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.”
The combination of full prisons and tight public finances has forced the government to urgently rethink its approach.
Top of the agenda for an overhaul are short sentences, which look set to give way to more community rehabilitation.
The cost argument is clear – prison is expensive. It’s around £60,000 per person per year compared to community sentences at roughly £4,500 a year.
But it’s not just saving money that is driving the change.
Research shows short custodial terms, especially for first-time offenders, can do more harm than good, compounding criminal behaviour rather than acting as a deterrent.
Image: Charlie describes herself as a former ‘junkie shoplifter’
This is certainly the case for Charlie, who describes herself as a former “junkie, shoplifter from Leeds” and spoke to Sky News at Preston probation centre.
She was first sent down as a teenager and has been in and out of prison ever since. She says her experience behind bars exacerbated her drug use.
More on Prisons
Related Topics:
Image: Charlie in February 2023
“In prison, I would never get clean. It’s easy, to be honest, I used to take them in myself,” she says. “I was just in a cycle of getting released, homeless, and going straight back into trap houses, drug houses, and that cycle needs to be broken.”
Eventually, she turned her life around after a court offered her drug treatment at a rehab facility.
She says that after decades of addiction and criminality, one judge’s decision was the turning point.
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.
“That was the moment that changed my life and I just want more judges to give more people that chance.”
Please use Chrome browser for a more accessible video player
0:22
How to watch Sophy Ridge’s special programme live from Preston Prison
Also at Preston probation centre, but on the other side of the process, is probation officer Bex, who is also sceptical about short sentences.
“They disrupt people’s lives,” she says. “So, people might lose housing because they’ve gone to prison… they come out homeless and may return to drug use and reoffending.”
Image: Bex works with offenders to turn their lives around
Bex has seen first-hand the value of alternative routes out of crime.
“A lot of the people we work with have had really disjointed lives. It takes a long time for them to trust someone, and there’s some really brilliant work that goes on every single day here that changes lives.”
It’s people like Bex and Charlie, and places like Preston probation centre, that are at the heart of the government’s change in direction.
“As far as I’m concerned, there’s only three ways to spend the taxpayers’ hard-earned when it comes to prisons. More walls, more bars and more guards.”
Prison reform is one of the hardest sells in government.
Hospitals, schools, defence – these are all things you would put on an election leaflet.
Even the less glamorous end of the spectrum – potholes and bin collections – are vote winners.
But prisons? Let’s face it, the governor’s quote from the Shawshank Redemption reflects public polling pretty accurately.
It’s a phrase that is frequently used so carelessly that it’s been diluted into cliche. But in this instance, it is absolutely correct.
More on Crime
Related Topics:
Without some kind of intervention, the prison system is at breaking point.
It will break.
Inside Preston Prison
Ahead of the government’s Sentencing Review, expected to recommend more non-custodial sentences, I’ve been talking to staff and inmates at Preston Prison, a Category B men’s prison originally built in 1790.
Overcrowding is at 156% here, according to the Howard League.
Image: Sophy Ridge talking outside Preston Prison
One prisoner I interviewed, in for burglary, was, until a few hours before, sharing his cell with his son.
It was his son’s first time in jail – but not his. He had been out of prison since he was a teenager. More than 30 years – in and out of prison.
His family didn’t like it, he said, and now he has, in his own words, dragged his son into it.
Sophie is a prison officer and one of those people who would be utterly brilliant doing absolutely anything, and is exactly the kind of person we should all want working in prisons.
She said the worst thing about the job is seeing young men, at 18, 19, in jail for the first time. Shellshocked. Mental health all over the place. Scared.
And then seeing them again a couple of years later.
And then again.
The same faces. The officers get to know them after a while, which in a way is nice but also terrible.
Image: Sophy Ridge talking to one of the officers who works within Preston Prison
The £18bn spectre of reoffending
We know the stats about reoffending, but it floored me how the system is failing. It’s the same people. Again and again.
The Sentencing Review, which we’re just days away from, will almost certainly recommend fewer people go to prison, introducing more non-custodial or community sentencing and scrapping short sentences that don’t rehabilitate but instead just start people off on the reoffending merry-go-round, like some kind of sick ride.
But they’ll do it on the grounds of cost (reoffending costs £18bn a year, a prison place costs £60,000 a year, community sentences around £4,500 per person).
They’ll do it because prisons are full (one of Keir Starmer’s first acts was being forced to let prisoners out early because there was no space).
If the government wants to be brave, however, it should do it on the grounds of reform, because prison is not working and because there must be a better way.
Image: Inside Preston Prison, Sky News saw first-hand a system truly at breaking point
A cold, hard look
I’ve visited prisons before, as part of my job, but this was different.
Before it felt like a PR exercise, I was taken to one room in a pristine modern prison where prisoners were learning rehabilitation skills.
This time, I felt like I really got under the skin of Preston Prison.
It’s important to say that this is a good prison, run by a thoughtful governor with staff that truly care.
But it’s still bloody hard.
“You have to be able to switch off,” one officer told me, “Because the things you see….”
Staff are stretched and many are inexperienced because of high turnover.
After a while, I understood something that had been nagging me. Why have I been given this access? Why are people being so open with me? This isn’t what usually happens with prisons and journalists.
Please use Chrome browser for a more accessible video player
1:10
Probation centres answer to UK crime?
That’s when I understood.
They want people to know. They want people to know that yes, they do an incredible job and prisons aren’t perfect, but they’re not as bad as you think.
But that’s despite the government, not because of it.
Sometimes the worst thing you can do on limited resources is to work so hard you push yourself to the brink, so the system itself doesn’t break, because then people think ‘well maybe we can continue like this after all… maybe it’s okay’.
But things aren’t okay. When people say the system is at breaking point – this time it isn’t a cliche.
Sky News weather presenter Jo Wheeler said: “Some areas may miss the showers, but where they occur, there’s likely to be hail, thunder, lightning, gusty winds and a temporary temperature drop.”
Almost 50mm of rain could fall in some places in just a couple of hours, she added.
While a dry spring means rain is needed in many areas, “the heavy nature of these showers [means] there is the potential for minor localised issues and flooding,” Met Office meteorologist Jonathan Vautrey said.
The Met Office said the rain could lead to difficult driving conditions and some road closures.
There is also a chance of power cuts and flooding, it added. People who live in areas at risk of flash flooding should consider preparing a flood plan and emergency kit, the Met Office warned.
The high pressure will rebuild from Tuesday, and dry conditions and sunshine will return across the country, Mr Vautrey added.