Overcrowding and corridor care in A&E ‘killing around 550 patients in the UK every week’, study reveals
Overcrowding and corridor care in A&E is killing around 550 patients in the UK every week, a damning study suggests.
The scale of the problem is an ‘absolute scandal’ with the fatalities the equivalent of a ‘fatal jumbo jet crash every single week’, doctors said.
The review of more than 19,000 patients in NHS hospitals found the chance of dying in the following 28 days rose by 1 per cent for every 10 per cent increase in emergency department occupancy.
Alarmingly, the 134 A&Es involved in the study had an average occupancy rate of 175 per cent, meaning they contained almost twice as many patients as they were designed to hold.
The Royal College of Nursing has previously warned that a shortage of A&E beds means patients are often left languishing on trolleys in corridors without proper access to oxygen and other emergency equipment, while staff become more stretched and can easily miss critical signs of deterioration.
Dr Ryan McHenry, an emergency medicine doctor in the west of Scotland and researcher at the University of Glasgow, analysed data from around 70 per cent of the A&Es in England, Wales and Northern Ireland over a two-week period.
The 134 A&Es involved in the study had an average occupancy rate of 175 per cent, meaning they contained almost twice as many patients as they were designed to hold
He said: ‘We found that increased crowding in emergency departments is associated with increased mortality for patients admitted to hospital.
‘This is important because we know that emergency departments are now often very crowded, and reducing that crowding has the real potential to save lives.’
He estimated around 550 deaths every week may be caused by this overcrowding but said the relatively small size of his study – presented at the European Emergency Medicine Congress in France – meant the range could be anywhere from 33 to 1,083 excess deaths.
For the research, occupancy was calculated by how many spaces, such as cubicles, the A&E department had compared with how many patients were being treated.
Dr McHenry and his colleagues also looked at the impact of ‘corridor care’ where patients receive treatment in non-standard clinical spaces such as corridors.
This was also linked to an increase in the risk of deaths at a similar rate as overcrowding, although the team said occupancy rate was much easier to measure and record.
Official NHS figures show an average of more than 3,000 patients were treated in corridors or other makeshift areas every day in England in July alone.
Dr Felix Lorang, a member of the conference’s abstract selection committee, said: ‘Many emergency departments are operating far beyond capacity, and the “exit block” – when patients are stuck in the emergency department because no inpatient ward beds are available – places an even greater burden on these emergency departments.
Dr Ryan McHenry (pictured) analysed data from around 70 per cent of the A&Es in England, Wales and Northern Ireland over a two-week period
‘This makes it harder for doctors and nurses to deliver the treatment patients need, or even the minimum treatment required to prevent further harm.
‘This research makes it unmistakably clear to all of us – patients, medical professionals, and hospital managers alike – that overcrowding and corridor care mean many emergency patients will not survive.’
Dr Ian Higginson, president of the Royal College of Emergency Medicine (RCEM), said: ‘People are dying in association with overcrowding in emergency departments.
‘This should be cause for alarm among policymakers, and yet we are not seeing any urgency.’
He said the findings ‘add yet more evidence about this utterly normalised and unacceptable state of affairs’.
Dr Higginson added: ‘RCEM continues to call for the governments of the four UK nations to act to address the catastrophic effect overcrowding and long waits in our emergency departments have on our patients – who are suffering harm and will continue to do so because of a failure to act.
‘They must also recognise the impact that working in such conditions has on staff, who we risk losing in droves should the problem persist.’
Dr Den Langhor, from the British Medical Association’s consultants committee, described the deaths caused by overcrowding as an ‘absolute scandal’.
She added: ‘That is the equivalent of a fatal jumbo jet crash every single week in the UK.
‘Doctors in emergency departments are doing all they can to provide patients with the care they need, but the system is stacked against them.’
A Department of Health and Social Care spokesman said: ‘The NHS faced the busiest summer in its history this year, but thanks to the incredible work of NHS staff, 75 per cent of people in A&E were seen in four hours in August.
‘Overcrowding can have a serious impact on patients’ experience and safety, which is why we are taking urgent action to reduce pressure on emergency departments and end corridor care.’
