Will death rates rise on ‘Black Wednesday’ as medical graduates start their first day in hospitals?

Posted: 07/08/2013

In the medical profession the first Wednesday in August has become known as ‘Black Wednesday’ because figures show that mortality rates in emergency admissions rise by an average of around 6 per cent when medical students start as trainee doctors in their hospitals and other junior doctors swap specialties.

There have long been many stories, supported by statistics, of errors being made on this day due to inexperience and/or lack of senior input. The situation is one of which the NHS is aware. Last year, in an attempt to pro actively manage the problem, a system of 'shadowing' was introduced where junior doctors work with a more senior colleague (often the junior doctor leaving that specific role) for a few days in order to be ‘shown the ropes’ before the changeover day. It is too early to assess to what degree the ‘shadowing’ project will help but it has previously been proved to be effective in reducing errors.

However there must be queries about the timings – to have graduates starting their first role on the same day as junior doctors all change roles and at a time when many senior medical staff may be away on holiday does seem to load the risk of problems.

The Academy of Medical Royal Colleges (AMRC), which represents the 20 medical institutions responsible for maintaining standards in the NHS, has called for rotas to be 'more flexibly and intelligently designed' so that more experienced doctors are available in August and September.

Philippa Luscombe, partner in Penningtons’ clinical negligence team, said: “Black Wednesday is not an old wives’ tale – the figures are there to support it. In these current times of looking at system failures within the NHS, this seems to be an area which needs to be revisited and reassessed. Steps need to be taken to avoid patients being put at additional risk on this day each year. It is also crucially important that junior doctors feel supported and able to ask for advice or report problems – again the culture of openness is important.”

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