New research is “yet more evidence that A&E overcrowding kills”, the Royal College of Emergency Medicine (RCEM) has said, as it calls on the Welsh Government to “urgently lay out its plans to tackle the issue ahead of the winter season.

A new study published on 25 September and presented at the European Emergency Medicine Congress by members of the Trainee Emergency Research Network (TERN), found that Emergency Department (ED) patients were more likely to die the more overcrowded the ED was.

For every 10 per cent increase in ED occupancy the risk of a patient dying within 28 days rose by one per cent, according to the study.

The research, which is part of the UNCORKED study series, concluded that overcrowding was estimated to have contributed towards 554 excess – otherwise avoidable – deaths each week in the UK last year.

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.

“The findings of this crucial study from the Trainee Emergency Research Network (TERN) add yet more evidence about this utterly normalised and unacceptable state of affairs.

“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 EDs 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 have on staff, who we risk losing in droves should the problem persist. Politicians need to focus efforts on the main causes of the problem rather than on apparent quick fixes which patently aren’t working.

“Governments must make tackling overcrowding, long ED waits and the associated risk to patients an urgent priority.”

The latest official performance figures for Welsh Emergency Departments (EDs) showed that around one in six people who attended A&E in August waited more than 12 hours before being discharged, admitted or transferred,

With waiting times showing no improvements on 2025, RCEM is airing its concerns ahead of winter – where seasonal illnesses and cold weather will bring even more pressure on an already overwhelmed system.

Dr Rob Perry, Royal College of Emergency Medicine Wales Vice President, said: “Every month, thousands of our patients are left waiting for hours and hours in Welsh Emergency Departments (EDs).

“This unacceptable state of affairs, it seems, is still not improving – not even in the warmer months of summer. In times gone by, August was an ‘easier’ month in ED – but now we’re seeing long waits for patients the likes of which would have horrified us in the depths of winter.

“Our EDs are in a year-round crisis in which patients are being left to languish in our departments for, all too often, more than half a day. If this is what summer looked like, I fear for winter.

“It is uncomfortable, undignified – and moreover it is dangerous. We know that there is an association with long stays in ED and harm to patients.

“The new Welsh Government has signalled that it is working on a plan to address this.

“But with each day, week or month that go by without concrete action, our patients are suffering. Meanwhile, staff are trying their hardest to give the best care possible to patients.

“This is not sustainable and I call on the government to expedite their plans to reduce ED overcrowding, restore patient flow through hospitals and reduce long stays.”

The official statistics also showed that only around half (50.5 per cent) of patients waited fewer than four hours in an ED.

The system-wide target is 95 per cent.

On average, each day a total of 1,374 ward beds were occupied by patients who are medically fit to leave, the statistics show.

The new study on ED overcrowding deaths backs findings from RCEM, published in June, which suggested that long waiting times and overcrowding in Emergency Departments contribute towards thousands of deaths each year.

Latest Wales NHS figures show there were just under 709,700 cases waiting for planned treatments in July, with just over 4,700 having been waiting two years or more.

The data for A&E departments in Wales for August showed a decrease in attendances compared to July, and 63.8 per cent of patients spent less than four hours in emergency departments from arrival.

While an improvement compared to the previous month the figure is far below the 95 per cent target set by the Welsh Government.

That target has never been reached.

In August, 10,977 patients waited 12 hours or more, latest figures show.

That represents a 6.3 per cent improvement from July, but targets say nobody should be waiting that long.

Health Minister Cabinet Minister for Health and Care, Mabon ap Gwynfor said: “These figures are disappointing and performance is not where we want it to be.

Paging Doctor Mabon art
(Cambrian News)

“The inherited waiting list backlog remains too high, and tackling it remains our top priority.

“This is why we are putting measures in place that will improve waiting times for people on a sustainable basis and ensure nobody is waiting more than two years for treatment.

“Earlier this month I announced how we are following a clinically led approach to clear the longest waits and bring the overall waiting list down to pre-pandemic levels before the end of this Senedd term.

“This is a new solution to an old problem, and one I am confident will not just cut down the existing backlog, but will keep it down on a permanent basis.

“We will do this by ensuring people start their treatment quicker, working with health boards to boost surgical capacity and reforming follow-up appointments to ensure more people are seen for the first time.

“Our plans to reset how planned care is delivered in Wales have been backed by an extra £145 million being invested in NHS Wales this financial year.

“The funding includes £100 million to support our aims of reducing NHS waiting times, £25 million in new surgical and diagnostic hubs, and £20 million on essential maintenance across the NHS estate.

“Health boards are now carrying out these plans and we need time for them to filter through the system and have an impact.

“I expect to see them making progress soon.

“I welcome the progress in urgent and emergency care, particularly on ambulance patient handovers, where performance within 45 minutes was the best since May 2021.

“Response times to the most serious incidents and 12-hour emergency department waits have also improved.

“But the overall position is still not good enough, and I expect health boards and NHS organisations to maintain momentum and deliver further, sustained improvement.”