The A&E crisis: what’s really driving poor performance?

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Accident and Emergency Departments are in crisis. According to the NHS’s own targets, at least 95 per cent of patients should be admitted, discharged, or sent home within four hours of arriving at A&E. In December, less than half of all patients at major hospital A&Es met that target.

Before the pandemic, waits of 12 hours after a decision had been made to admit a patient to a hospital bed were virtually unheard of – in December, more than 50,000 patients found themselves in that position. Images of ambulances backed up outside of hospitals, patients on trolleys in hospital corridors, and burnt-out staff have become familiar sights.

This short briefing paper seeks to understand what is actually happening in our emergency departments and, using publicly available data, challenges some of the arguments frequently heard about the A&E crisis. We identify areas for further investigation which we believe could be key to stabilising the system.