The Royal College of Emergency Medicine (RCEM), which has noted that the Government’s urgent and emergency care services plan for 2025/26 contains “some good and some bad,” has expressed concern about one important target, to:
“Reduce the number of patients waiting over 12 hours for admission or discharge from an emergency department compared to 2024/25, so this occurs less than 10% of the time. This will improve patient safety for the 1.7 million attendances a year that currently exceed this timeframe.”
The RCEM says this “lacks ambition” – “accepting that 10% of people will face A&E waits of more than 12 hours, when no patient should.”
And the RCEM criticises the plan to maintain the four-hour standard at 78% “when the stated aim is that 95% of patients should move through the ED within this time – something which hasn’t happened for a decade.”
And the College also points out the dangerously high level of occupancy, with 92,910 out of 99,956 beds filled in May (93%): this is well above the accepted safe occupancy level of 85%. England’s NHS would need another 9,350 beds to achieve safe levels – or ensure more rapid flow through the hospital system and much swifter discharge of patients ready to go home.
The RCEM has for years stressed the link between long delays in getting patients in to a hospital bed and increased levels of mortality, contributing to an estimate of over 16,000 excess deaths in England last year.
The NHS currently publishes two different sets of statistics for 12-hour plus waits. The main official NHS statistics for 2024/25 calculated delays from the decision to admit.
These show that trusts appear to be already comfortably meeting the 10% target: 532,000 patients waited over 12 hours on trolleys during that year (an average of 44,300 per month): this is 8.2% of the 6.5 million emergency admissions in the year.
This figure is shocking (it was 163 times the number of 12 hour-plus trolley waits in the last full pre-Covid year 2018/19). But it is far less than 1.7 million, and well below 10%.
However, the RCEM has long argued for delays to be calculated from first arrival in the Emergency Department, which are much higher numbers.
These figures are now published separately by the NHS as ECDS Supplementary Analysis, and the UEC Plan has made an important step forward by using them to estimate the scale of the problem.
These figures show that in April 2025, 144,084 (10.1% of all the total attendances) spent more than 12 hours from arrival at A&E, whereas this fell to 9.3% in May (135,219 people waiting more than 12 hours from arrival at A&E).
So the target even on these figures is far from ambitious, and the RCEM is rightly concerned that even 9% of patients enduring 12 hour trolley waits means misery and increased risk for tens of thousands of patients.
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