As many as 500 people are dying every week in England because of the crisis in NHS emergency departments, according to analysis. A&E performance has plummeted to its worst ever level over recent months with patients waiting up to 40 hours for a bed, while the sick are facing near-record waits for ambulances.
So far in 2022, there have been over 11,000 ‘excess deaths’ — the number of fatalities above the five-year average, which is a marker of how many are expected.
Excess deaths had been high for most of the pandemic because so many people were dying from Covid.
But the trend shifted towards the end of 2021 when vaccines stifled the virus death rate. While Covid deaths have remained low, since June there have been around 1,000 more people dying every week in England and Wales than usual from unexplained causes.
It prompted some scientists to theorise it was down to the knock-on effects of lockdown restrictions and delays to hospital care worsening conditions like cancer, diabetes and heart disease.
The Department of Health has ordered an ‘urgent review’ into the cause of these deaths.
But now an analysis by the Financial Times suggests the crisis in A&E across the country is also partly to blame — using models of the increased risk of death among those facing long casualty waits to the number of patients queuing six-plus hours.
As many as 500 people are dying every week in England because of the crisis in NHS emergency departments, according to an analysis that lays bare the devastating toll of the summer crisis. The graph shows the numbers of excess deaths linked to long A&E waits
Office for National Statistics data shows weekly deaths in England and Wales, highlighting those not involving Covid (green) and fatalities due to Covid (blue). The black dotted line shows the five-year average — the expected number of deaths each week based. Excess deaths had been high for most of the pandemic because so many people were dying from Covid. But the trend shifted towards the end of 2021 when vaccines stifled the virus death rate. While Covid deaths have remained low, since June there have been around 1,000 more people dying every week in England and Wales than usual from unexplained causes
HOW BAD IS THE NHS CRISIS IN ENGLAND?
The overall waiting list jumped to 6.73million in June. This is up from 6.61m in May and is the highest number since records began in August 2007.
There were 3,861 people waiting more than two years to start treatment at the end of June, down from 8,028 in May but still higher than April 2021, when the figure started to be recorded.
The number of people waiting more than a year to start hospital treatment was 355,774, up from 331,623 the previous month and the highest ever logged.
A record 29,317 people had to wait more than 12 hours in A&E departments in England in July. The figure is up from 22,034 in June and is the highest for any month since record began in 2010.
A total of 136,221 people waited at least four hours from the decision to admit to admission in July, down slightly from the all-time high of 136,298 in March.
Just 71 per cent of patients were seen within four hours at A&Es last month, the worst ever performance. NHS standards set out that 95 per cent should be admitted, transferred or discharged within the four-hour window.
The average category one response time – calls from people with life-threatening illnesses or injuries – was nine minutes and 35 seconds. The target time is seven minutes.
Ambulances took an average of 59 minutes and seven seconds to respond to category two calls, such as burns, epilepsy and strokes. This is three times longer than the 18 minute target.
Response times for category three calls – such as late stages of labour, non-severe burns and diabetes – averaged three hours, 17 minutes and six seconds. Ambulances are supposed to arrive to these calls within two hours.
Some 430,037 patients (27.5 per cent) were waiting more than six weeks for a key diagnostic test in June, including an MRI scan, non-obstetric ultrasound or gastroscopy.
Official statistics show nearly 1,000 patients a day waited more than 12 hours in emergency departments in June.
But this figure only counts ‘trolley waits’ — the time between medics deciding a patient needs to be admitted and when they actually are given a bed.
Separate data, which measures the number of 12-hour waits between when a patient arrives at A&E until they are admitted, discharged or transferred, shows the true figure is 3,000.
The FT analysis used the later figures and applied an existing mathematical model developed by medics from the Royal Bolton Hospital and the University of Exeter.
It estimates the number of excess deaths that will occur among patients forced to wait too long for treatment.
Based on death rate among 5.2million people who attended NHS A&E units between April 2016 and March 2018, the researchers found those who waited more than six to eight hours were eight per cent more likely to die within the following month.
And the increased risk of death jumped to 16 per cent among those forced to queue for eight to 12 hours.
Experts say long waits delay access to pain relief, antibiotics and other vital treatments, resulting in worse outcomes and longer stays. And overcrowding means patients may be treated in suboptimal parts of the hospital where it is hard for medics to check on them regularly.
When applied to recent NHS A&E waits, which show 102,000 people waited 12 hours or more in June and 441,000 waited four to 12 hours, John Burn-Murdoch’s analysis suggests more than 2,000 excess deaths would occur.
The results showed that 500 non-Covid excess deaths in England would take place per week — which matches the number of excess deaths logged in the country, after accounting for factors such as the ageing population.
Professor Sir David Spiegelhalter, an eminent statistician from Cambridge University, told MailOnline the analysis ‘seems a fine example of forensic statistics’.
He said: ‘The excess non-Covid deaths are spread over a range of causes requiring emergency care, and so I agree that they are primarily due to the huge problems in healthcare at the moment, demonstrated by ambulance delays and long waits in A&E.
‘This is not due to lockdown or any specific measures, but reflects general issues in the NHS, although exacerbated by the pandemic.’
Professor Kevin McConway, a statistician from the Open University, told MailOnline: ‘Deaths in England have been running considerably above what we’d expect to see at this time of year for many weeks now, and this is the best analysis I’ve seen of why that might be happening.’
However, he noted that the hot weather this summer had ‘more effects on deaths than the analysis makes out’.
The analysis pins the crisis ‘firmly on lack of available hospital beds to take people who require them’, rather than showing more people are going to A&E or that those attending are more unwell than usual, he said.
Latest NHS England data for July shows that more than 29,000 sickened people waited 12 hours at A&E units last month (yellow lines) — four times more than the NHS target and up by a third on June, which was the previous record. Meanwhile, the proportion of patients seen within four hours — the timeframe 95 per cent of people are supposed to be seen within — dropped to 71 per cent last month (red line), the lowest rate logged since records began in 2010
Up to 12% more Brits than usual died every DAY during last month’s heatwave, official data shows
Daily deaths from all causes spiked during the heatwave in England and Wales last month, analysis shows for the first time.
On average, 1,149 people in England and 74 people in Wales died per day in July, the Office for National Statistics found.
But this rose to 1,224 and 83 average deaths per day, respectively, on the days when temperatures soared.
This represented a 6.5 per cent and 12.3 per cent increase in daily deaths for Wales and England compared to non-heatwave days.
The ONS said ‘further investigation is required to understand’ the trends and investigate the deaths further.
But heatwaves are known to increase the risk of death for people with circulatory conditions or problems with their lungs or heart as their body struggles to keep cool.
Elderly people in general are also considered to be at higher risk, in part due to their age but also because they tend to live alone and may not drink enough.
Dangerously hot days were recorded between July 10 to 25 and again on July 30 to 31.
This included the temperature hitting a record 40.3C (104.5F) at Coningsby in Lincolnshire on July 19.
‘So ill people, sometimes very ill, have to spend far too long waiting in A&E, or in an ambulance outside A&E, or worse still at home waiting for the ambulance, because people can’t be moved on to a hospital bed when they need one,’ Professor McConway said.
‘Currently one in seven hospital beds in English hospitals is occupied by someone who doesn’t need it any longer, but has not been discharged,’ he said.
While a ‘considerable’ proportion of those patients are waiting for social care facilities, others are stuck in hospital because NHS staff haven’t had time to deal with the necessary processes to discharge the patient due to outdated IT and ‘chronic under-investment’, Professor McConway said.
‘Doubtless there are some inefficiencies there that could be addressed, but not when we’re in the middle of a crisis,’ he said.
Data shows that many countries are still logging excess deaths.
This is despite Covid waves subsiding and the virus killing fewer people due to vaccine rollouts, built-up immunity from previous infections and the milder Omicron strain being dominant.
However, most of this excess can be explained by ageing populations, with more natural deaths among the elderly now than there was five years ago.
Once ageing population demographics are accounted for, England, Wales, Spain and Portugal, are still logging more fatalities than expected.
Prolonged heatwaves across Europe this summer was a major factor in the fatality counts in Spain and Portugal, which saw prolonged periods above 40C.
But England and Wales were still logging high and rising levels of excess deaths from June — despite the heatwave not hitting until July and August, when they lasted a few days.
The FT analysis used figures published by the Office for Health Improvement and Disparities (OHID), which shows most excess deaths are due to liver disease, diabetes and circulatory diseases, such as heart attacks and strokes.
This wide-range of causes of death suggest the data ‘might be explained by the sudden collapse of emergency care’.
The NHS says the current crisis is being driven by so-called bed blockers but hospitals are also grappling with record backlogs, staff shortages, excess admissions due to the heatwave and the residual effects of a recent spike in Covid.
Experts have also warned that hospitals face an influx of patients later in the year when the cost of living crisis bites. A triple threat of Covid, flu and the cost of living crisis is expected to put record demand on the health service.
