Age UK has warned that long waits are having a ‘terrible impact’ on older people. (Image: Getty) Last year in England, half a million patients waited more than 24 hours in an emergency department. The National Audit Office estimates that a further 1.2 million people waited between 12 and 24 hours from arrival to be discharged, transferred or admitted. The report said NHS England had increased resources and made improvements following the severe impact of Covid-19, but these were “fewer and slower than expected”. Medical leaders and experts have called on the government to reform social care and reduce discharge delays that are causing problems for patients admitted to hospital. Caroline Abrahams, director of charity Age UK, said: “It’s appalling that deferred discharges are so high and continue to rise, it really is a crisis hiding in plain sight. They cause enormous harm to older people and cost the NHS and taxpayers a fortune.” “Furthermore, we will never end the horror of corridor care at the front doors of hospitals until we can solve the problem of delayed discharge at the back door.” Dr Ian Higginson, president of the Royal College of Emergency Medicine, said the NAO’s findings “will come as no surprise to those working in emergency departments”. He added: “This confirms what we have been saying for years. The system is in a state of permanent crisis. Our hospitals are not operating effectively seven days a week and services are not open when they are needed.” “Delayed discharge—when patients who do not have a medical need to remain in hospital cannot be discharged, largely due to a lack of follow-up services—results in a congestion effect that causes overcrowding in emergency departments and puts lives at risk.” The NAO report cites previous research that shows that people who endure waits of 12 hours or more are “twice as likely to die within 30 days of leaving the emergency department compared with those who wait just two hours.” It also notes that hospital trusts reported spending £6.6 billion on acute care services in 2024-25, while NHS England estimated that delayed discharges cost £2 billion between August 2025 and April 2026 alone. In July, there were an average of more than 14,000 delayed discharge patients and 2,300 patients receiving hallway care per day. Professor Nicola Ranger, general secretary and chief executive of the Royal College of Nursing, said there was a “precious small improvement on the severe pressures” staff had faced for many years. She blamed an “unacceptable” lack of social care funding, adding: “The real human cost of long waits and overcrowding is patients languishing in corridors, suffering cardiac arrest, receiving intimate care or receiving news of death in front of others. “Now more than ever, we need ministers to make progress on delivering national care services and recognize how investing in nursing staff closer to people’s homes, such as in the community, can improve hospital performance.” People who wait more than 12 hours in the emergency room are more likely to die within a month (Image: Getty) The NAO report acknowledges that demand for A&E has increased significantly over recent decades. Attendance was 28 million in 2025–26, up from 21.5 million in 2011–12. The long-standing target of 95% of patients being discharged, transferred or admitted within four hours has not been met since 2013-14. A new, lower target of reaching 85% by 2028–29 was set in 2023. The NAO found that there has been a gradual improvement since the pandemic. The NHS met the four-hour standard in 74.9% of visits in 2025-26. Meanwhile, the cost of an A&E appointment per patient has risen by a third when adjusted for inflation, from £211 in 2018-19 to £280 in 2024-25. The report recommends that health officials review the successful approaches of high-performing trusts and try to replicate them elsewhere. He called for support for trusts “to more consistently use comprehensive hospital flow management tools and reduce discharge delays caused within hospitals”. It also states that patient feedback and other indicators of patient experience should be included in regular performance monitoring. Gareth Davies, chief executive of the NAO, said: “Despite significant efforts to improve emergency department services, patients continue to face long waits and delays in care. “NHS England and the DHSC must understand more fully why improvements have been slow and ensure successful approaches are implemented more consistently across the system. “Closer attention to patient flow, timely discharge and patient experience will be vital to improving patient outcomes.” Some patients are forced to receive assistance in the corridors (Image: Getty) A Department of Health and Social Care spokesman said the government “inherited an NHS under enormous pressure, particularly in acute care”. They added: “While there are encouraging signs of progress, including better ambulance and emergency department performance in four years last winter, we know that too many patients are still waiting too long for emergency care. “We are taking action to improve the flow of patients through hospitals, tackle corridor care and reduce delays, including sending expert teams to the most problematic settings, publishing data on corridor care for the first time and investing £450 million to improve A&E care. “Alongside this, we are expanding urgent care centers and mental health emergency departments, moving more care into the community and working with social care partners to help people leave hospital safely and on time, supporting a more resilient health system for the future.” Waiting too long can have dire consequences, says CAROLINE ABRAMS Delayed discharge has a terrible impact on older people when they are medically ready to be discharged but action cannot be taken quickly enough or at all to allow this to happen. They are the victims in such situations. Waiting for a long time, often on a hard chair in a hallway or other overflow area, when you are very unwell, in pain, likely alone, perhaps fearing for your life, would be terrible at any age, let alone if you are in your eighties or older. And yet, this still happens day in and day out in the hardest hit hospitals, to the point where it has become commonplace. The good news is that we can solve this problem with political will, the right policies, and by applying the lessons of those hospitals that have made progress in addressing delay problems and that once had serious problems with them and have managed to reduce them. First and foremost, we must agree a new approach that ends arguments between councils and the NHS over who pays to support an older person when they are ready to return home from hospital; increase the total number of hospital beds; and build community capacity to bring these older people back and help them make a full recovery, partly through much greater use of voluntary sector efforts such as what we offer at Age UK. Ultimately, of course, we also need to reform social care so that more and better services are available to reduce the risks for older people needing hospitalization and give them the support they need to get well again when a hospital stay is unavoidable and they are well enough to leave. – Caroline Abrahams is director of the charity Age UK. Post navigation Europe’s wildest pilgrimage route: a trek through the mountains of northwest Sweden A Queensland driver is in deep trouble with police after he was caught eating and driving.