rising from 14.5 per thousand during the week to 15.3 per thousand on the weekend. The days that had the lowest rate of injury to the baby during birth were Wednesday and Thursday.

The rate of emergency readmissions for the baby within three days of birth was also higher for babies born on a Saturday and Sunday compared to weekdays, 12.3 per thousand births compared to 11.8 per thousand births.

In a second arm of the study, the team investigated whether there was a link between birth complications and the recommended consultant staffing levels in labour wards.

 

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Professor Paul Aylin, from the School of Public Health at Imperial, said: “We tried to account for the fact that differences in rates of complications on different days may be due to chance, or that births on certain days are more complicated in some way.

“However, even after making these adjustments, we found the rates of complications vary on different days.

“We don’t know what causes this difference, and when we looked at consultant staffing levels we didn’t see a strong link between reduced staffing and complications. Maternity care involves a whole team including midwives and other medical staff, so one avenue for future research might be to look at staffing levels beyond consultants.”

 

Mr Hunt has told doctors he wants the new contract, which will increase basic salaries but will cut pay for working evenings and Saturdays, to help “eradicate” the weekend effect.

But the British Medical Association (BMA) has called the Health Secretary’s plans a ‘wholesale attack on doctors’ and said the government was attempting to distract from its failure to invest in emergency care.

Consultants claim that excess weekend deaths occur not because of a lack of doctors, but the unavailability of pharmacists, laboratory and x-ray staff, translators, dieticians and physiotherapists.

 

Prof Andrew Whitelaw, Emeritus Professor of Neonatal Medicine,at the University of Bristol, said: “Several previous studies have found that babies born at weekends have slightly higher mortality than those born on weekdays and this has been a stimulus to increase the number of hours specialist obstetricians are physically present on delivery wards.

“We need much better clinical information to know how much is due to differences in the babies born at weekends and how much to differences in the quality of the clinical care.”

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