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People’s experiences of hospital care on the weekend: secondary analysis of data from two national patient surveys
  1. Chris Graham
  1. CEO’s Office, Picker Institute Europe, Oxford, Oxfordshire, UK
  1. Correspondence to Chris Graham, Picker Institute Europe, Oxford, Oxfordshire OX2 0JB, UK; chris.graham{at}


Objective To determine whether patients treated in hospital on the weekend report different experiences of care compared with those treated on weekdays.

Design This is a secondary analysis of the 2014 National Health Service (NHS) adult inpatient survey and accident and emergency (A&E) department surveys. Differences were tested using independent samples t-tests and multiple regression, adjusting for patient age group, sex, ethnicity, proxy response, NHS trust, route of admission (for the inpatient survey) and destination on discharge (for the A&E survey).

Setting The inpatient survey included 154 NHS hospital trusts providing overnight care; the A&E survey 142 trusts with major emergency departments.

Participants Three cohorts were analysed: patients attending A&E, admitted to hospital and discharged from hospital. From the inpatient survey’s 59 083 responses, 10 382 were admitted and 11 542 discharged on weekends or public holidays. The A&E survey received 39 320 responses, including 11 542 (29.4%) who attended on the weekend or on public holidays. Weekday and weekend attendees’ response rates were similar once demographic characteristics were accounted for.

Main outcome measures For the A&E survey, six composite dimensions covered waiting times, doctors and nurse, care and treatment, cleanliness, information on discharge, and overall experiences. For the inpatient survey, three questions covered admissions and two dimensions covered information about discharge and about medicines.

Results People attending A&E on weekends were significantly more favourable about ‘doctors and nurses’ and ‘care and treatment’. Inpatients admitted via A&E on a weekend were more positive about the information given to them in A&E than others. Other dimensions showed no differences between people treated on weekdays or on weekends.

Conclusions Patients attending emergency departments or admitted to or discharged from an inpatient episode on weekends and public holidays report similar or more positive experiences of care to other patients after adjusting for patient characteristics.

  • health services research
  • patient-centred care
  • patient satisfaction
  • standards of care
  • surveys

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  • Contributors CG conceived of the article, undertook the analysis and prepared the manuscript.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. The surveys used as the data source for the secondary analysis were funded by the Care Quality Commission and by participating organisations.

  • Competing interests CG is employed by the Picker Institute, a charity dedicated to promoting person-centred care. The Picker Institute is commissioned by the Care Quality Commission to coordinate surveys in the NHS Patient Survey Programme, including the two surveys analysed in this study. The Picker Institute is also contracted by a number of NHS hospital providers to administer surveys and collect responses.

  • Ethics approval This study used secondary analysis of existing data from two national studies. Both original surveys were reviewed and received favourable ethical opinions from NHS research ethics committees (see The secondary analysis did not require ethical review.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Abridged data sets for each of the surveys are available via the UK data service.