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I find it hard to believe a lack of GP cover can be blamed for a rise in death rate at weekends (News, July 2). As an SHO in a large hospital in south Wales, I have often seen patients deteriorating over the weekend.

First, it is difficult to get routine investigations (except bloods) done out of hours. Second, to comply with the European Working Time Directive, we cover a range of different specialties in the hospital.

This involves reviewing patients we have never met before and means that several doctors are involved in the continuing weekend care (which relies on good handovers).

GP referrals over the weekend, in my experience, do not differ from that on weekdays. Occasionally these patients are not seen by a consultant or the relevant specialty consultant until Monday morning which can delay optimum treatment.

There are many confounding reasons to why the mortality rate is increased.

Dr Patricia de Lacy



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