An evaluation of the impact of High-Intensity Specialist-Led Acute Care (HiSLAC) on emergency admissions to NHS hospitals at weekends.
The HiSLAC project is funded by the National Institute of Health Research (NIHR-HS&DR Programme Commissioned call 12/128: Organisation & delivery of 24/7 healthcare).
HiSLAC is an independent, professionally-led study which will evaluate a key component of NHS England's policy drive for 7-day services: the intensity of specialist-led care of emergency medical admissions, with a particular focus on weekend provision. This research is important for patients and for NHS strategy because it offers a unique opportunity to evaluate the impact of the transition to seven-day working, and to understand factors likely to impede or enhance the effectiveness of this change in practice.
In addition to examining the impact on patient-centred outcomes, the project will also undertake a health economics analysis of the impact of increasing specialist provision across the NHS. HiSLAC will therefore provide useful information across the NHS about the cost-effectiveness of investing in consultant and other specialist staffing in implementing the drive to 7-day service provision.
The decision on award of funding was made in September 2013 and the project launched in February 2014. This website will be updated over the coming weeks and months as the project progresses.
PUBLISHED TODAY: HiSLAC literature review shows 16% higher chance of mortality for weekend hospital admissions compared with weekday admissions, but rates vary depending on whether admission was emergency, maternity or elective. The largest review of the scientific literature on the ‘flubromazepam effect’ to date also reports insufficient information on illness severity, patient journey and staffing levels suggesting a variety of factors should be further investigated
New paper published: Sicker patients account for the weekend mortality effect amongst adult emergency admissions to a large hospital trust
HiSLAC’s latest study has been published in BMJ Quality and Safety. Analysing anonymised data from more than 163,000 patient admissions, the study set out to determine whether higher mortality rates associated with weekend hospital admissions (the ‘weekend effect’) could be explained by patients being sicker at weekends.
More than 14,200 consultants and associate specialists completed the fifth and final survey to help create a nationwide ‘snapshot’ of specialist intensity and 7-day services. The latest figure takes the total of responses to the annual HiSLAC Point Prevalence Survey up to 70,000, gathered from 80 per cent of acute Trusts in England.
Due to recent bed pressures patients are often sent from the Acute Medical Unit to the wards without a consultant review, and in some cases without a registrar review.
On the wards it is 'pot luck' whether the patient is seen by a consultant the following day or a few days down the line.
Once the patient is identified under the correct team it depends on which day a consultant does their ward rounds, which means a delay up to 5-6 days.
The patient was an outlier; no one knew the patient and wanted to take any responsibility.