Almost 400,000 patients spend 24 hours or more in A&E, figures show
Twenty-four hours in A&E is now “no longer a documentary”, leading medics have warned, as figures show almost 400,000 patients spent a day or more in an emergency department in England last year.
The Royal College of Emergency Medicine (RCEM) said the very long waits are a “matter of national shame”.
Figures uncovered by the college and shared with the PA news agency show 399,908 people waited 24 hours or more in an emergency department in England in 2022-23.
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The college warned there could be a similar situation this year, with Dr Adrian Boyle, its president, cautioning that patients are coming to avoidable harm as a result of long waits.
“We know that long stays in emergency departments are harmful,” Dr Boyle said.
“There is good scientific data that shows that once people spend more than about six hours, and they need to be admitted into hospital, actually their mortality starts to get worse.
“I think it should be a matter of national shame that we have these very long waits for admitted patients.”
He said people caught up in the long waits are “often elderly and vulnerable”.
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Political parties urged to end overcrowding
The RCEM has made a number of calls to political parties in its general manifesto, including:
• To end overcrowding in emergency departments, including by ensuring there are enough hospital beds to prevent people being stuck in emergency departments when they need a bed on a ward.
• More funding for social care to prevent a system where people who no longer need hospital care can be discharged when ready.
• More emergency medicine staff to deliver “safe and sustainable care” and for more work to retain current staff.
• More data to be published on hospital performance.
• A call to “resource the NHS to ensure the emergency system can provide equitable care to all”.
Record number attend A&E
A record number of patients attended A&E in England in 2022-33, 25.3 million, up 4% from the previous year, according to figures released last week.
The data also shows 71% of people spent four hours or less in A&E in 2022-23.
The NHS recovery plan sets a target of March 2024 for 76% of patients attending A&E to be admitted, transferred or discharged within four hours, with further improvements expected the following year.
An NHS England spokesperson said: “This data relates to last year and winter, when services were facing record demand, industrial action and a twindemic of COVID and flu, but since we published our urgent and emergency care recovery plan in January we have seen significant improvements.
“Thanks to the hard work of NHS staff Category 2 ambulance response times are now an hour faster than in December, A&E four-hour performance is up from 69% to 73%, and the proportion of patients waiting 12 hours in A&E is down a sixth.
“We know there is more to do, which is why we set out our winter plans earlier than ever before this year, expanding care ‘traffic control’ centres, delivering additional ambulance hours and extra beds to boost capacity and reduce long waits for patients, and other initiatives like same day emergency care units and virtual wards which can mean patients are able to get the care they need without an unnecessary trip to an emergency department – this is better for them, and means A&E staff can continue to prioritise those with the most urgent clinical need.”
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There is “no doubt” the UK “will spend 3% of our GDP on defence” in the next parliament, the defence secretary has said.
John Healey’s comments come ahead of the publication of the government’s Strategic Defence Review (SDR) on Monday.
This is an assessment of the state of the armed forces, the threats facing the UK, and the military transformation required to meet them.
Prime Minister Sir Keir Starmer has previously set out a “clear ambition” to raise defence spending to 3% in the next parliament “subject to economic and fiscal conditions”.
Mr Healey has now told The Times newspaper there is a “certain decade of rising defence spending” to come, adding that this commitment “allows us to plan for the long term. It allows us to deal with the pressures.”
A government source insisted the defence secretary was “expressing an opinion, which is that he has full confidence that the government will be able to deliver on its ambition”, rather than making a new commitment.
The UK currently spends 2.3% of GDP on defence, with Sir Keir announcing plans to increase that to 2.5% by 2027 in February.
This followed mounting pressure from the White House for European nations to do more to take on responsibility for their own security and the defence of Ukraine.
The 2.3% to 2.5% increase is being paid for by controversial cuts to the international aid budget, but there are big questions over where the funding for a 3% rise would be found, given the tight state of government finances.
While a commitment will help underpin the planning assumptions made in the SDR, there is of course no guarantee a Labour government would still be in power during the next parliament to have to fulfil that pledge.
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From March: How will the UK scale up defence?
A statement from the Ministry of Defence makes it clear that the official government position has not changed in line with the defence secretary’s comments.
The statement reads: “This government has announced the largest sustained increase to defence spending since the end of the Cold War – 2.5% by 2027 and 3% in the next parliament when fiscal and economic conditions allow, including an extra £5bn this financial year.
“The SDR will rightly set the vision for how that uplift will be spent, including new capabilities to put us at the leading edge of innovation in NATO, investment in our people and making defence an engine for growth across the UK – making Britain more secure at home and strong abroad.”
Sir Keir commissioned the review shortly after taking office in July 2024. It is being led by Lord Robertson, a former Labour defence secretary and NATO secretary general.
The Ministry of Defence has already trailed a number of announcements as part of the review, including plans for a new Cyber and Electromagnetic Command and a £1bn battlefield system known as the Digital Targeting Web, which we’re told will “better connect armed forces weapons systems and allow battlefield decisions for targeting enemy threats to be made and executed faster”.
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PM Sir Keir Starmer and Defence Secretary John Healey on a nuclear submarine earlier this year. Pic: Crown Copyright 2025
On Saturday, the defence secretary announced a £1.5bn investment to tackle damp, mould and make other improvements to poor quality military housing in a bid to improve recruitment and retention.
Mr Healey pledged to “turn round what has been a national scandal for decades”, with 8,000 military family homes currently unfit for habitation.
He said: “The Strategic Defence Review, in the broad, will recognise that the fact that the world is changing, threats are increasing.
“In this new era of threat, we need a new era for defence and so the Strategic Defence Review will be the vision and direction for the way that we’ve got to strengthen our armed forces to make us more secure at home, stronger abroad, but also learn the lessons from Ukraine as well.
“So an armed forces that can be more capable of innovation more quickly, stronger to deter the threats that we face and always with people at the heart of our forces… which is why the housing commitments that we make through this strategic defence review are so important for the future.”
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