Half a million patients in England waited more than 24 hours for care in accident and emergency (A&E) departments last year, according to a report by the National Audit Office (NAO). An additional 1.2 million patients experienced waits between 12 and 24 hours before being discharged, transferred, or admitted.
The report highlighted that although NHS England increased resources and made some improvements following the Covid-19 pandemic, progress has been slower and less extensive than anticipated. Medical professionals and experts emphasized the need for government reforms of social care and reductions in discharge delays, which create bottlenecks for incoming patients.
Caroline Abrahams, director of Age UK, described the high number of delayed discharges as a "crisis hiding in plain sight," pointing to the significant harm caused to older patients and the considerable financial costs to the NHS and taxpayers. “We will never end the horror of corridor care at the front door of hospitals for as long as we fail to get a grip on the problem of delayed discharges at the back door,” she said.
Dr. Ian Higginson, president of the Royal College of Emergency Medicine, said the report’s findings confirmed what emergency staff have long observed. He described the healthcare system as being in a "state of perma-crisis," citing inefficiencies in hospital operations and limited availability of services on weekends. He warned that delayed discharges create a logjam effect, leading to overcrowded emergency departments and increased risks to patient safety.
The NAO report drew on previous research indicating that patients who wait 12 or more hours in A&E are twice as likely to die within 30 days of leaving compared to those with waits under two hours. It also noted that hospital trusts were projected to spend £6.6 billion on emergency services in 2024-25, while delayed discharges cost the NHS an estimated £2 billion between August 2025 and April 2026.
Data from July showed an average of more than 14,000 patients experiencing delayed discharges daily, with 2,300 receiving care in hospital corridors. Professor Nicola Ranger, general secretary and chief executive of the Royal College of Nursing, criticized what she called an “unacceptable” lack of social care funding. She urged the government to deliver a national care service and invest in community nursing to relieve pressure on hospitals, stressing the human toll of prolonged waits, including patients receiving care in corridors and facing serious medical emergencies in crowded settings.
The NAO also noted a steady increase in demand for emergency services over recent decades, with attendances rising from 21.5 million in 2011-12 to 28 million in 2025-26. The longstanding target of treating 95% of A&E patients within four hours has not been met since 2013-14. A revised target of 85% by 2028-29 was introduced in 2023. In 2025-26, the four-hour target was met by 74.9% of cases, reflecting some post-pandemic improvement.
The average cost per A&E attendance has risen by about one-third over the past six years, increasing from £211 in 2018-19 to £280 in 2024-25, adjusted for inflation.
The Department of Health acknowledged the ongoing challenges, stating that “too many patients are still waiting too long for urgent care.” Officials said they are taking steps to improve patient flow, reduce corridor care, and cut delays, including deploying expert teams in the most affected trusts and investing £450 million to enhance emergency and urgent care services. The department is also expanding urgent care facilities and mental health A&Es, alongside efforts to shift more care into community settings.