One patient is dying every 23 minutes in England after they endured a long delay in an A&E unit, according to analysis of NHS figures by emergency care doctors.
In all, 23,003 people died during 2022 after spending at least 12 hours in an A&E waiting for care or to be admitted to a bed, according to the Royal College of Emergency Medicine (RCEM).
That equates to roughly one every 23 minutes, 63 every day, 442 a week or 1,917 each month.
The college said its findings, while “shocking”, were also “unsurprising” and reflected the fact that emergency departments are often overwhelmed and unable to find patients a bed in the hospital.
Daisy Cooper, the Liberal Democrats’ health spokesperson, said “patients are now dying in their droves” due to successive Conservative governments neglecting the NHS, and added that the lives lost due to A&E snarl-ups constituted a “national disaster”.
It has been warning since last September that up to 500 deaths have been occurring every week in A&Es in England because so many patients have spent so long there – a claim the NHS denies.
The RCEM previously based its claim on Office for National Statistics figures showing that it was recording 500 “excess deaths” a week that it could not explain.
However, the college’s new research uses different data, this time showing the number of people – 1,656,206 in total – who spent at least 12 hours in an emergency department after arrival last year. It obtained that from NHS England using freedom of information laws.
It then analysed those figures alongside existing evidence by a group of A&E doctors, published in a medical journal last year. Using a measure known as the standard mortality ratio, they concluded that one extra patient dies for every 72 who spend between eight and 12 hours in A&E.
“Long waiting times are associated with serious patient harm and patient deaths,” said Dr Adrian Boyle, RCEM’s president. “The scale shown here is deeply distressing.”
Boyle said that NHS England’s practice of only publishing data on the number of patients who end up spending 12 hours in A&E after doctors have decided to admit them was “misleading” and disguised the full scale of long waits that are now endemic across the health service.
NHS England’s data shows that far fewer patients – 347,703 – waited 12 hours or more to get a bed or be transferred or discharged after the decision to admit.
However, the NHS figures the RCEM obtained show that the true number of those spending such long spells in A&E, as measured from their arrival, is almost five times higher. NHS England recently agreed to start publishing data on 12-hour waits from arrival from April after coming under pressure from the House of Lords and Office for Statistics Regulation to do so.
The Financial Times, the actuary firm LCP Health Analytics and the factchecking charity Full Fact have all undertaken their own research into A&E delay-related excess deaths and come up with figures very similar to the RCEM’s original estimate that about 500 a week occur.
Hospitals need more staff, more beds and more space if they are to get back to treating and admitting patients more quickly, Boyle added. He urged ministers to publish their long-promised NHS workforce plan urgently and take action to improve social care, in order to reduce the 14,000 hospital beds that are filled with patients who are medically fit to be discharged.
“Thanks to 13 years of Conservative failure to train the staff the NHS needs, people can no longer be sure the NHS will be there for them in an emergency,” said Labour’s Wes Streeting, the shadow health secretary.
“Labour will double medical school places and train 10,000 more nurses a year, paid for by abolishing non-doms, so patients are treated on time again.”
NHS England again disputed the RCEM’s findings but did not indicate how many avoidable deaths it thinks are occurring due to A&E delays.
“The cause of excess deaths is down to a number of different factors and so attributing deaths to one exact thing, as the figures quoted by the RCEM attempt to do, is very unlikely to give a full or certain picture”, a spokesperson said.
“It therefore would not be appropriate for NHSE to recognise these as fact and it is right that the experts at the ONS – as the executive branch of the statistics authority – continue to analyse excess deaths.
“The data highlighted looks at time in A&E rather than waits and covers a year when the NHS experienced four record-breaking months for attendances in A&E.”
• This article was amended on 28 February 2023. The Liberal Democrats’ health spokesperson is Daisy Cooper, not Rosie Cooper. The latter was a Labour MP until December 2022.
