Prolonged A&E Waits Linked to Increased Mortality and Urgent Need for Increased Treatment Capacity

Increased Mortality and Unprecedented Waiting Times

The true toll of the NHS winter crisis has been laid bare by a new analysis, revealing a stark correlation between prolonged A&E waits and increased mortality. The study, based on data from the Office for National Statistics, found that patients who spend 12 hours or more in A&E are twice as likely to die within 30 days of discharge compared to those who spend two hours or less. This risk of death increases progressively with longer waiting times, with a 1.9-fold increase for nine-hour waits, 1.6-fold for six-hour waits, and 1.1-fold for three-hour stays.

The impact of these delays is even more pronounced among younger patients, with 20-year-olds facing a 4.6-fold higher risk of death after experiencing the longest waits. Additionally, patients in London, those seeking care for eye problems, and those not admitted to hospital following their visit are also at significantly higher risk.

These findings highlight the critical need to address the issue of prolonged A&E waits, which have reached unprecedented levels. Figures based on the time between admission decision and bed availability show that over half a million patients breached the 12-hour mark in 2024. However, when considering waiting times from the point of arrival, the picture becomes even more concerning. Provisional NHS figures reveal that 1.75 million people spent more than 12 hours in A&E departments after arriving last year, with December alone seeing almost 167,000 patients affected.

This situation has been exacerbated by the recent surge in winter virus cases and cold weather, placing immense pressure on hospitals. Despite flu cases peaking, Professor Julian Redhead, NHS national clinical director for urgent and emergency care, warns that hospitals are "not out of the woods yet." He emphasizes the tireless efforts of staff amidst challenging circumstances, but highlights the concerning combination of high winter virus prevalence, cold weather, and discharge difficulties leading to overcrowded hospitals.

Furthermore, achieving the government's target of 92% of patients receiving planned treatment within 18 weeks will require a significant increase in treatment capacity. The Health Foundation estimates that the number of patients removed from the waiting list would need to rise from 20.8 million per year in July 2023 to 23.5 million per year in July 2029 to meet this target.

The NHS winter crisis has exposed the vulnerability of the healthcare system and the urgent need for solutions to address prolonged A&E waits, improve patient outcomes, and ensure timely access to planned treatment. Addressing these challenges will require a multifaceted approach, including increased resources, improved discharge planning, and effective management of winter pressures.