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Observations Medicine and the Media

Consultant cover and mortality among hospital patients

BMJ 2012; 344 doi: (Published 11 January 2012) Cite this as: BMJ 2012;344:d8276
  1. Margaret McCartney, general practitioner, Glasgow
  1. margaret{at}

Dr Foster’s assertions that in-patient mortality is linked to the level of out of hours consultant cover is based on a flawed analysis of the data, argues Margaret McCartney

Late last year the Dr Foster company, which produces “unique consumer guides to health services,” released its annual Dr Foster Hospital Guide (BMJ 2011;343:d7791, doi:10.1136/bmj.d7791). Its press release, headlined “New report finds higher death rates at hospitals with fewer doctors at evenings and weekends,” stated, “The chances of survival are better in hospitals that have more senior doctors on site” (

Roger Taylor, cofounder and director of Dr Foster, appeared on the BBC, saying, “It’s very worrying . . . What we’ve been able to do is to actually see where the problem is greatest, which hospitals have the biggest issue—which is highest death rates at weekends—and also identify that those are the hospitals where we don’t have the senior doctors in the hospitals at the weekends” ( He continued, “What we can really clearly see is that it’s about senior doctors, it’s about the more experienced staff, in the hospital, looking after patients, out of normal working hours.

“Almost every hospital does have a higher death rate at …

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