Intended for healthcare professionals

Feature 24/7 NHS

The weekend effect—how strong is the evidence?

BMJ 2016; 353 doi: (Published 19 May 2016) Cite this as: BMJ 2016;353:i2781

Re: The weekend effect—how strong is the evidence?

In the pursuit of definitive evidence for or against the weekend effect we must guard against seeking a precise answer to the wrong question as opposed to an approximate answer to the right question.. In my view the crucial question is whether or not a seven day service is compliant with the core values of the profession, which include a compassionate recognition of the distress that patients experience when the availability of NHS services such as emergency endoscopy or imaging modalities is demonstrably not the same at weekends as it is on weekdays.

Consequences of suboptimal availability include an unnecessarily longer hospital stay, with resulting risk of complications such as hospital acquired infections, falls, and delirium for elderly patients (who now constitute the majority of hospital inpatients), as opposed to the hard point of mortality risk. If, however, the precise answer we want is the end point of mortality risk we run the risk of seeking a precise answer to the wrong question.

Competing interests: No competing interests

20 May 2016
oscar jolobe
retired geriatrician
manchester medical society