New report shows gaps in Wigan's seven-day NHS services

Patients discharged from Wigan Infirmary on a Sunday are almost twice as likely to be readmitted than those released midweek, figures have revealed.
Seven-day NHS services in Wigan have come under the microscopeSeven-day NHS services in Wigan have come under the microscope
Seven-day NHS services in Wigan have come under the microscope

Reports published by NHS England have highlighted gaps in standards of care for those patients treated at a weekend and those treated from Monday to Friday.

The data, which spans from October 2016 to September 2017, has recorded that on average, 2.8 per cent of patients discharged on a Thursday who were admitted for both emergencies and non-emergencies were to be readmitted for an “associated emergency” whereas five per cent of patients released on a Sunday returned to hospital for the same reason.

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A spokesman for Wrightington, Wigan and Leigh NHS Foundation Trust said: “We are a pilot site for seven-day services, which aim to ensure that patients receive consistent high-quality safe care every day of the week.

“We have acute physicians providing care to the 10 standards set out by NHS England. We hope that working in this way will continue to reduce the current deviation in care between weekdays and weekends.

“The positive impact of our seven-day working can be seen particularly when looking at the seven-day services mortality indicator data which shows the trust as being equal to or performing better than the national average.”

The hospital also confirmed that it has both specialist consultants and specialist nurses working every day of the week.

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As well as the readmission rate, the data showed the “odds” of a patient dying on each day compared to midweek.

The report explains that odds ratios which are greater than one “indicate an increased likelihood of mortality” compared to the midweek (Tuesday, Wednesday and Thursday) while odds ratios which are less than one “indicate a decreased likelihood of mortality”.

The annual figures for 2016/17 show that the mortality odds at Wigan hospitals for patients who were admitted in both emergencies and non-emergencies were 1.06 on a Saturday and Sunday compared to 1 on a Monday and Friday.

However odds are much lower than the national average of 1.14 for the weekend and 1.02 for Monday and Friday - the latter of which are classed as a “transitional periods”.

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The seven-day report said that 46 per cent of trusts have an odds ratio of mortality within 30 days of admission at the weekend compared to midweek which is significantly higher than one, indicating a “statistically significant weekend effect.”

An “NHS Improvement scheme” helps trusts to make sure that the that four “critical standards” will be met by 2020.

These are implemented to ensure that all patients:

* Do not wait longer than 14 hours for an initial consultant review;

* Do get access to diagnostic tests with a 24-hour turnaround time - for urgent requests this drops to 12 hours and for critical patients one hour;

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* Do get access to specialist, consultant-directed interventions;

* Do receive two specialist consultant reviews if they are high-dependency patients and it will also ensure that those admitted in an emergency will experience daily consultant-directed ward rounds.