A&E delays linked to tens of thousands of patient deaths, top doctors claim

The Royal College of Emergency Medicine said the scale was ‘deeply distressing’

(EPA)

A&E delays may have led to more than 20,000 patient deaths last year, top emergency doctors have claimed.

“Hidden data” analysed by the Royal College of Emergency Medicine said 1.65 million people waited more than 12 hours for treatment after arriving in A&E departments in 2022 - with 23,003 of these later dying as a result.

The RCEM warned that long waiting times can have “catastrophic consequences for patient safety and mortality”.

Dr Adrian Boyle, president of the RCEM, said: “For a long time, we have known that the true scale of long waits in emergency departments has been hidden.

“Long-waiting times are associated with serious patient harm and patient deaths – the scale shown here for 2022 is deeply distressing.”

The figures came after the RCEM sent a Freedom of Information request to NHS Digital to discover the number of patients who waited for more than 12 hours from their time of arrival in A&E.

This information is not currently routinely published, although, following several exposes byThe Independent, NHS England has agreed to release the data, from April.

These figures are nearly five times higher than what is shown in publicly available data each month.

It comes as an analysis by The Independent suggested more than 448,000 patients may have come to harm as a result of paramedic crews being delayed in handing over patients to stretched A&Es in 2022. Of these, 47,000 may have suffered severe harm.

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‘Fit to sit’

Alysha Whynn, who suffers from sickle cell, told The Independentshe was forced to wait for 16 hours during a medical emergency and 25 hours for a bed in late November. For much of this time, she only had a chair to sit on as there were no beds and she was deemed “fit to sit”, she said.

“It was horrible, distressing, and also [I] was sitting on a chair so it was making it worse… I cry every time I have to go into A&E,” she said.

Prior to her time in A&E, Ms Wynn waited for three hours at home, in pain, for an ambulance crew to attend.

‘The NHS collapsed’

One paramedic, speaking with The Independent, said staff were being driven off-sick due to stress and being “blamed” for patient deaths.

He said “Before Christmas, when it was really bad, I remember one shift that I had to report nine patients in my area alone. Nine deaths in one shift because the delays were so long.

“It’s very often now to [see] category three, category two patients waiting 18 hours. It’s not uncommon any more. Quite often 90 of [our] workforce are stuck at a hospital... they're stuck at hospitals, and there's nobody to go get some in the community.”

He said, a few nights ago, ambulance crews at the local A&E were delayed for 12 hours.

The ambulance worker said: “The NHS collapsed when we couldn’t get to a cardiac arrest, within a reasonable timeframe. The NHS collapsed when we were unable to give life-saving care, due to insufficient resources. We are being forced to be gods and being blamed [for patient deaths].”

The RCEM found that in 2022, some 1,656,206 patients in England waited 12 hours or more from their time of arrival in an emergency department until they were admitted, transferred or discharged.

It then calculated the standardised mortality ratio linked to the long waits. A standardised mortality ratio describes whether a specific population are more, less or equally as likely to die compared with the general population.

The RCEM performed this analysis by using data from a previous study, published in the Emergency Medicine Journal in 2021, which linked excess deaths to long emergency department waits in England between 2016 and 2018. The study concluded that there was one extra death for every 72 patients that spend eight to 12 hours in the emergency department.

Using the standardised mortality ratio from the study and the 12-hour wait figure from NHS Digital, the RCEM estimated that 23,003 excess patient deaths in 2022 in England were associated with long stays in emergency departments.

It is worth noting that the study analysed data from 2016-18 so the figures may not be comparable with A&E waits in 2022.

A spokesperson for NHS England said: “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 – 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.”

However, in September 2021 an NHS England report, carried out by its Getting it Right First Time Team, said in 2021, that for every 72 patients delayed 8 to 12 hours one patient death is likely to occur.

Full fact previously said it could not be certain of RCEM’s estimates.

Wes Streeting MP, Labour’s shadow health and social care secretary, commenting on the analysis, said: “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.

“Twenty-four hours in A&E isn’t just a TV programme, it is the reality for far too many patients.”

A department of health and social sare spokesperson said: “There are a wide variety of factors contributing to excess deaths and it is important not to ascribe them to one cause.

“However, no one should have to wait longer than necessary to access urgent and emergency care and it’s encouraging to see significant improvements in performance last month including across all ambulance response times categories and in A&E departments.”