PATIENTS are no more likely to die if they undergo emergency surgery at weekends compared to weekdays, according to a major new Scottish study which contradicts claims that a "seven-day NHS" would save lives.

Researchers at Edinburgh University said they were "unable to demonstrate an association" between the day of the week that emergency surgery took place and subsequent mortality in an analysis of 50,844 patients who were admitted to hospitals in Scotland over a three-year period from 2005 to 2007.

Previous studies have pointed to a so-called "weekend effect" in the NHS whereby patients face an increase risk of death and complications on Saturdays and Sundays, with the pattern identified in emergency hospital admissions, surgery, obstetrics, and intensive care admissions.

The phenomenon has been blamed on a shortage of expertise and resources at weekends, especially senior medical staff, used to justify attempts to overhaul hospital rotas to force more consultants to work at weekends.

The authors of the new report, published today in the British Journal of Surgery and funded by the Chief Scientist's Office of Scotland, say their findings challenge that theory.

They write: "Emergency surgery is undertaken at any time, on any day of the week, by both junior and consultant staff, for patients at high risk of death or complications. It would be expected

therefore that any structural effect resulting from reduced availability of staff or resources would be more apparent in these procedures than in elective surgery. Yet no effect was seen in this study."

More than a third of all surgical procedures in the UK are classified as emergencies, and emergency patients are eight times more likely to die than those opting for an elective procedure.

The Scottish study covered patients undergoing emergency general surgery, orthopaedics, ear/nose/throat (ENT), gynaecology, ophthalmology, thoracic surgery and spinal surgery, but excluded anyone who underwent emergency cardiac surgery, neurosurgery, transplantation and the surgical management of burns, as well as patients under 16.

The cohort was then split between 31,499 patients operated on between Monday and Thursday, and 19,345 who underwent surgery on Friday to Sunday.

Patients operated on at weekends were more likely to be male, younger, and to have fewer co-morbidities, but were also more likely to also more likely to require risky and complex procedures and were more likely to be operated on sooner. The authors said the faster time to surgery at weekends "may reflect increased severity of illness of those presenting at the weekend or simply reduced competition with elective cases for theatre time".

In total, 1,468 patients died prior to discharge and a further 5,755 died within the following four years, but "no difference in overall survival was associated with any particular day of surgery".

In England, Health Minister Jeremy Hunt faced a backlash after claiming that a 2015 study linking 11,000 excess deaths in the NHS to the "weekend effect" was because "we don't have a proper seven-day service". However, the authors said did not prove a link with staffing levels.

Dr Michael Gillies, a consultant and associate medical director in Edinburgh University's Department of Anaesthesia, Critical Care and Pain Medicine, said: “Emergency surgery is associated with far greater risks than elective surgery so it is reassuring to find that patients in Scotland are receiving the same high standards of care throughout the week.”

Dr Peter Bennie, chairman of the BMA in Scotland, said: “Despite some of the heavily misleading claims that have been made around seven day services in England, it is important for patients to understand and be assured that emergency care is already provided every day of the week in the NHS.

“In Scotland, the focus has rightly been on ensuring that urgent and emergency care is there when it is needed, rather than attempting to dilute scarce resources by trying to make every part of the NHS operate on a 24/7 basis.”