A recent study in Quality & Safety in Healthcare by Paul Aylin and colleagues examined death rates in patients admitted as emergencies to NHS hospitals in England. This is the largest study published on weekend mortality and highlights an area of concern in relation to the delivery of acute services. Several studies have shown higher mortality for patients admitted as emergencies at weekends compared with emergency admissions on week days. Using routinely collected hospital administrative data, they examined in-hospital deaths for all emergency inpatient admissions to all public acute hospitals in England for 2005/2006. Odds of death were calculated for admissions at the weekend compared to admissions during the week, adjusted for age, sex, socioeconomic deprivation, comorbidity and diagnosis. The overall adjusted odds of death for all emergency admissions was 10% higher in those patients admitted at the weekend compared with patients admitted during a weekday The study was widely reported in the media, including in the Guardian, Telegraph, and Nursing Times.
NHS budgets are under considerable pressure. It is therefore unsurprising that many NHS Integrated Care Boards (ICBs) In England will aim to prioritise price in contract awards, But this approach is a significant threat to community-centred healthcare. While competitive tendering is a legally required, an excessive focus on costs in awarding NHS contracts risks overshadowing key factors such as established community trust, local expertise, and the long-term impact on continuity of care. This shift towards cheaper, often external, commercial providers threatens to cut the links between communities and their local health services. The argument that competitive tendering is solely about legal compliance, and not cost, is undermined by the very nature of such tendering, which by design encourages the lowest bid. This approach risks eroding the social fabric of local healthcare provision, where established relationships and understanding of specific community needs are essential. Establishe...
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