Report quantifies excess deaths due to Emergency Department ‘crowding’

[A REPORT by the Royal College of Emergency Medicine has found that at least 4,519 patients have died as a result of crowding and 12-hour stays in Emergency Departments in England in the year 2020-2021.

The new report, Crowding and its Consequences, investigates the extent of harm that crowding causes and applies NHS England’s own findings from the Getting It Right First Time (GIRFT) programme, which found that one in 67 patients staying in the Emergency Department for 12 hours come to excess harm.

Dr Adrian Boyle, vice president of the Royal College of Emergency Medicine, said: “To say this figure is shocking is an understatement. Quite simply, crowding kills. For many years we have issued warnings about the harm that dangerous crowding causes, but now we can see the number of excess deaths that have occurred as a result. This will not surprise any member or fellow of the Royal College.

“October 2021 saw an unimaginable 7,059 12-hour stays from decision to admit, the highest number ever recorded and 40% higher than September 2021, which was the previous highest on record. The number of 12-hour stays has risen drastically for six months and is very likely to rise again in coming months. We now know that at least one in 67 of these patients are coming to avoidable harm. It is appalling.”

Commenting on the report, the BMA’s emergency medicine lead Dr Denise Langhor said: “These devastating figures in the report are not the fault of emergency departments or their staff, who are regularly going above and beyond to provide the best possible care for their patients. They are a result of a severe lack of capacity across health and social care coupled with a lack of doctors and other vital staff. The doctors we do have are exhausted and are being left with little option but to reduce their hours or take early retirement because of punitive pensions taxation rules. We can’t go on like this.

“We call on the government to put together a workable plan to tackle these problems starting urgently with how we are to retain our workforce. We have an immediate problem because we just don’t have the required 13 years to wait for new consultants to be trained, so the focus must be on keeping highly-skilled and experienced consultants in their jobs so that as many patients as possible can access the care they need.

“The situation is unacceptable, unsustainable and unsafe for patients and staff. Political and health leaders must realise that if performance continues to fall this winter, more and more patients will come to avoidable harm in the Emergency Department. Staff will face moral injury and the urgent and emergency care system will be deep into the worst crisis it has faced. We continue to urge the Secretary of State to meet with us to discuss patient safety and the unprecedented pressures facing the urgent and emergency care system.” q