1.7 million waited for more than 12 hours for A&E care last year – review
More than 1.7 million patients waited for more than more than half a day for emergency care, despite concerns that long A&E waits are linked to an increased risk of death, according to a new report.
The National Audit Office (NAO) has estimated that during 2025, 1.2 million patients in England waited between 12 and 24 hours from their arrival in A&E to be discharged, transferred or admitted.
And 500,000 more patients waited for more than 24 hours, it estimated.
The NAO estimated that in 2024/25 and 2025/26 some 3% of people who went to A&E waited for over 24 hours to be discharged, transferred or admitted – despite NHSE documents stating that there should be a zero tolerance for waits of over a day, describing this as a “red-line safety standard”.
It pointed out that people who face long waits of 12 or more hours are “twice as likely to die within 30 days of leaving A&E, compared with those who only wait two hours”.
And that “long waits in A&E are associated with increased mortality, but the percentage of people waiting for more than 12 hours in A&E has increased”.
A new NAO report says patients are still waiting for “too long” in A&E as it highlighted that the NHS has only made “modest gains” in improving emergency care, despite “significant investment”.
It highlights how A&Es have become “markedly more crowded” over the last 14 years.
The new NAO report concludes that the NHS is “beginning to improvements in A&Es” post-pandemic, but that improvements have been “smaller and slower than hoped”.
“Patients are still waiting too long for the emergency care that they need,” the authors wrote.
“NHSE (NHS England) has made significant investment into A&E, but so far this has only resulted in modest gains, with the result that spending has grown without achieving equivalent improvements for A&E patients.”
It warned that the NHS will not meet the overall A&E performance standards without very substantial improvement in many Type 1 A&Es – which deal with the most complex and urgent cases.
This includes a target that 95% of patients will be discharged, transferred or admitted within four hours of arrival in A&E – a target set in 2011/10 but that has not been met since 2013/14.
In 2025/26 the NHS met the four-hour target for 74.9% of people who attended A&E, the NAO said.
It said that success in improving attendances in A&E depends on efforts to provide care in “alternate settings” and managing “patient flow” throughout the whole hospital system.
The NAO made a series of recommendations on improving patient flow though hospitals.
Gareth Davies, head of the NAO, said: “Despite significant efforts to improve A&E performance, patients continue to experience long waits and delays in care.
“NHS England and DHSC need to understand more fully why improvements have been slow and ensure successful approaches are adopted more consistently across the system.
“A stronger focus on patient flow, timely discharge and patient experience will be vital to improving outcomes for patients.”
Sir Geoffrey Clifton-Brown, chairman of the Public Accounts Committee of MPs, said: “It is deeply concerning that that so many patients are still waiting far too long for emergency care, despite the NHS committing significant resources to address the problem.
“Today’s NAO report makes clear that the causes of poor performance extend far beyond the doors of A&E, with overcrowded hospitals and a lack of available beds preventing patients from receiving timely treatment and necessitating the undesirable outcome of ‘corridor care’.
“While there are encouraging examples of improvement, this simply has not been enough to make a meaningful change.
“NHS England and the Department for Health and Social Care must now focus relentlessly on tackling the root causes of poor patient flow across the whole system and ensure patients receive the care they need, when they need it.”
Professor Nicola Ranger, chief executive and general secretary of the Royal College of Nursing, said: “The real human cost of long waits and overcrowding is patients languishing in corridors, going into cardiac arrest, receiving intimate care, or being given end-of-life news in full view of others.
“Overcrowding and corridor care are symptoms of the failure to get to grips with care in alternate settings, including in social care and the community.”
Dr Ian Higginson, president of the Royal College of Emergency Medicine, said: “The system is in a state of permacrisis.
“Our hospitals do not work efficiently seven days a week, and services aren’t open when they are needed.
“Delayed discharges – where patients who have no medical need to stay in hospital cannot be discharged, largely due to the unavailability of follow-on services – result in a log-jam affect that causes overcrowding in emergency departments and puts lives at risk.”
A Department of Health and Social Care spokesperson said: “After years of rising demand and underinvestment, this report shows we inherited an NHS under huge pressure particularly in emergency care.
“But while there are encouraging signs of progress, including the best ambulance and A&E performance in four years last winter, we know too many patients are still waiting too long for urgent care.
“As the NHS increasingly faces increasing summer heat pressures as well as winter pressures, we are taking action to improve patient flow through hospitals, tackle corridor care and cut delays, including deploying expert teams into the most challenged trusts, publishing corridor care data for the first time and investing £450 million to improve urgent and emergency care.
“Alongside this, we are expanding urgent care centres and mental health A&Es, shifting more care into the community and working with social care partners to help people leave hospital safely and on time, supporting a more resilient NHS for the future.”
An NHS spokesperson said: “The National Audit Office report recognises that A&E waiting times are improving despite staff seeing more patients than at any point in NHS history, alongside challenges with discharging patients to the most appropriate setting.
“The number of patients seen, treated or discharged from A&E within four hours hit a seven-year high last year, patient satisfaction with NHS services including A&E is rising and we are delivering more service in the community with a record number of GP appointments delivered – but we know there is more to be done, which is why we are sharing successes across the health service so the most challenged A&Es can match the best-performing departments.”
Published: by Radio NewsHub