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More than 16,600 excess deaths in England last year were linked to accident and emergency (A&E) department waits of 12 hours or more, according to an analysis by the Royal College of Emergency Medicine (RCEM).

This equates to around 320 additional deaths each week and marks a 20% increase from 2023 figures.

“To give it some context, it is the equivalent of two aeroplanes crashing every week,” said RCEM President Adrian Boyle, MD.

The findings were presented at Westminster on Thursday during the launch of an all-party parliamentary group (APPG) on emergency care, supported by the RCEM.

1 Death for Every 72 Patients Waiting

The figures are based on the standardised mortality ratio, which compares actual deaths in a particular cohort with those expected in a reference, age-standardised population.

According to the RCEM, one additional death occurs for every 72 patients waiting between 8 and 12 hours in the A&E department before admission.

In total, 16,644 excess deaths in 2024 were estimated to be linked to department waits of 12 hours or longer.

Boyle warned that the analysis captures only portion of the problem because the methodology applied only to patients waiting in the A&E department. Other patients likely to be affected include those left waiting in the community due to ambulance handover delays or those too anxious to seek help because of widespread access issues.

“The issue also affects A&E staff who are trying their best to deliver care in areas that are designed to be thoroughfares, not treatment spaces,” Boyle said.

Calls for Urgent System Reform

Nick Murch, MBBCh, president of the Society for Acute Medicine (SAM), described the findings as “shocking.”

He said the scale of 12-hour department waits reflects a systemic failure and highlighted a 2024 paper published in Acute Medicine, co-authored by SAM President Elect Vicky Price, MBChB. It warned that so-called “corridor care” in emergency departments “is being normalised in many hospitals across the United Kingdom.” The situation caused both harm to patients and “morale injury” to staff.

Murch told Medscape News UK: “As we have said continuously about the dire state of monthly 12-hour waiting figures, it signifies a profound failure within our healthcare system.” Fixing the issue would require urgent action on workforce and capacity challenges, he added.

Need to Resuscitate Emergency Care

Boyle said that emergency care is solvable if flow through the system is improved. It required “getting patients into a ward bed when they need one and home again as soon as they are well enough to leave.”

The new APPG on emergency care will explore how to improve flow and reduce waits.

In 2024, over 1.7 million patients waited more than 12 hours in the A&E department to be admitted, discharged, or transferred. That’s a 14% rise on the previous year. Of those, 69.2% were waiting to be admitted.

Almost half a million patients (478,901) waited more than 24 hours — 1 in every 35 attendances and over 100,410 more than the comparable figure for 2023.

The Office for National Statistics reported earlier this year that patients who stay in the A&E department for 12 hours or more are twice as likely to die within 30 days as those treated, admitted, or discharged within 2 hours.

NHS Response

NHS England figures showed A&E department attendances in 2024 reached a record high of 27.42 million, up 7.1% on the 25.61 million the previous year.

Julian Redhead, MBBS, national clinical director for Urgent and Emergency Care, NHS England, told Medscape News UK that the RCEM data highlighted the “unacceptable long waits” that too many patients face in the A&E department.

“Action to stop this happening will be at the heart of the upcoming 10 Year Health Plan,” he said.

He added that the NHS is reducing the number of national targets, “giving space to local clinical leaders to improve patients’ care.”

Sheena Meredith, MBBS, MPhil, is an established medical writer, editor, and consultant in healthcare communications, with extensive experience writing for medical professionals and the general public. She is qualified in medicine and in law and medical ethics.