The organisation and delivery of 24/7 care
Research type
Research Study
Full title
The future of 24/7 care: investigating the links between staffing levels, patient access and inequalities in health outcomes
IRAS ID
150924
Contact name
Tim Doran
Contact email
Sponsor organisation
Salford Royal Foundation Trust
Research summary
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 of 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 improve access and outcomes for patients, but could increase costs for the NHS, would require staff to work more anti-social hours, and may lead to the provision of services that are under-used.
In this study we intend to assess how extending fully-operational hours affects costs for the NHS and whether it leads to improved outcomes for different patient groups. The main study will be based at Salford Royal Foundation Trust, which has gradually extended its hours of full operation between 2007 and 2012, and now provides a full service from 7am to 11pm seven days per week. Salford Royal has kept electronic records for patients, both within the hospital and when attending local general practices, as well as for hospital staff. We will link these data together in order to follow each patient’s journey through the hospital and examine whether patient outcomes (such as length of stay, health complications and death) are associated with the time of their admission and the levels of staffing during their stay. We will also assess whether the hours of operation of patients’ general practices are related to their attendance at hospital and their health outcomes. Finally, we will extend the study 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.
REC name
North West - Greater Manchester East Research Ethics Committee
REC reference
14/NW/0175
Date of REC Opinion
21 Mar 2014
REC opinion
Favourable Opinion