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.
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.”
A night of heavy rainfall and thunderstorms has caused travel delays and damaged a care home in West Sussex.
Thunderstorms hit southeast England overnight – with a Met Office warning in place until 10am.
In southwest England and Wales a similar storm warning was in place until 8am Thursday morning.
However, the wet weather may be sandwiched between two of the hottest days of 2024 so far.
Overnight, two buildings in Sussex were damaged by lightning strikes, according to West Sussex Fire & Rescue.
A care home in Elmer, West Sussex, was struck, causing damage to its roof, and a university building in Chichester sustained damage to its roof and power system.
The service confirmed that no one was injured and occupants were relocated while the damage was assessed.
There were travel delays on South Western Railway trains after the stormy weather, causing delays between Axminster and Honiton expected to last until at least 11am on Thursday.
Advertisement
This has affected trains running into London Waterloo, from as far as Exeter St David’s.
The Met Office warned the storms overnight may trigger travel disruption leading into Thursday’s rush hour, causing “difficult driving conditions and some road closures”.
There is also a chance of possible cancellations to public transport, as well as power cuts.
Temperatures could reach 24C
Marco Petagna, a meteorologist at the Met Office, said that some places could see the warmest weather of the year on Thursday, with temperatures reaching as high as 24C.
This comes after Wednesday saw temperatures peak at their highest of the year so far as well, at 22.1C.
However, even as it becomes warmer, more thunderstorms could come on Thursday afternoon.
“After a night of storms, the rain will ease in the south of England for a while,” Mr Petagna said.
“We could see the skies brightening up in a few places and it will be another warm day.
“Parts of the southeast could even get to 24C and beat Wednesday’s temperatures.
“But as the skies brighten and temperatures increase, this could spark a few more thundery showers in the afternoon, so it is likely to still be a bit unsettled and the forecast will be changeable over the next few days.”
Follow Sky News on WhatsApp
Keep up with all the latest news from the UK and around the world by following Sky News
Looking ahead to the Bank Holiday weekend, Mr Petagna said the forecast was a “very mixed picture”.
Most of the UK is likely to experience some rain, but temperatures will remain fairly warm in the mid to late teens.
Wednesday was the warmest day of the year so far, with temperatures peaking at 22.1C in Santon Downham, in Suffolk, and reaching 21.9C in Aultbea, in the northwest Highlands.
However, other parts of the UK saw temperatures over 10C lower in some coastal areas – in Inverbervie, northeast Scotland, temperatures only peaked at 9.9C.
“When Finn was born, I turned to Ruth and said, just wait. He’ll cry, he’ll cry… But he never did,” says Martin, wiping tears from his eyes.
Warning: This article contains distressing content.
His wife, Ruth, had just given birth to their first son. But after a traumatic delivery, Finn was born pale and limp, needing urgent resuscitation.
Ruth was also injured, suffering a birthing tear so severe it required surgery.
As the room at the London-based birthing centre flooded with doctors ready to whisk their son away, Martin asked his wife: “What do you want me to do? Stay with you, or go with Finn?”
Follow Finn, she told him. As the plastic cot containing his newborn son was wheeled out of the room, a sense of helplessness swept over him. “There was nothing I could do for either of them,” he says, his voice breaking.
While we talk, both Ruth and Martin break down in tears, taking turns to comfort each other, but when I ask if they want to take a break, they refuse. They are clear that what matters now is sharing Finn’s story.
“He was our first,” says Ruth, adding that she had no idea what to expect from the birth in June 2021. “Everyone was still coming out of COVID times.”
Despite this, she said the pregnancy “was smooth sailing”.
“It was when we turned up for the actual birth that things went horribly wrong.”
Ruth gave birth to Finn at the Oasis Birth Centre, a midwife-led unit within the Princess Royal University Hospital in Orpington, Bromley. It is mainly used for women with uncomplicated pregnancies, with access to birthing pools, massages and aromatherapy.
If extra care is needed during labour, patients are transferred to a delivery suite which the hospital trust’s website says is “just seconds away”.
The website adds that it intends to give parents the “control and support” they need and a place where they can “feel at home”.
But that wasn’t Ruth’s experience.
From the moment she entered the building, she says: “I wasn’t being listened to.”
Despite her labour progressing quickly and feeling the “overwhelming” urge to push, Ruth says, the midwives largely left her and Martin alone in the birthing pool with no real guidance.
“I remember on a couple of occasions saying to Martin, ‘Why are they not with us? Why are they not telling us what to do?'” she adds.
During this period, midwives failed to identify that Finn was in foetal distress.
Tragically, he suffered a severe brain injury as a result of complications during labour. He was starved of oxygen, a condition called hypoxic-ischemic encephalopathy (HIE).
Ruth and Martin would later learn that midwives failed to check Finn’s heart rate in line with national guidelines. There should have been at least 24 readings, but only eight were recorded.
One of his biggest regrets, says Martin, is that during the birth he told Ruth: “They are the professionals. We need to trust them.”
The brain damage Finn experienced during birth was so severe, consultants eventually recommended turning off the support that was keeping him alive.
Instead of leaving hospital with their beautiful baby boy, Ruth and Martin, in a deep state of shock, left with a memory box containing mementoes including a lock of Finn’s hair.
“No one expects that,” she adds tearfully.
“Finn had a blessing done by a vicar,” Martin recalls. “Then later that day, we turned his ventilator off and held him while he died.”
Ruth and Martin are now also parents to their second son, Remy, who has brought joy back into their lives. They are taking care to ensure the 17-month-old knows all about his big brother.
“We have Finn’s pictures around the house. Martin handmade the cot for Finn. It’s got his name engraved in it, and Remy uses it now,” Ruth says. “And we had Finn’s handprint made into a stamp so we can include him in birthdays and Christmas cards.”
The inquest into Finn’s death concluded on 25 April, Ruth’s birthday.
Coroner Dr Julian Morris found there was a lack of clear leadership at the birthing centre, and a failure to follow established guidelines in place. He committed to writing to all birth centres across London to give recommendations.
“If other birthing centres operate like that three years later, the likelihood is that more children will die as a result of poor care, understaffing, and a lack of leadership and management,” says Martin.
King’s College Hospital NHS Foundation Trust apologised to the Kennedy family and said it “fully accepts” the coroner’s findings.
Tracey Carter, director of midwifery for King’s College, said: “In recent years, we have made positive changes to maternity services at the trust, including a review of midwifery staffing, enhanced training for midwives and ensuring more senior supervision in the department at all times.”
But Martin thinks the same guidance needs to be given to birthing centres across the country, to help avoid future tragedies.
Follow Sky News on WhatsApp
Keep up with all the latest news from the UK and around the world by following Sky News
The UK is increasingly vulnerable to the threat of missiles and drones after decades of cost-saving cuts eroded its once world-class air defences, military sources and Cold War veterans have warned.
Defence chiefs are understood to be exploring options to regrow Britain’s ability to protect critical national infrastructure – like power stations, military bases and government buildings – from the kind of Russian cruise and ballistic missile strikes that are devastating Ukraine.
But any credible “integrated air and missile defence” plan will cost billions of pounds and would likely require a further increase in defence spending beyond a proposed rise to 2.5% of national income recently announced by the prime minister, according to defence sources.
“Can the UK defend its cities from the skies if there was a barrage of missiles? No,” a senior defence source said, speaking on condition of anonymity.
“Do the public know what to do in the event of an air attack? No… Put simply, are we defended? No.”
As part of a series called Prepared For War? Sky News visited air defence sites that once played a key role in protecting Britain during the Cold War – and spoke to veterans who were part of the force that had been on alert to respond to any Soviet air threat.
Pressing the big red button
Flicking a line of switches to prime a simulated batch of missiles from inside a cabin at an old military-base-turned-museum in Norfolk, a former Royal Air Force technician watches a screen as a radar scans for enemy aircraft.
“It’s picked up a target,” says Robert Findlater, pointing at a dot on the monitor, which looks more like a retro computer game.
Advertisement
A beeping noise indicates the signal from the radar is becoming stronger as the hostile aircraft approaches.
Once in range, red letters on one of the screens that had read “hold fire” switch to the words “free to fire”, written in green.
Mr Findlater leans forward and presses a big red button.
Suddenly there is a roar as the simulated noise of a missile blasting off shakes the cabin.
The Bloodhound air defence missile, powered with a Rolls Royce engine, could reach 60 miles per hour in a tenth of a second before rocketing up to twice the speed of sound as it powered towards an enemy aircraft or missile – state-of-the-art technology in its day.
“We’ve been successful in our launch,” the RAF veteran says, with a smile.
He then peers back at the screen, watching a line of what looks like radio waves jumping up and down, until there is a spike to indicate the missile closing in on the target.
“It [the radar] is now looking for the missile, and there she is in the beam. Next thing you see – that’s the warhead.
“It’s gone off, and you killed it,” the veteran says, finishing the simulation.
Long retired, Mr Findlater joined the RAF in 1968.
He rose up through the ranks to become chief technician on a Bloodhound unit, charged with ensuring the missiles were ready and able at all times to fire at any threat.
Stepping outside the cabin, from where the system was operated, to a patch of grass, the veteran showed Sky News around the actual weapon – a lethal-looking collection of rockets and warheads, painted white and lying horizontal now, rather than pointing towards the sky.
Asked what message it had been designed to send to NATO’s former Warsaw Pact foes, Mr Findlater said with a chuckle: “Don’t come knocking… It says we’re ready for you.”
The ground-based systems, which had been dotted around the UK’s coastlines, used to be part of a layered grid of Cold War air defences that also included fighter jets and other weapons.
But the entire arsenal of Bloodhound air defence missiles was taken out of service after the Soviet Union collapsed in 1991, while air bases and fast jet squadrons were reduced to save money as successive prime ministers took what has been described as a “peace dividend”.
There had been talk at the time of investing in US-made Patriot air defence systems – an even more capable piece of kit that remains a core part of the air defences of the United States and a number of other NATO allies.
“But I think the government just gave up and shut everything down because there was no threat any more,” Mr Findlater said.
Asked whether he thought the UK was well defended now, he said: “I don’t feel we’re defended, no, not at all.”
As for how that made him feel, he said: “Sad… Considering what we had in the 1970s and 1980s.”
Frozen in time
Also at the RAF Air Defence Radar Museum is an old Cold War operations room – frozen in time, with giant boards along one wall, charting the number of fighter jets once ready to scramble.
There are also rows of desks, fitted with radar screens and important-looking buttons.
John Baker, 69, once worked in this hub as an aircraft identification and recognition officer.
Asked if the UK’s air defences had been prepared for war back when he served, he said: “We practised. There were exercises for war.
“Every couple of months or so there would be a small exercise and once or twice a year there would be a major NATO exercise in which this – because this radar site was closest to Europe – would be the epicentre.”
While cautioning that he was no longer up-to-date on the military’s air defence capabilities, he sounded less certain about whether they could handle a major attack today.
Spreaker
This content is provided by Spreaker, which may be using cookies and other technologies.
To show you this content, we need your permission to use cookies.
You can use the buttons below to amend your preferences to enable Spreaker cookies or to allow those cookies just once.
You can change your settings at any time via the Privacy Options.
Unfortunately we have been unable to verify if you have consented to Spreaker cookies.
To view this content you can use the button below to allow Spreaker cookies for this session only.
“If hundreds and hundreds of drones and cruise missiles were to come in. I don’t think we could safely take out all of them,” Mr Baker said.
He added: “I’m glad I did my time back then – and not now.”
Air defences ‘woefully inadequate’
The UK does have highly capable air defence equipment – just no longer enough of it to be able to protect the vast array of critical infrastructure across the country and also to defend troops deployed on operations overseas.
Follow Sky News on WhatsApp
Keep up with all the latest news from the UK and around the world by following Sky News
Making the situation more grave is a growth in the quality and quantity of missiles and drones that hostile states such as Russia, China, Iran and North Korea have developed.
At present, the RAF has just nine frontline fast jet squadrons – including the quick reaction alert aircraft that are at the sharp end of defending against any air threat.
While modern jets – F-35 and Typhoon – are far more sophisticated than their predecessors, the UK had 30 frontline squadrons towards the end of the Cold War.
The Royal Navy’s six Type 45 destroyers are kitted with the country’s only ballistic missile defence systems.
But only three of these ships are “available for operations”, according to a navy spokesperson, including one that is deployed on operations in the Middle East.
On land, the military has around six Sky Sabre ground-based air defence systems – each one able to shoot down multiple missiles.
But at least two of these weapons – almost certainly more – are deployed overseas, and those in the UK only have a very limited range.
Jack Watling, a senior research fellow at the Royal United Services Institute, called the UK’s current array of air defences “woefully inadequate”.
Britain does benefit from its geography, with a lot of European NATO countries between its shores and Russia.
However, the air defences of many European nations have also been reduced to save money since the Soviet Union collapsed.
“We always hear this argument from the Ministry of Defence that gaps in our own capability are acceptable because we’re part of an alliance,” Mr Watling said.
“It’s a little bit like if you were going round to a ‘bring your own booze’ party and you said: ‘Well, there’s other people coming, so I’m not going to bring any alcohol’.
“If everyone adopts that approach, then there is simply nothing to drink. And when we look across NATO, there is an overall shortage [in air defences].”
A Ministry of Defence spokesperson said: “The UK is well prepared for any event and defence of the UK would be taken alongside our NATO allies.
“As part of our commitment to invest an extra £75bn for defence over the next six years, we continue to review potential opportunities to develop our capabilities and modernise air defence across Europe in close discussion with allies and partners.”