New study shows how hospital services around clock affects patient care

A major new study is to look at how providing more hospital services around the clock affects patient care - and how cost effective it is.

The research will investigate patient experiences and outcomes at Salford Royal NHS Foundation Trust over eight years to provide vital information on the benefits, costs and potential consequences of extending the hours of full operation. 

It is funded by the National Institute for Health Research Health Services and Delivery Research  (NIHR HS & DR) Programme and is a collaboration between Salford Royal, The University of Manchester, The University of York, The University of Bristol, and Haelo, an innovation and improvement centre, also based at Salford Royal. 

Principal Investigator Professor Tim Doran said: "Nationally, patients attending hospitals outside of normal working hours, for example at night and at weekends, are more likely to receive poorer care and to have worse health outcomes than patients admitted during weekdays.  

"Outside normal working hours fewer hospital staff are at work - in particular senior doctors - and a full clinical service is not available. Extending the hours for which hospitals are fully operational could therefore improve outcomes for patients.  

"But it would also increase costs for the NHS, would mean staff have to work more anti-social hours, and could lead to us providing services that are under-used." 

Salford Royal has already led the way on extending its hours of full operation for acute medical patients and now provides a full service of consultant-led care in its Emergency Village - which includes A&E, the Emergency Assessment Unit and support services - from 7am to 11pm seven days a week. 

The research will also assess whether the opening hours of patients' GP surgeries are related to their attendance at hospital and their health outcomes. The study will look at patient care in Salford from 2007 to 2015 but will also be extended to  examine whether quality of care and patient outcomes varies with time of admission for all 24 Acute Hospital Trusts in the North West of England.  

Professor Matthew Sutton, Professor of Health Economics at The University of Manchester, said: "This research will provide hospitals, local commissioners and the Department of Health with vital information on the costs, benefits and potential unintended consequences of extending the hours of full operation of the NHS. 

"It's a tricky area because services with the potential to meet patient demand are inter-related but often offered by different organisations. For example, the hours of operation of local general practices has an impact on the demand for services in A&E." Professor Doran added:

"Patients have a right to expect the same high quality of care whenever they are admitted to hospital. We need to understand why patients admitted at night and at weekends have poorer outcomes, and whether these outcomes can be improved by extending normal hours of operation."