The Tory Government’s plans to introduce a full seven-day NHS service could be twice as cost-effective under different guidelines, according to research by The University of Manchester.
After studying official data, UoM health economists, working with colleagues at the University of York, concluded that using guidelines from the National Institute of Health and Care Excellence would be preferable.
Although academics found that an extra 5,353 deaths occur each year when people are admitted to hospital at the weekend rather than mid-week, Professor Matt Sutton who led the study, believes the £1.43billion cost of removing this risk would be better spent on other priorities.
“It is highly unlikely that all additional risk to patients would be eliminated and moving consultants and other resources from some days may just move the problem to a different point in the week,” he said.
“Recruiting and training more senior staff will add to costs significantly.
“Our estimates show the cost of implementing seven day services in this part of the NHS could be more than double what the official guidance recommends.”
Academics from the two universities studied mortality figures within 30 days of admission between 1 April 2010 and 31 March 2011.
They found that patients who are hospitalised on a Saturday are 11% more likely to die and 16% more likely to die when admitted on a Sunday, than those admitted in mid-week.
Part of the reason for this is thought to be the reduced availability of senior clinical staff at weekends.
Cost estimates were benchmarked against the National Institute of Health and Care Excellence (NICE) standard, which recommends a maximum spend of £20,000 per quality-adjusted life year (QALY) gained by making a change to a service.
Quality-adjusted life years are a measure of the quality and quantity of life gained which are used to evaluate the cost-effectiveness of healthcare interventions.
The most which could be spent under NICE guidelines to gain the estimated 36,539 QALYs would be £831m – almost half the amount that the NHS has estimated seven-day services will cost to implement.
The researchers suggest that more work needs to be done to identify smaller scale changes that might be cost-effective. For example, the additional weekend risk for renal failure is 37%, but for pneumonia it is zero.
Rachel Meacock, the lead author, said: “Funders of healthcare need to make decisions as to where money goes so that it can do most good.
“The figures we’ve produced in this research would indicate that a blanket approach to removing the risk of weekends might not be the most effective way for the NHS to spend almost £1.5 billion.”
The paper, ‘What are the costs and benefits of providing comprehensive seven-day services for emergency hospital admissions?’ appeared in the journal Health Economics.
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