HiSLAC “is doing precisely what the authors of the letter want”

HiSLAC’s Chief Investigator, Professor Julion Bion appears in The Guardian today to respond to a letter calling for the Prime Minister to hold an inquiry into the evidence of a ‘weekend effect’.

Signed by Stephen Hawking, Robert Winston and a number of senior doctors, it calls into question Health Secretary Jeremy Hunt’s claim that 11,000 patient deaths a year are caused by a lack of medics on duty in hospitals at weekends.

Professor Bion was asked to comment on the letter by the Guardian’s health policy editor, Denis Campbell; here’s his response in full:

“The High-Intensity Specialist Led Care (HiSLAC) project is doing precisely what the authors of the letter want – it is an independent scientific investigation into the weekend effect, funded by the NIHR, and conducted by a national collaboration which includes patient representatives, senior clinicians, scientists, and managers. We started the project in early 2014, and have already delivered preliminary results published in the Lancet in May this year. Our work includes a systematic review of the weekend effect which we will submit for publication by the end of this year. We therefore strongly support the need for a scientific investigation of the weekend effect, and are already undertaking this work.

“Preliminary results from HiSLAC - and that of others - show that the weekend effect (which has been studied in more than 100 publications covering different health systems and continents) is multifactorial. There is evidence that patients admitted at weekends are sicker (i.e. there are fewer low-risk admissions at weekends), and the weekend effect may therefore have a ‘community dimension’ - the causes may include community and social care as much as hospital care.

“Most of the research in this area has focused on duplicating the existence of the weekend effect, instead of trying to understand the cause. HiSLAC is funded to investigate the cause. We are collaborating with others in this area (including Prof Sutton in Manchester). As we said in our Lancet article: "Policy makers should exercise caution before attributing the weekend effect mainly to differences in specialist staffing”.

“The HiSLAC study has therefore anticipated the authors’ concerns by two years – we are strongly of the view that health policy should be based on good evidence and that when policy decisions have to be taken before that evidence is available, implementation must be accompanied by scientific evaluation.

“This is precisely what HiSLAC is doing.”




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