More than 250 patients a week in England may have died unnecessarily last year due to very long waits for a bed in A&E, new estimates suggest.
A study by the Royal College of Emergency Medicine (RCEM) suggests patients are put at risk by spending hours in A&E, particularly after a decision has been made to admit them.
The NHS recovery plan set a target in March for 76% of patients attending A&E to be admitted, transferred or discharged within four hours.
But data for the month shows just 70.9% of patients were seen within that time.
In February, the number of people waiting more than 12 hours in A&E departments – from a decision to admit to actually being admitted – was 44,417.
For its new excess death estimates, the RCEM used a study of more than five million NHS patients published in the Emergency Medicine Journal (EMJ) in 2021.
This found there was an excess death for every 72 patients that spent eight to 12 hours in A&E.
More on Nhs
Related Topics:
The risk of death increased after five hours and got worse with longer waiting times.
In 2022, the RCEM said it believed 300 to 500 excess deaths were likely to have occurred in England each week using this calculation.
Advertisement
But after a Freedom of Information audit of NHS trusts to refine this figure, it found that 65% of people waiting 12 hours or more in A&E are patients waiting for a hospital bed.
NHS data for England shows more than 1.5 million patients waited 12 hours or more in major emergency departments in 2023, meaning more than a million of those were waiting for a bed.
Please use Chrome browser for a more accessible video player
0:55
More than 250 patients a week in England may have died unnecessarily last year
The RCEM has calculated that, when looking solely at patients awaiting admission, an average of 268 excess deaths are likely to have occurred each week in 2023, which is “only 17 fewer than 2022 when applying the same method”.
The college added that patients delayed in the back of ambulances, “of which there are thousands”, are not included in the figures but are also at risk.
Image: File pic: iStock
Professor Pat Cullen, general secretary and chief executive of the Royal College of Nurses, said her members reported hospital corridors “packed with patients” and were living with the reality of the new study’s findings.
She added: “This crisis is taking lives and nursing staff in England’s hospitals are forced to witness it every shift.
“Care is not only undignified but fatally unsafe.
“One nurse told me a lady had died on a trolley in a corridor and it went unnoticed far too long – that is the current state of our health service.”
Dr Adrian Boyle, president of the RCEM, said: “The direct correlation between delays and mortality rates is clear. Patients are being subjected to avoidable harm.
“Urgent intervention is needed to put people first. Patients and staff should not bear the consequences of insufficient funding and under-resourcing.
“We cannot continue to face inequalities in care, avoidable delays and death.”
Asked about the figures by Sky News, business minister Kevin Hollinrake pointed to “huge demand-side pressures” – like admissions and attendances at A & E being up 8% year-on-year.
Please use Chrome browser for a more accessible video player
2:42
Satisfaction with NHS slumps
The minister said the “extra demand” was partially down to “demographics”, which makes “life difficult in providing health care and social care in our system”.
He also blamed strikes in the NHS for the situation in the health service.
Mr Hollinrake said 110,000 more doctors and nurses work in the NHS now when compared to 2010, and said the government has brought in a 13% real-terms increase in funding after inflation over the past five years.
Follow Sky News on WhatsApp
Keep up with all the latest news from the UK and around the world by following Sky News
NHS England said hospitals were responding to “significant increases in demand for A&E”, with attendance up by 8.6% in February, and emergency admissions up by 7.7%.
It added: “The latest published data shows our urgent and emergency care recovery plan – backed by extra funding with more beds, capacity and greater use of measures like same day emergency care – is delivering improvements, alongside continued work with our colleagues in community and social care to discharge patients when they are medically fit to go home, freeing up beds for other patients.
“The cause of excess deaths is down to several different factors and so it is right that the experts at the ONS – as the executive branch of the stats authority – continue to analyse these causes.”
The Department of Health and Social Care added: “We are committed to ensuring people get the emergency care they need, when they need it, and all patients attending A&E are assessed by a doctor or nurse before any treatment takes place, to ensure the most seriously unwell people are treated first.
“We are determined to continue improving experiences for patients and making access to care faster, simpler and fairer.
“We are making progress in reducing A&E waiting times, including adding an extra 5,000 permanent staffed beds this winter to increase capacity and help patients be seen as quickly as possible.”
More than 600 artefacts have been stolen from a building housing items belonging to a museum in Bristol.
The items were taken from Bristol Museum’s British Empire and Commonwealth collection on 25 September, Avon and Somerset Police said.
The force described the burglary as involving “high-value” artefacts, as they appealed for the public’s help in identifying people caught on CCTV.
It is not clear why the appeal is being issued more than two months after the burglary occurred.
The break-in took place between 1am and 2am on Thursday 25 September when a group of four unknown males gained entry to a building in the Cumberland Road area of the city.
Detectives say they hope the four people on CCTV will be able to aid them with their enquiries.
This breaking news story is being updated and more details will be published shortly.
Ramesh lives in fear every day. A police siren is enough to alarm him.
He’s one of up to 400,000 visa overstayers in the UK, one lawyer we spoke to believes.
It’s only an estimate because the Home Office has stopped collecting figures – which were unreliable in the first place.
Britain is being laughed at, one man told us, “because they know it’s a soft country”.
Image: ‘Ramesh’ came to the UK from India
We meet Ramesh (not his real name) at a Gurdwara, a Sikh place of worship, where he goes for food and support.
He insists he can’t return to India where he claims he was involved in political activism.
Ramesh says he came to the UK on a student visa in 2023, but it was cancelled when he failed to continue his studies after being involved in a serious accident.
He tells us he is doing cash-in-hand work for people who he knows through the community where he is living and is currently working on a house extension where he gets paid as little as £50 for nine hours labouring.
“It’s very difficult for me to live in the UK without my Indian or Pakistani community – also because there are a lot of Pakistani people who give me work in their houses for cleaning and for household things,” he adds.
‘What will become of people like us?’
Anike has lived in limbo for 12 years.
Now living in Greater Manchester, she came to the UK from Nigeria when her sister Esther was diagnosed with a brain tumour – she had a multi-entry visa but was supposed to leave after three months.
Esther had serious complications from brain surgery and says she is reliant on her sister for care.
Immigration officials are in touch with her because she has to digitally sign in every month.
Anike has had seven failed applications for leave to remain on compassionate grounds refused but is now desperate to have her status settled – afraid of the shifting public mood over migration.
“Everybody is thinking ‘what will become of people like us?'” she adds.
‘It’s a shambles’
The government can’t say with any degree of accuracy how many visa overstayers there are in Britain – no data has been collated for five-and-a-half years.
But piecing together multiple accounts from community leaders and lawyers the picture we’ve built is stark.
Immigration lawyer Harjap Singh Bhangal told us he believed there could be several hundred thousand visa overstayers currently in Britain.
He says: “At this time, there’s definitely in excess of about 200,000 people overstaying in the UK. It might even be closer to 300,000, it could even be 400,000.”
Asked what evidence he has for this he replies: “Every day I see at least one overstayer, any immigration lawyers like me see overstayers and that is the bulk of the work for immigration lawyers.
“The Home Office doesn’t have any accurate data because we don’t have exit controls. It’s a shambles. It’s an institution where every wall in the building is cracked.”
The number of those who are overstaying visas and working cash in hand is also virtually impossible to measure.
‘They know Britain is a soft country’
“They’re laughing at us because they know Britain is a soft country, where you won’t be picked up easily,” says the local man we’ve arranged to meet as part of our investigation.
We’re in Kingsbury in northwest London – an area which people say has been transformed over the past five years as post-Brexit visa opportunities opened up for people coming from South Asia.
‘Mini-Mumbai’
The man we’re talking to lives in the community and helps with events here. He doesn’t want to be identified but raises serious questions about visa abuse.
“Since the last five years, a huge amount of people have come in this country on this visiting visa, and they come with one thing in mind – to overstay and work in cash,” he says.
“This area is easy to live in because they know they can survive. It looks like as if you are walking through mini-Mumbai.”
Please use Chrome browser for a more accessible video player
2:43
‘The system is more than broken’
‘It’s taxpayers who are paying’
And he claims economic migrants are regularly arriving – who’ve paid strangers to pretend they’re a friend or relative in order to obtain a visitor visa to get to Britain.
He says: “I’ve come across so many people who have come this way into this country. It’s widespread. When I talk to these people, they literally tell me, ‘Oh, someone is coming tomorrow, day after tomorrow, someone is coming’.
“Because they’re hidden they may not be claiming benefits, but they can access emergency healthcare and their children can go to school.
“And who is paying for it? It’s the taxpayers who are paying for all this,” says the man we’ve met in north London.
A Home Office spokesperson said: “We will not tolerate any abuse of our immigration system and anyone found to be breaking the rules will be liable to have enforcement action taken against them.
“In the first year of this government, we have returned 35,000 people with no right to be here – a 13% rise compared to the previous year.
“Arrests and raids for illegal working have soared to their highest levels since records began, up 63% and 51%.”
Harjap Singh Bhangal described the situation as a “shambles”.
“The Home Office doesn’t have any accurate data because we don’t have exit controls. It’s a shambles. It’s an institution where every wall in the building is cracked,” he told Sky’s Lisa Holland.
Please use Chrome browser for a more accessible video player
5:05
The visa overstayers in ‘soft’ Britain
Why doesn’t the government know?
The Home Office used to gather data on visa overstayers by effectively checking a list of passport numbers associated with visas against a list of passport numbers of people leaving the UK, taken from airlines and other international travel providers.
If there was a passport number match in the arrivals and departures part of their database, that person was recorded to have left when they should have. If there wasn’t, they were a potential overstayer.
They stopped producing the figures because a combination of Brexit and COVID added complications that made the Home Office conclude they wouldn’t be able to get to a reliable number using the same method.
It’s now four and a half years since EU citizens had freedom of movement to the UK revoked, and more than three and a half years since pandemic-era travel restrictions ended.
And yet we are still waiting to see what a new method might look like.
The old method wasn’t perfect. If someone changed their passport while in the UK, for example, or if the airline or individual entered the number wrong when they were leaving, there wouldn’t be a match.
The Home Office regarded the statistics as likely overestimating the true number of overstayers, and the Office for National Statistics designated the figures as “experimental” rather than “official” statistics, meaning the conclusions should be treated with caution. But they were a reasonable best guess.
With all that in mind, between April 2016 and March 2020 upwards of 250,000 people were flagged as potential overstayers, equivalent to 63,000 per year.
That’s more than the 190,000 people who are recorded to have arrived in the UK on small boats since 2018.
It represents 3.5% of the seven million visas that expired over that period, so at least 96.5% of people left when they should.
Other Home Office data reveals that more than 13 million visas were issued between 2020 and the end of June 2025, including a record 3.4 million in 2023.
But what we don’t know is how many have expired, which means it’s difficult for us to even guess how many people might have overstayed.