Health Secretary responds to our correction request on weekend deaths in hospitals

11 December 2015 | Phoebe Arnold

In October we factchecked the Health Secretary’'s claim that, “there are 11,000 excess deaths because we do not staff our hospitals properly at weekends,” part of the argument for seven-day working in the NHS.

We concluded that the claim is incorrect.

We wrote to Mr Hunt to ask him to correct the parliamentary record, which Ministers can do by writing to the Editor of Hansard. In our letter we noted that clearer information in the debate would be welcome——this is why we raised the possibility of commissioning further research.

The response from Mr Hunt’'s office is below. We have published our letter too so that readers can judge both.

“Thank you for your letter of 23 October addressed to Jeremy Hunt about weekend hospital admissions. I have been asked to reply.

As you know, a recent study in the British Medical Journal (BMJ) found there were 11,000 excess deaths for patients admitted between Friday and Monday compared to the rest of the week.  This study provides only one piece of evidence regarding the link between the 'weekend effect'’ and the way services are organised.  There is growing evidence that there is an increased risk of death following weekend admission to hospital.  The Academy of Medical Royal Colleges report, Professor Sir Bruce Keogh’'s extensive research on this subject and the recent BMJ study all point to, in Professor Keogh'’s words, 'an avoidable weekend effect which if addressed could save lives'.’  All of those studies suggest a link between the weekend effect and reduced clinical cover at weekends.

The Secretary of State'’s statement gave a rough approximation of the BMJ article and also drew on this other evidence.  The authors of the article themselves, although noting that it was not possible to determine how many of these deaths were avoidable, also said that the statistic of 11,000 deaths 'raises challenging questions about reduced service provision at weekends.'’  Research into 'the weekend effect’' on patient outcomes and mortality can be found at by searching 'research into the 'weekend effect' on hospital mortality'’.”

Separately, the UK Statistics Authority has responded to an anonymous complaint about the same claim. They say, “"We are speaking with Department of Health officials to ask that future references to this article are clear about the difference between implying a causality that the article does not demonstrate, and describing conclusions reached by authors."”

The Authority also says, "“In your letter you also asked for my opinion on the Secretary of State’'s statement to the House in relation to the Code of Conduct for MPs and the Ministerial Code of Conduct. This is a matter for the Permanent Secretary of the Department of Health, Una O'’Brien.”"

Update September 2016

Corrections don’t always happen right away. Sometimes we have to ask multiple times to find the source of a claim, or to get the claim corrected if necessary. In fact, we were so persistent with the Department of Health about previous claims, that in August last year it started producing an internal data document, listing the sources of ministerial claims, "to enable our Media Centre to respond rapidly to queries from the media and from organisations such as Full Fact”.

So following the above exchange, we wrote back to the Health Secretary, reiterating that his statement in the House of Commons in October 2015 was an inaccurate representation of the evidence. We’ve published the letter here.

His office did not reply. The outgoing Permanent Secretary, Dame Una O’Brien, disagreed with us and said there was no need to correct the Parliamentary record. She quoted the authors of the British Medical Journal article, which was the source for the Mr Hunt’s claim, as saying that the 11,000 statistic “raises challenging questions about reduced service provision at weekends”.

We agree: that’s why we suggested that further research would be welcome in our first letter to Jeremy Hunt.

But these challenging questions  are  not the same as  a causal link between weekend service provision and excess deaths, and Mr Hunt’s inaccuracy still stands. You can read the Permanent Secretary’s full response here.

Since then, a doctor has obtained an internal Department of Health email via Freedom of Information. This was reported in the Mirror. The email acknowledges that experts such as the Nuffield Trust “say it is not clear how or to what extent investment in seven day services will reduce weekend deaths”. However, the Department directed staff on a ‘Line to take’:

"This analysis, led by doctors and other clinicians, provides further evidence of a ‘weekend effect’ in hospitals. It reinforces the case doctors are already making that we need to make important changes to the way NHS provides high quality, safe care, every day of the week”

The debate is ongoing, and is only going to get more heated as the plans for a “seven-day NHS” started to be rolled out across the whole health service. There are arguments about contracts, costs, and cancellations, and important decisions need to be made. When lives are at stake, the cost of bad information should be given greater importance that the cost of a correction. We hope the Health Secretary agrees.

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