A record 350,000 patients in England waited more than 12 hours to be admitted to hospital from A&E last year, according to figures that raise fears about unsafe care as the NHS faces further waves of strike action.
The figures, uncovered in an analysis by the Liberal Democrats, show a steep rise in delays since 2015, when just 1,306 patients waited 12 hours. Senior doctors described the situation as “unbearable” for patients and staff, ahead of a strike in which thousands of ambulance workers will walk out across England and Wales on Monday.
The Liberal Democrat leader, Ed Davey, warned that frequent and lengthy delays in emergency medicine are “needlessly costing lives of patients” and said that the government is in “total denial” about the scale of the problem facing hospitals, social care and GP services.
“The failure of the Conservative government to grip this crisis is simply unforgivable,” he said. “Instead they have shamefully allowed the situation to go from bad to worse through years of neglect and failure.”
The latest figures revealed a huge rise in 12-hour delays, from 1,306 in 2015 to 8,270 in 2019, before the Covid pandemic hit. By 2022, the number of patients left waiting more than 12 hours to be admitted reached 347,700 or almost 1,000 a day. This made up 6% of patients admitted in an emergency last year.
These figures cover the waiting times for patients adjudged to need a hospital bed, for example, after A&E doctors have assessed them as needing to be admitted. All such patients are by definition a medical emergency.
The figures are based on emergency admissions, which refer to patients who were admitted to hospital, either for immediate treatment, a bed in a ward or for an X-ray or other diagnostic test. Earlier this month, the Royal College of Emergency Medicine estimated that as many as 500 people could be dying each week because of delays to emergency care.
Dr Adrian Boyle, president of the Royal College of Emergency Medicine, said the true waiting times are likely to be even worse than the figures suggested because the start time is counted from once a decision to admit, rather than registration, and the figures only include people who are admitted.
“This problem is almost entirely caused by a lack of capacity, both beds and staff within hospitals,” he said. “On a personal level, making a decision to admit a patient to hospital and knowing that they could be spending over 24 hours waiting for a bed is increasingly difficult. Elderly and frail patients can be made worse by these waits. This is a fixable problem with the right political will.”
Boyle and other senior NHS figures are due to give evidence to the Commons health select committee on Tuesday about the college’s fear as many as 500 patients a week are dying because of delays in emergency care.
Dr Tim Cooksley, president of the Society for Acute Medicine, said the numbers were “shocking but not surprising” for frontline care workers. “This data illustrates the unbearable situation for patients and staff in urgent and emergency care over the last 12 months,” he said. “Patients are enduring unacceptably long waits for beds on acute medical units and inpatient wards.”
Prof Philip Banfield, BMA council chair, said: “These appallingly long waits in emergency departments can have life and death consequences for not only those patients, but others waiting to get seen in the first place who are suffering daily from this government’s neglect.”
The NHS is facing more industrial action on Monday with up to 15,000 Unison ambulance workers striking for the third time in five weeks across five trusts. Almost 1,000 ambulance workers in the West Midlands, together with paramedics, emergency care assistants and other members of the GMB union will also walk out.
Monday 6 February is likely to be the biggest day of strike action the NHS has ever experienced, with thousands of nurses and ambulance workers due to stage walkouts if no deal has been reached by then.
The government has been in talks with unions, but Unite’s general secretary, Sharon Graham, said on Sunday that pay has not been on the table.
“They’re not pay talks and this is the problem. The big issue here is about pay,” she told Sky’s Sophy Ridge on Sunday.
She indicated a 10% pay rise would be considered by union members, but Steve Barclay, the health secretary, had appeared to rule out a double-digit pay rise for nurses, saying it was “not affordable” while speaking to broadcasters during a hospital visit last week.
In response to the A&E waiting time figures, a Department of Health and Social Care spokesperson said: “We are taking urgent action to improve access to urgent and emergency care – including investing up to £250m of funding to immediately free hospital beds, alleviate pressures on A&E and unblock delays in handing patients over from ambulances.”
“This is on top of £500m to speed up the safe discharge of patients, and creating the equivalent of 7,000 more beds as well as establishing 24/7 data-driven system control centres in every local area to manage demand and capacity.”
• The headline and first paragraph of this article were amended on 23 January 2023 to clarify that the figures relate to England.