The ‘dire’ state of A&Es was today exposed in fascinating detail with data showing England fares the worst in the UK.
That’s despite patients in Labour-run Wales having typically faced the longest delays over the past decade.
More than 40 per cent of patients attending casualty in England wait at least four hours to be seen — the equivalent of around 900,000 every month.
It marks a five-fold rise in the space of a decade, illustrating the extent of the crisis which has seen patients forced to sleep on the floor or sat on trolleys in hospital corridors as they wait for a bed.
Experts fear the situation is only going to get worse, with the ailing NHS stuck in an ‘eternal winter’ amid staffing shortages and unprecedented demand.
The same Office for National Statistics (ONS) analysis also suggested England’s A&E units are the quietest.
In September 2023, it recorded 13.6 attendances for every 1,000 people — half the figure logged in Northern Ireland (29). Scotland and Wales, meanwhile, both reported 20.8.
Attendance rates plunged in the pandemic as patients were put off going to A&E in case they caught Covid.
Wales, Scotland and Northern Ireland have seen rates catch-up to pre-Covid levels, yet England’s are still lagging far behind.
Experts speculated that the diabolical waits seen in A&E may have put thousands of patients off seeking care.
Dennis Reed, of Silver Voices, which campaigns for elderly Brits, told MailOnline: ‘These statistics show that relatively fewer patients attend A&E in England than other UK nations, but the waits are longer.
‘NHS England should explain the reasons for this.
‘It could be that with hundreds of thousands waiting more than 12 hours, people are being put off attending hospital at all and attempt to self-treat, or that they go through the door of the emergency department, see the length of the waits on the monitors and turn on their heels immediately.’
He added: ‘At all levels of the NHS it is becoming more difficult to access the required level of care and we are becoming a sicker nation as a result.’
Dr Tim Cooksley, immediate past president of the Society for Acute Medicine, said: ‘Each winter in the past decade, particularly within urgent and emergency care, has become slightly worse.
‘That trend has resulted in a dire situation which has not yet been halted, let alone show any signs of being reversed.
‘At the heart of the crisis remains the fact there is insufficient workforce and capacity to meet the demands of an increasingly ageing population with multiple health issues — issues we and many other have consistently raised in recent years.
‘There is no resilience to cope with any excess strain caused by any of the highly predictable storms we see occurring in what is now commonly termed an “eternal winter” in the NHS.’
He added: ‘High staff absence levels, burnout and low morale are a constant throughout the NHS, with high mortality rates and increasing numbers of patients waiting more than 12 hours in emergency departments illustrating the problem.
‘The solutions are not easy, nor are they quick, and it will take at least a decade to return to the delivery of high quality acute care’.
Meanwhile, Dr Adrian Boyle, president of the Royal College of Emergency Medicine, told MailOnline: ‘This data sets out clearly and starkly how bad things have got over the last decade for patients attending A&Es, and for those who work in them.
‘Far too many people are having to stay too long. Long stays are not just inconvenient or tedious, they are harmful, especially for older people.
Steven Wells (pictured sleeping on the floor at William Harvey hospital in Ashford, Kent) endured a 45-hour A&E wait after starting to vomit blood and was forced to sleep on the floor in November while waiting to be admitted
The 31-year-old forklift driver (pictured sleeping on the floor at William Harvey hospital) said: ‘It was honestly like a war zone at times. It makes me not want to go back to hospital, as the last time was so traumatic and embarrassing. ‘You have people looking down on you, stepping over you, and all you want is to just be looked after’
‘Increasingly emergency department staff are reporting that they are having to look after people who should be in-patients, in addition to assessing new arrivals.
‘This creates further delay for patients and intolerable working conditions for staff.
‘Our urgent and emergency care system exists to make people better, but the current situation is actually making people sicker.’
England saw the largest increase in the proportion of patients waiting at least four hours over the last decade, the ONS data revealed.
Rates stood at 8.1 per cent in 2013 but jumped to 42.4 per cent in September last year.
In comparison, Scotland saw rates rise from 11.7 per cent in 2013 to 33.5 per cent in 2023, while Wales recorded a jump of 15.6 per cent to 40.5 per cent.
Four-hour waits, however, were higher in Labour-run Wales than England in every month from January 2013 to August 2022.
Liberal Democrat health and social care spokesperson Daisy Cooper MP warned patients were being forced ‘through endlessly long waits’.
She added: ‘This Conservative government has brought our health service to its knees.
‘They have ignored the needs of patients, allowed hospital buildings to crumble, and have proven themselves completely unfit to run our NHS.
‘Inexplicably they are refusing to cancel their planned cut to the NHS budget.
‘Our health service needs to be at the heart of the government’s priorities, not just left to fall apart.’
Health services operating in the three nations all follow policy guidance that states every effort should be made to transfer or admit patients, who require a period of observation, assessment, or recovery, to suitable facilities where available – at which point the waiting time ‘clock’ stops.
But no such policy exists in Northern Ireland, meaning the nation cannot be directly compared with the rest of the UK.
Becky Tinsley, a deputy director at the ONS, said the report was intended to ‘make it easier to understand health data from across the UK’ and help create ‘a joined-up statistical picture’.
She added: ‘This doesn’t mean that we’re developing a one-size-fits-all approach to data across the four nations.
‘We understand that there are differences in policy, infrastructure and processes which may impact data collection and our ability to make comparisons.
‘There are also other factors that are important to consider, like differences in the age of each of the countries’ populations, which impact people’s health and result in different demands on the health service.
