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 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 in order to deliver the vision set out by the NHS Services Seven Days a Week Forum. 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.
The first HiSLAC paper has found no association between hospital specialist weekend staffing and weekend emergency admission mortality risk. Published today in The Lancet, the authors say further investigation is needed but warned that policy makers should exercise caution before attributing the weekend effect primarily to differences in specialist senior staffing.
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.