A&Es have seen a surge in elderly patients waiting more than 12 hours since the NHS was forced to normalise ‘corridor care’ to get ambulances back on the road
A&Es have seen a huge surge in elderly patients waiting to be admitted since the normalisation of “corridor care”. NHS data collated by the Royal College of Emergency Medicine (RCEM) shows the older they are, the more likely they are to have to wait.
Figures obtained under Freedom of Information Act laws show that 1.15 million people aged 60 and over waited more than 12 hours to be transferred, admitted or discharged in England’s major A&E departments last year. This is a jump on the 991,068 in 2023 and about three times the figure for 2019, when 305,619 were affected.
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Dr Adrian Boyle, president of the RCEM, said: “The healthcare system is failing our most vulnerable patients – more than a million last year. These people are our parents, grandparents, great-grandparents. They aren’t receiving the level of care they need, as they endure the longest stays in our emergency departments, often suffering degrading and dehumanising corridor care.
“It’s an alarming threat to patient safety. We know long stays are dangerous, especially for those who are elderly, and puts people’s lives at risk.”
The research found that the likelihood of experiencing a 12-hour wait in an emergency department increases with the age of the patient. People aged 60 to 69 have a 15% chance of waiting 12 hours or more, whereas for those aged 90 and above, the likelihood rises to 33%.
It comes after the NHS decided to start letting patients into A&E en masse from ambulances queuing outside, even when there is no bed available. Last winter the Mirror reported from the frontline of the NHS “corridor care” crisis which the Royal College of Nursing said was the worst it has ever been.
A 460-page RCN report in January chronicled testimony from 5,000 nurses which laid bare the consequences of a decade of NHS under-funding with patients spending hours slowly dying on trolleys in busy corridors and a dead patient being found under a pile of coats in a waiting room.
Seven in ten nurses said they were daily delivering care in over-crowded or unsuitable places like corridors, converted cupboards, bathrooms, cloakrooms, paediatric recovery rooms with children in and even car parks – something that had previously been a temporary measure for emergencies.
The RCEM says the NHS data it obtained also suggests older people are missing out on vital checks in A&E. It compiled a Quality Improvement Programme (QIP) study using data from 149 emergency departments involving 24,865 patients. Among patients over 75, the research found insufficient screening for three common conditions which frequently affect older people.
The report found only 16% of patients were screened for delirium – a reversible condition which is linked to increased risk of death and is noted by a sudden change in mental function. On average, fewer than half (48%) of patients were screened for their risk of falls. Just over half (56%) were screening for general frailty – which if picked up early can lead to prompt extra support in hospital and at home.
The report recommended changes, including “front door frailty screening” in every A&E. This is already being introduced across Scotland.
RCEM president Dr Adrian Boyle added: “The healthcare system is failing our most vulnerable patients – more than a million last year. These people are our parents, grandparents, great-grandparents. They aren’t receiving the level of care they need, as they endure the longest stays in our emergency departments, often suffering degrading and dehumanising corridor care.
“It’s an alarming threat to patient safety. We know long stays are dangerous, especially for those who are elderly, and puts people’s lives at risk. As our QIP highlights, more needs to be done to improve their care – vital tests need to get underway as soon as they arrive to inform the care they need and mitigate the risk of another visit to the emergency department.
“There are good pockets of practice, and emergency medicine clinicians are trying their best to deliver the care they need. It’s the system that’s the issue and will continue to disproportionally affect older people unless governments across the UK make A&E a political priority.”
Dr Anu Mitra, project lead of RCEM’s care of older people QIP, said: “Older people make up a large proportion of attendances to the emergency department, bringing greater health complexities and evolving care needs. In the backdrop of worsening crowding and increasing long stays, emergency clinicians need to ensure they maintain the basic elements of care and comfort for older patients.
“It’s been encouraging to see that, despite the challenging environments emergency medicine clinicians are working in, there has already been improvements in ensuring these patients are receiving the assessments they need. It’s vital we continue this work for this vulnerable patient cohort to meet their needs and provide the level of care they deserve.”
A Department of Health and Social Care spokesman said: “It is unacceptable that older people are waiting up to 12 hours or more in A&E. This Government is investing £26 billion in the NHS and social care over the next two years, has ended the resident doctor strikes so staff are on the frontline, and is committed to cutting A&E waiting times so patients are seen faster.
“Through our 10-year health plan, we will ensure that patients, including older people, are seen promptly in A&E, waiting times continue to come down, and more people get a GP appointment.”
