A&E overcrowding may be linked to around 550 deaths a week across the UK, a study of more than 19,000 hospital patients suggests.
Researchers found that the risk of dying within 28 days increased by 1 per cent for every 10 per cent rise in emergency department occupancy. The findings were presented at the European Emergency Medicine Congress in France.
The review covered 134 A&E departments, which had an average occupancy rate of 175 per cent. This meant they were treating almost twice as many patients as they were designed to accommodate.
Dr Ryan McHenry, an emergency medicine doctor in the west of Scotland and a researcher at the University of Glasgow, analysed data from around 70 per cent of A&Es in England, Wales and Northern Ireland over a two-week period.
He estimated that overcrowding could be responsible for about 550 deaths each week, although he said the relatively small size of the study meant the figure could range from 33 to 1,083 excess deaths.
“We found that increased crowding in emergency departments is associated with increased mortality for patients admitted to hospital,” Dr McHenry said.
“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.”
The researchers also examined corridor care, in which patients are treated in non-standard clinical areas such as corridors. This was associated with a similar increase in the risk of death, although occupancy rates were considered easier to measure and record.
Official NHS figures show that more than 3,000 patients a day were treated in corridors or other makeshift areas in England during July.
The Royal College of Nursing has warned that a lack of A&E beds can leave patients waiting on trolleys without proper access to oxygen and other emergency equipment. Overstretched staff may also miss signs that a patient’s condition is deteriorating.
Dr Felix Lorang, a member of the conference’s abstract selection committee, said many emergency departments were operating “far beyond capacity”. He said patients being unable to leave A&E because no inpatient ward beds were available placed further pressure on staff.
“This makes it harder for doctors and nurses to deliver the treatment patients need, or even the minimum treatment required to prevent further harm,” Dr Lorang said.
Dr Ian Higginson, president of the Royal College of Emergency Medicine, 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 added to evidence of an “utterly normalised and unacceptable state of affairs”, and called on the governments of the four UK nations to address the impact of overcrowding and long waits on patients and staff.
Dr Den Langhor, from the British Medical Association’s consultants committee, described the estimated deaths as an “absolute scandal”.
“That is the equivalent of a fatal jumbo jet crash every single week in the UK,” she said. “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.”
