Doctors warn of ‘threat to patient safety' over elderly people stuck in A&E

Yahoo

05-05-2025

Senior doctors have warned of an 'alarming threat to patient safety' after figures showed more than a million elderly people endure long waits in A&E – and the older they are, the more likely they are to experience it.
A report from the Royal College of Emergency Medicine (RCEM), shared with the PA news agency, shows that rising numbers of elderly and frail people are stuck in A&E, often on trolleys in corridors.
Figures obtained by RCEM via the Freedom of Information Act 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 from the 991,068 in 2023 and about three times the figure for 2019, when 305,619 were affected.
The research also found that the likelihood of experiencing a 12-hour wait in an emergency department increases with the age of the patient.
People aged 60-69 have a 15% chance of waiting 12 hours or more, whereas for those aged 90 and above, the likelihood rises to 33%.
The RCEM has been looking in detail at the care older people receive and also found that many are missing out on vital checks in A&E.
Its Quality Improvement Programme (QIP) study received 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.
Although there have been some improvements, the report found:
– Only 16% of patients were screened for delirium – a reversible condition which is linked to increase 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.
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.
'As our QIP highlights, more needs to be done to improve their care – vital tests need to get under way 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.'
Dr Nick Murch, president of the Society for Acute Medicine, said: 'This situation, where over a million older patients are known to have endured prolonged periods of over 12 hours in emergency departments, frequently in unsuitable and undignified settings such as corridors, is a matter of grave concern.
'It is clear that, despite the considerable dedication and hard work of multidisciplinary teams including emergency medicine, acute medicine and acute frailty services, these extended waiting times signify a profound failure within our healthcare system.
'We must ensure that 12-hour waits in emergency departments again become an infrequent exception rather than the norm.'
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 front line, 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.'