More than 250 patients a week may have died in England last year due to long waits in A&E for a hospital bed, a new study suggests. Research by the Royal College of Emergency Medicine (RCEM) indicates that patients are coming to harm after spending hours in emergency departments, particularly once a decision has been made to admit them.
The NHS recovery plan set a target for March that 76 per cent of patients attending A&E should be admitted, transferred or discharged within four hours. This target will rise to 78 per cent next March after criticism it was not ambitious enough. However, figures for last month show that only 70.9 per cent of patients were seen within that timeframe. In February, 149,075 people waited more than 12 hours in A&E from arrival to being seen, admitted or discharged, down from a high of 174,110 in January.
For its latest excess death estimates, the RCEM used a 2021 study of over 5 million NHS patients published in the Emergency Medicine Journal. This found one excess death for every 72 patients who spent eight to 12 hours in A&E, with the risk of death increasing after five hours. In 2022, the RCEM estimated 300 to 500 excess deaths per week, but a subsequent Freedom of Information audit of NHS trusts refined this figure. It found that 65 per cent of people waiting 12 hours or more in A&E are waiting for a hospital bed.
NHS data for England shows more than 1.5 million patients waited 12 hours or more in major emergency departments in 2023, meaning over a million were waiting for a bed. The RCEM calculated that, when looking solely at patients awaiting admission, an average of 268 excess deaths likely occurred each week in 2023, only 17 fewer than in 2022 using the same method. The college added that patients delayed in ambulances are not included but are also at risk, and overall estimates are likely conservative.
Dr Adrian Boyle, president of the RCEM, said: “Excessively long waits continue to put patients at risk of serious harm. Small improvements in four-hour access standard performance are not meaningful when there are so many people staying more than 12 hours. The direct correlation between delays and mortality rates is clear. Patients are being subjected to avoidable harm. Urgent intervention is needed to put people first.” An NHS spokesperson said demand for A&E services has increased significantly, with attendances up 8.6 per cent in February compared to last year, and that the urgent and emergency care recovery plan is delivering improvements through extra funding, more beds and capacity.
