5:34 pm - February 13, 2025
The state of emergency care in England has reached a critical point, with record numbers of patients facing excessively long waiting times in Accident and Emergency (A&E) departments. In January, the number of patients waiting on trolleys for over 12 hours after a decision to admit them—referred to as “trolley waits”—surpassed 60,000 for the first time. This stark figure represents more than 15% of all patients admitted through A&E that month, a situation that was virtually unheard of before the COVID-19 pandemic. Despite overall A&E attendance being lower than this time last year, the system continues to struggle with bed shortages and overwhelming demand, leading to these unprecedented delays. The crisis is further highlighted by the fact that the total trolley waits recorded in January alone exceed the combined total from over 11 years prior, between August 2010 and October 2021.
While the headline statistics paint a grim picture, there are some signs of improvement in other areas of urgent care. Overall A&E waiting times in January showed a slight improvement compared to December and January of the previous year, with 71.1% of patients being admitted, transferred, or discharged within the four-hour target. However, this figure remains far below the NHS’s goal of 95%, underscoring the ongoing challenges faced by emergency departments. The government has also reported progress in reducing the overall waiting list for elective care, which fell by 20,000 in December to 7.46 million—a figure that still represents one in 10 people in England waiting for treatment. While the number of patients waiting over a year for care has decreased to 200,375—the lowest since November 2021—it remains dramatically higher than pre-pandemic levels.
Health and Social Care Secretary Wes Streeting has highlighted the government’s efforts to address these challenges through the Prime Minister’s Plan for Change, which has reportedly reduced NHS waiting lists by nearly 160,000 since July. Streeting emphasized the need to end the “misery” of long waiting times and pledged to tackle the root causes of delays in A&E departments. He also acknowledged that winter pressures should not automatically translate to annual crises, signaling plans to improve urgent and emergency care services. These ambitions are commendable, but the reality on the ground remains fraught with difficulty, as evidenced by the growing number of patients stuck on trolleys and the persistent strain on acute care.
Despite some progress in reducing waiting lists and easing winter pressures, critical challenges persist in other areas of the healthcare system. Ambulance handovers, bed occupancy, and flu-related hospitalizations have all begun to decline, offering cautious optimism. However, the number of medically fit patients who cannot be discharged due to a lack of social care support has increased, highlighting one of the most pressing issues facing hospital trusts. This bottleneck not only prolongs patient stays but also exacerbates the shortage of available beds, creating a vicious cycle that further overwhelms A&E departments. Furthermore, while the total waiting list for elective care has fallen for four consecutive months, the number of patients waiting on trolleys has risen, underscoring the uneven nature of progress across the system.
The crisis in emergency care is further compounded by growing concerns about cancer treatment waiting times. Data reveals that in 2024, just over 62% of patients began their cancer treatment within the recommended 62 days following an urgent referral, a slight improvement from 2023 but still far short of the government’s target of 85%. More than 50 cancer charities have called on the government to take urgent action to address these delays, which leave thousands of patients facing unbearable stress and anxiety. Michelle Mitchell, Chief Executive of Cancer Research UK, emphasized the human cost of these delays, stating that “behind every one of these numbers is a family member, friend, or loved one facing unbelievable stress and anxiety, where every day can feel like forever.” The situation is a stark reminder of the broader systemic issues plaguing the NHS, where hardworking staff are doing their best but are constrained by insufficient resources and staffing shortages.
In conclusion, while there are glimmers of progress in some areas of the NHS, the scale of the challenge facing the healthcare system remains immense. The record number of trolley waits, alongside persistent delays in A&E and cancer treatment, underscores the human impact of these systemic failures. Patients are not just statistics; they are individuals and families enduring unnecessary suffering due to a system under strain. The government’s commitments to reform and invest in the NHS are steps in the right direction, but meaningful change will require sustained effort, increased transparency, and a focus on addressing the root causes of these issues. Until then, the NHS will continue to struggle to meet the needs of those who rely on it most.