Nearly 14,000 people died unnecessarily in England last year while waiting up to 12 hours in A&E for a hospital bed, according to a new estimate.
Calculations from the Royal College of Emergency Medicine (RCEM), based on a major study into excess deaths and waiting times, show that 268 people are likely to die every week by 2023 due to excessive waiting in A&E.
The estimate used a study of more than 5 million NHS patients, published in the Emergency Medicine Journal in 2021, which found there was one excess death for every 72 patients who spent eight to 12 hours in an emergency department .
The risk of death started to increase after five hours and got worse as wait times got longer, the study found.
The RCEM previously said it believed there would likely have been 300 to 500 extra deaths each week in England by 2022, based on this calculation, but has since carried out a freedom of information audit of NHS trusts to refine its figures .
It found that 65% of people waiting 12 hours or more in A&E were patients waiting for a hospital bed.
NHS data for England shows that more than 1.5 million patients waited in major emergency departments for 12 hours or more in 2023, meaning more than a million of them were waiting for a bed.
The RCEM calculated that if only patients waiting to be admitted were taken into account, an average of 268 additional deaths would have occurred each week by 2023, or 13,919. It said this was 17 fewer each week than in 2022, when a severe flu outbreak and Covid cases overwhelmed the NHS.
The RCEM said the 2023 estimates were likely conservative. It said patients who were delayed in the backs of ambulances, “of which there are thousands”, were not included in the figures but were also at risk of injury.
Dr. Adrian Boyle, chairman of the RCEM, said: “Extremely long waiting times still leave patients at risk of serious harm. Small improvements in the standard performance of four hours of access are not meaningful when so many people stay longer than twelve hours. Efforts and money must go where the damage is greatest.”
The NHS recovery plan set a target in March for 76% of emergency department patients to be admitted, transferred or discharged within four hours. But data for March shows 70.9% of patients were seen within that time.
In February, the number of people who waited more than 12 hours in A&E from a decision to admit to actual admission was 44,417.
Boyle said: “In 2023, more than 1.5 million patients waited 12 hours or more in major emergency departments, with 65% awaiting admission. Lack of hospital capacity means patients stay indoors longer than necessary and are cared for by emergency department staff, often in clinically inappropriate areas such as corridors or ambulances.
“The direct correlation between delays and mortality rates is clear. Patients are exposed to avoidable harm. Urgent intervention is needed to put people first. Patients and staff should not bear the consequences of insufficient financing and too few resources. We cannot continue to be confronted with inequalities in care, avoidable delays and deaths.”
An NHS source suggested the RCEM figure could be misleading because it applies an average figure to people on waiting lists without knowledge of individual cases.
An NHS spokesperson said: “We have seen a significant increase in demand for emergency services, with attendance in February up 8.6% on last year and emergency admissions up 7.7% %. additional funding with more beds, capacity and greater use of measures such as same-day emergency care – delivering improvements, alongside continued work with our community and social care colleagues to discharge patients when they are medically fit to go home to go, freeing up beds for other patients.
“The cause of the excess deaths is due to several factors and it is therefore right that the experts at the ONS – as the executive arm of the statistical authority – continue to analyze these causes.”