Waits of more than eight hours in A&E cause 4,519 excess deaths

MORE than 4,500 patients died after waiting 12 hours on trolleys in crowded A&ES last year, according to a report.

Crowding in emergency departments is a “major threat” to public health and can cause increased deaths and longer hospital stays, says the Royal College of Emergency Medicine (RCEM) report.

It comes as Sajid Javid, the Health Secretary, revealed the proportion of adults with depression has nearly doubled since before the pandemic as he described the “dispiriting” backlog of care in a speech to health leaders. “We must be ambitious about restoring services and not let anything stand in our way,” Mr Javid told the NHS Providers conference.

One in 67 patients staying in emergency departments for 12 hours will come to avoidable harm, the RCEM said.

The link between how long a patient stays in hospital and their chance of death was calculated in the NHS England Getting It Right First Time (GIRFT) plan, designed to improve treatment and care through reviews of services.

There were 4,519 excess deaths in emergency departments in England based on harm suffered by patients waiting on trolleys between eight and 12 hours, the report estimated using the GIRFT findings and NHS England hospital episode statistics from 2020-21.

“This may be an underestimate, as stays longer than 12 hours would be expected to confer a greater risk of death,” the report warned.

A study published in 2019 found 5,500 patients died over a period of three years in A&E departments while waiting for a bed.

RCEM said the analysis did not specifically account for Covid deaths but warned the issue of 12-hour waits and excess deaths started long before the pandemic. Dr Adrian Boyle, of the Royal College of Emergency Medicine, said: “To say this figure (4,519 excess deaths) is shocking is an understatement. Crowding kills. For many years we have issued warnings about the harm that dangerous crowding causes, but now we can see the number of excess deaths that have occurred as a result.”

October saw the highest number of patients waiting 12 hours for a bed after a decision was made to admit them, 7,059, 40 per cent higher than September which was the previous record.

More than 1.4 million attended A&E in October, the third highest number of attendance on record, compared to 1.38 million in the same month in 2019.

Dr Boyle said: “The situation is unacceptable, unsustainable and unsafe for patients and staff. Political and health leaders must realise that if performance continues to fall this winter: more patients will come to avoidable harm in the Emergency Department; staff will face moral injury; and the urgent and emergency care system will be deep into the worst crisis it has faced.”

Pressures are also being felt in ambulance services, after an injured elderly woman was rushed to hospital on a bus because the local ambulance service was too busy to attend.

The woman fell and hit her head while trying to board the bus in Falmouth, Cornwall, but after phoning 999 an operator said it could take three to four hours for an ambulance to arrive.

An NHS spokesman said: “As set out in our 10 point plan, the NHS is maximising the availability of urgent care services to provide alternatives to A&E so anyone who needs care should come forward through NHS 111 Online so staff can help signpost the best option for you.”