Crowding costs thousands of lives in UK hospital casualty departments

Research points to a long, hard winter for the UK health services as pent-up demand emerges

NHS England's research has found that one in 67 patients staying in the emergency department for 12 hours comes to excess harm. EPA

Health leaders have issued fresh warnings about pressures on the National Health Service over the winter as a new report found thousands of deaths were caused by crowding in emergency departments.

At least 4,519 patients died as a result of crowding and 12-hour stays in A&E departments in England in 2020-2021, the report by the Royal College of Emergency Medicine (RCEM) found.

Dr Adrian Boyle, vice president for policy of the RCEM, said: “To say this figure is shocking is an understatement.

“Quite simply, 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.”

He said October saw 7,059 12-hour stays – the highest number recorded and a 40 per cent rise from September.

Dr Boyle also said there were harder months ahead, following the number of long stays rising “drastically” over the past six months.

NHS England's own research has found that one in 67 patients staying in the emergency department for 12 hours comes to excess harm.

The RCEM said there was a shortfall of 2,000 to 2,500 emergency consultants and shortages of emergency nurses, juniors and supporting staff.

“This is the beginning of a long winter and an extremely challenging time for the current workforce as pressures will rise and patient safety will continue to be put at risk,” Dr Boyle said.

Responding to the RCEM report, Matthew Taylor, chief executive of the NHS Confederation, said the heath service was under “critical and unsustainable pressure".

“NHS leaders and staff are doing their utmost to provide patients with the treatment that they need. However, the health service requires urgent support to address severe workforce shortages as well as a waiting list for elective care which now stands at 5.82 million patients”, he said.

NHS Providers, the membership organisation for the NHS hospital, mental health, community and ambulance services, said trusts were working “flat out”, while “already working beyond full stretch".

NHS Providers has recommended providing a £500 retention bonus to workers in the social care sector and for the government to give “greater leadership” on public health through stronger messaging on how to manage the risks of coronavirus in addition to a long-term workforce plan.

An NHS spokesperson said: “NHS staff have gone above and beyond over the last 18 months treating 500,000 seriously ill Covid inpatients and as most recent data shows, they also contended with the busiest October ever for major A&Es and for life-threatening ambulance call outs in a single month.

“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 sign post you to the best option for you.”