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Emergency pneumonia cases surge to half a million a year in England

The number of people requiring emergency care for pneumonia has risen by a quarter over two years to reach more than half a million cases, new figures show, amid warnings that preventable cases are adding pressure on overstretched A&E departments.

Analysis of the most recent NHS England data from between April 2024 and March 2025 found that there were 579,475 cases of pneumonia requiring emergency hospitalisation, and this was likely to have risen further since, according to the charity Asthma + Lung UK. There were 461,995 cases between April 2022 and March 2023.

Pneumonia is the single biggest cause of emergency admissions and is responsible for more than double the number of cases of the next biggest. It can also be deadly: between April 2022 to March 2025 more than 97,000 people died of pneumonia after ending up in hospital.

Dr Andy Whittamore, the clinical lead at Asthma + Lung UK, said: “These alarming figures are the result of respiratory care being neglected and deprioritised for too long.

“Following recommended basic care guidelines for respiratory conditions can save and transform lives. I’ve seen first-hand with my patients the dramatic effect good basic care has on reducing hospital admissions.

“However, too often we’re not getting the basics right and the result is increasing A&E and hospital pressures, rising healthcare costs and people with lung conditions left to deteriorate without support.”

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Source: The Guardian, 3 February 2026

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Emergency patients staying an extra day in ‘congested’ hospitals

Patients are spending an extra day in hospital on average when admitted as an emergency compared to before covid, consuming millions of additional ‘bed days’, HSJ analysis has found.

The finding explains in part why fewer people are being treated in hospitals, but more resources are being consumed to do so. This has prompted concerns about an apparent big drop in productivity.

NHS England chief finance officer Julian Kelly told HSJ the marked increase in length of stay meant hospitals needed to focus on “discharge and decongest” of emergency care, to help recover activity rates and productivity in elective care. The NHS also needs to create more elective capacity insulated from emergency care, he said, and for “local leadership [to] keep people focused”.

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Source: HSJ, 19 December 2022

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Emergency departments 'having to choose between very sick patients'

Doctors are having to choose which "very sick people" they prioritise because of the pressures on Northern Ireland's emergency departments (ED), the Royal College of Emergency Medicine (RCEM) has said.

Department of Health (DoH) statistics for the first three months of this year show that no ED achieved targets for seeing patients within the four-hour and 12-hour benchmarks.

RCEM Northern Ireland said, so far, the figures for 2026 are "the worst they have ever been" and described the state of emergency departments in Northern Ireland as "utterly horrifying".

The association's vice president, Dr Michael Perry, said the environment staff are working in was making their jobs very difficult.

"We're basically pleading with our policy makers and our elected representatives in our government to allow us to do our jobs," he said.

"Don't put us in this position where we have to choose out of two very sick people who we prioritise," Dr Perry told BBC Radio Ulster's Good Morning Ulster.

Nursing staff turnover in Northern Ireland's emergency departments is "vast and it is largely to do with the environment that they work in", he continued.

"I've had staff very distressed where something's happened, they have tried their best to deliver the best care that they can, but because of the environment they're being forced to work in something adverse has happened."

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Source: BBC News, 24 April 2026

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Emergency care issues in England contributed to 200 deaths last week, says medical chief

More than 200 people who died last week in England are estimated to have been affected by problems with urgent and emergency care, according to the president of the Royal College of Emergency Medicine.

Dr Adrian Boyle, who is also a consultant in emergency medicine, told BBC Radio 4’s Today programme that a failure to address problems discharging patients to social care was a “massive own goal”.

Ambulances had become “wards on wheels” while patients waited to get hospital treatment, Boyle said, adding that those most at risk “are the people that the ambulance can’t go to because it’s stuck outside the emergency department”.

His comments came as the NHS launched 42 “winter war rooms” across England, designed to use data to respond to pressures on the health system.

When asked about the project, Boyle said it was too early to tell if it was a good idea, adding: “You can paralyse yourself with analysis, it really is actually more simple and about building increased capacity.”

He said the problem was best solved by focusing on hospital discharge and social care. “Fixing this starts at the back door of the hospital and being able to use our beds properly,” he said.

“At the moment, there are 13,000 people waiting in hospitals, about 10% of the bed base, who are waiting to be discharged either to home, with a little bit more support, or to a care facility. And that’s just a massive own goal. We just need to reform the interface between acute hospitals and social care.”

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Source: The Guardian, 1 December 2022

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Emergency care in ‘dire’ situation as performance plummets over weekend

Several ambulance trusts have moved to the highest level of alert in the wake of severe pressure on emergency services in recent days.

Internal data seen by HSJ suggests ambulance response times have deteriorated dramatically, while the average time for call handlers to answer 999 calls has increased to almost two minutes in some areas.

Staff across the country have been sounding the alarm over the pressures, with one senior source saying the situation was “really dire” again, after a period in which pressures had eased in August and September.

The internal data showed ambulance trusts in the South West, East of England, London and the West Midlands had all declared the highest level of alert, known as REAP 4. More are expected to follow.

The average response time for category 2 calls in the South West – including suspected heart attacks and strokes – was 1 hour 24 minutes, with 10% of these calls responded to in more than 3 hours 11 minutes. The target is 18 minutes.

Emergency departments have also faced severe pressure. An emergency care consultant in Plymouth tweeted that patients were facing 70-hour waits to be admitted to wards, with some waiting 18 hours to be handed over by ambulance staff. Fionna Lowe added: “I have taken to asking families to feed their relatives. It has never been this bad.”

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Source: HSJ, 4 October 2022

 

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Elon Musk's bid to implant microchips in human brains rejected over safety concerns

Elon Musk's attempt to implant microchips into human brains has been rejected by US medical regulators over concerns about the safety of the technology.

Mr Musk's Neuralink business, which is hoping to insert tiny chips into people's skulls to treat conditions such as paralysis and blindness, was denied initial permission for clinical trials last year.

US medical regulators were said to have "dozens" of concerns over the risks posed by the device, Reuters reported. Concerns include fears that tiny electrodes could get lodged in other parts of the brain, which could impair cognitive function or rupture blood vessels.

Neuralink's chips are designed to be threaded into the brain using tiny filaments and harness artificial intelligence technology to pick up brain activity using a so-called "brain computer interface".

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Source: The Times, 3 March 2023

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Eljamel patient Jules Rose says NHS Tayside tried to 'silence' her

A mother who endured a botched surgery at the hands of a disgraced neurosurgeon claims NHS Tayside tried to silence her against making complaints.

Professor Sam Eljamel removed Jules Rose's tear duct during a failed attempt to operate on a brain tumour - setting the 55-year-old on a path to becoming a prolific campaigner for patients' rights.

Ms Rose, however, has received sight of documents that show NHS Tayside writing to the then-health minister Humza Yousaf to say she had been "aggressive" and "vulgar" and they would no longer communicate with her.

In a letter in response, Mr Yousaf says he sees no evidence of any such conduct by the mother-of-two and tells the health board to enter into mediation with her.

Ms Rose said: "In the letter I have been given, Humza Yousaf writes back and say, 'She's quite right to feel aggrieved at the treatment she's received.

"'Therefore, I suggest that you continue liaising with Miss Rose and enter into mediation.'

"This was last November but I've only just had copies of the letters sent to me and when I saw them I thought, 'They've tried to shut me down, they're tried to silence me'."

The ongoing dispute with NHS Tayside is as a result of Ms Rose's long-running campaign for justice for patients - thought to be as many as 270 - harmed by Eljamel while he was in the health board's employ.

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Source: The Herald, 16 December 2023

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Elizabeth Dixon: Lessons not learned after baby death cover-up, says family

The family of a baby who died after errors in her care have criticised the failure of the NHS to learn lessons.

Elizabeth Dixon died due to a blocked breathing tube shortly before her first birthday and a subsequent independent investigation found a 20-year cover-up.

A year on, Elizabeth's mother Anne told the BBC: "My daughter has not been a catalyst for change."

The Department of Health said it was working on the report's recommendations and will publish "a full response".

Elizabeth Dixon, known as Lizzie, was born prematurely at Frimley Park Hospital, in Surrey, in December 2000. But a series of errors by the hospital and by Great Ormond Street Hospital, which took over her care shortly after birth, left Elizabeth with brain damage and needing to breathe through a tracheostomy. She was further let down by Nestor Primecare, a private nursing agency, which was hired to support her parents when Elizabeth returned home. She died 10 days before her first birthday.

An official investigation, published last year, found a "20 year cover-up" by health workers, with some of those involved described as "persistently dishonest".

"I would have expected them to take it seriously," Mrs Dixon said in response to the lack of action.

She believes that if a similar incident happened today, there would be a danger it would also be covered up.

"That's the default option - if its bad enough, they'll cover up," she said.

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Source: BBC News, 1 December 2021

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Elizabeth Dixon death inquiry 'exposes 20-year cover-up' of mistakes

The death of a premature baby in 2001 led to a "20-year cover-up" of mistakes by health workers, an independent inquiry has found.

Elizabeth Dixon, from Hampshire, died due to a blocked breathing tube shortly before her first birthday. The government, which ordered the inquiry in 2017, said the mistakes in her care were "shocking and harrowing".

The inquiry report by Dr Bill Kirkup said some of those involved had been "persistently dishonest".

Elizabeth, known as Lizzie, died from asphyxiation after suffering a blockage in her tracheostomy tube while under the care of a private nursing agency at home.

Dr Bill Kirkup, who was appointed by the government to review the case, said her "profound disability and death could have been avoided".

He said: "There were failures of care by every organisation that looked after her, none of which was admitted at the time, nor properly investigated then or later."

"Instead, a cover-up began on the day that she died, propped up by denial and deception."

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Source: BBC News, 26 November 2020

Patient Safety Learning's statement on the Dixon Inquiry report

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Eleven patients suffered harm after ambulance handover delays

Eleven patients have suffered harm after being kept waiting in ambulances outside accident and emergency departments, a review has found. 

South East Coast Ambulance (SECamb) Service Foundation Trust launched the review after a specific incident at Medway Foundation Trust on Monday 16 November. Although details of the incident have not been released, HSJ has been told one patient waited for nine hours before being seen in the trust’s A&E department that day.

The review covered all long waits across SECAmb’s area over the last few weeks. Out of 120 cases examined, 11 patients were found to have suffered some degree of harm, SECAmb’s executive director of nursing and quality Bethan Eaton-Haskins told Kent’s health overview and scrutiny committee last week. However, the trust has not revealed which hospitals were involved. 

Ms Eaton-Haskins said the ambulance trust was “struggling significantly” with handovers and expecting the recent pressure experienced at Medway FT to affect the county’s other hospitals soon. However, she indicated some other trusts in Surrey and Sussex had also had long delays.

Ambulance services have been concerned for some time that handover delays could pose significant problems this winter. They are thought to have contributed to the North West Ambulance Service Trust declaring a major incident earlier this month. HSJ has also been told of waits of several hours in other ambulance trusts.

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Source: HSJ, 1 December 2020

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Electronic decision support ‘to be the norm for all clinicians’ under NHSE plan

Electronic systems and clinical decision support software must become “the norm” for all NHS clinicians, under plans being drawn up by NHS England’s new transformation directorate, HSJ has revealed.

The massive increase in clinicians’ use of technology forms a major part of the draft plans, seen by HSJ, with the new directorate set to launch ambitious targets for the health service.

Other targets include every integrated care system creating virtual wards which are the equivalent size of a district general hospital — around 500 beds each — and installing electronic patient records at every NHS trust.

The proposals are led by former US healthcare chief Tim Ferris, NHSE’s new transformation director, who was appointed last year.

According to the plans, NHSE’s ambition is to increase the “safe and effective use” of computer assisted processes and clinical decision support so it becomes the “expected norm for all clinicians”.

NHS leaders have welcomed the use of virtual wards to improve home care and reduce hospital occupancy, but clinicians have warned of safety issues within virtual wards, with some prominent doctors calling for a careful implementation of the policy.

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Source: HSJ, 2 February 2022

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Elective recovery scheme ‘wide open to gaming’

Plans to pay trusts to validate and sometimes remove patients from their waiting lists could be “wide open to gaming” and create a public perception problem, senior NHS figures have told HSJ.

The new proposals were set out in the elective reform plan, published last week, which says NHS England “will ensure validation is, for the first time, formally reflected as a form of activity within the 2025-26 NHS Payment Scheme”.

HSJ understands the plans, already piloted by 10 trusts, involve relatively modest payments being paid to providers for “clock stops”—where an entry is removed from the referral to treatment waiting list—achieved by checking whether the entry remains valid.

So-called “removals other than treatment”, known as ROTTs, from the waiting list are common, and happen for numerous reasons such as patients moving house, no longer requiring the treatment, or having been treated elsewhere.

Waiting list expert Barry Mulholland, a partner at the MBI Health consultancy, said he was in favour of paying providers for ROTTs, but understood “concerns” among some in the NHS “that it provides an increased risk that patients may be removed incorrectly”.

Further details of the scheme are expected in the delayed 2025-26 NHS planning guidance.

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Source: HSJ, 15 January 2025

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Elective recovery requires ‘very radical’ service change, says Stevens

The NHS must think “very radically” about how it redesigns its elective pathways following the coronavirus pandemic, Sir Simon Stevens has told HSJ. 

Speaking at the HSJ Leadership Congress yesterday, NHS England’s chief executive said the service should ensure as much elective work is done as possible, while covid prevalence is low, while at the same time thinking about “different ways of doing things”.

He declined to outline how many very long-waiters the service had or would have in coming months, explaining that some predictions have been “significantly off” in the past, and that future demand is unknown.

The NHS chief stressed that other areas of the service would also face post-covid pressures, announcing a further investment in and expansion of long-covid clinics.

“We want to see equivalent attention paid to the increased needs we’ve seen in mental health services, including eating disorders, and we want to make sure that the health service continues to expand its offer for long covid,” he said.

“To that end we have 69 clinics identified last year, we will have 83 long covid clinics in place by the end of this month, so a significant expansion there.” There will be at least one in each integrated care system area, he said.

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Source: HSJ, 14 April 2021

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Elective recovery drive at risk from product shortages, warns NHS Supply Chain

Long-running supply issues with blood collection equipment risk delaying the elective recovery, according to an internal NHS Supply Chain communication seen by HSJ.

Global supply and manufacturing delays have caused the delivery of blood collection sets, apparatus used to draw intravenous blood into vacuum tubes, by months. The problems are affecting multiple products and suppliers.

An NHS Supply Chain procurement advisory cell communication warned trusts: “There is a risk that the continued supply disruption of blood collection sets is delaying elective recovery, with providers restricting blood collection to continue to prioritise urgent procedures.” 

This is the second “important customer notice” relating to supply problems with blood collection equipment issued by the national procurement agency.

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Source: HSJ, 9 May 2023

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Elderly woman dies alone on corridor trolley in 'final straw' for NHS A&E staff

Exhausted NHS staff have told how a woman was tragically left to die alone on a trolley in a crowded A&E corridor.

Staff at Arrowe Park Hospital's emergency department in Merseyside said they have reached breaking point as they are repeatedly faced with more patients than they can safely care for.

Wirral University Teaching Hospital Trust (WUTH) said the hospital's A&E department is experiencing "extremely high demand", with attendances around 30 per cent higher than expected for this time of year. Daily patient numbers have exceeded 330, peaking at 370 on some days in December.

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Source: The Mirror, 11 January 2026

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Elderly people waited nearly twice as long in A&E in England as in 2021

The amount of time people over 80 spend in A&E in England has almost doubled in a year, leaving them at increased risk of coming to harm and dying, emergency care doctors are warning.

An analysis by the Royal College of Emergency Medicine (RCEM) found that people of that age are spending 16 hours in A&E waiting for care or a bed, a huge rise on the nine hours seen in 2021.

The college, which represents the UK’s A&E doctors, warned that long waits, allied to overcrowding in hospitals and older people’s often fragile health, is putting them in danger.

Doctors specialising in emergency and elderly care warned that older people forced to spend a long time in A&E are more likely to suffer a fall, develop sepsis, get bed ulcers or become confused.

Dr Adrian Boyle, the RCEM’s president, said that it is also likely that some older people are dying as a result of the delays they are facing, combined with their often poor underlying health.

The risks older people face while waiting in sometimes chaotic A&E units are so great that they are likely to be disproportionately represented among the 500 people a week who the RCEM estimates are dying as a direct result of delays in accessing urgent medical help.

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Source: The Guardian, 31 January 2023

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Elderly people being 'poisoned' by medication, say drug experts

Elderly patients are being “poisoned” with medication because too little is known about how different drugs interact with each other and correct dosages for older people, experts have said.

Speaking at the House of Lords’ science and technology committee hearing on healthier living in old age, Sir Munir Pirmohamed, Professor of Molecular and Clinical Pharmacology at Liverpool University, said most of his patients are on more than 10 and often more than 20 drugs.

“Those drugs are used at conventional doses and those doses have been tested in younger populations who had exclusion criteria for trials – so they have been tested in people who don’t have the multiple diseases,” he said. “So when we use a drug at a dose which is licensed at the moment, we are often ‘poisoning’ the elderly because of the dosing that we are using.”

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Source: Guardian, 29 October 2019

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Elderly patients' five-day wait in 'intolerable' A&E

Two elderly patients have been in the emergency department (ED) of the Royal Victoria Hospital (RVH) in Belfast for more than five days, BBC News NI can reveal.

This comes after more than 500 patients were unable to be discharged from Northern Ireland's hospitals on Sunday night, despite being medically fit.

With no suitable care for them in the community, it meant they remained in beds preventing other sick people from being admitted to hospital wards.

Lead nurse Claire Wilmont said that staff in the RVH were "treating the most vulnerable elderly sick patients in an intolerable environment".

At 17:00 GMT on Monday, 1,052 people were in Northern Ireland's nine EDs, up from 797 on Sunday night.

There were 349 people who had waited more than 12 hours.

The Department of Health said longer-term solutions required sustained investment and reform.

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Source: BBC News, 6 January 2025

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Elderly patient left unable to swallow after 52-hour A&E wait

An elderly man was left unable to swallow after waiting over two days in A&E without being given regular medication, and died four weeks later.

In a “shocking” case that has raised fresh concerns over the state of urgent NHS care, the 85-year-old was sent to a hospital emergency department after a routine appointment. Amid massive delays, his A&E wait went into a third day, with most of it spent on a bed in the corridor.

He had Parkinson’s disease and required medicine at various intervals to control his symptoms. During his time in A&E, the man should have received 18 doses but seven were not given and three were given late, according to a report from the Health Services Safety Investigations Body (HSSIB).

The report, which does not name the patient or hospital, highlights how the man was advised to go to A&E after complaining of back pain following a fall at home the day before.

After 52 hours in A&E, he was finally admitted to a ward where his Parkinson’s symptoms deteriorated and he lost the ability to swallow, the HSSIB said.

He died four weeks later, with the causes of death listed on the death certificate as a severe chest infection, Parkinson’s and frailty of old age.

The HSSIB report highlights how the man spent most of his time in A&E on a bed in a corridor because of demand on services. Corridor care can cause problems for emergency staff because there are “limited opportunities to store medication brought from home”, the authors said.

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Source: The Guardian, 5 November 2024

Further reading on the hub:

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Elderly fall victims having to wait six hours for ambulances dealing with Covid patients

Elderly people who suffer falls are having to wait up to six hours for an ambulance because of rising Covid pressures, a medical body has warned. 

The delays are due to paramedics having to prioritise 999 calls from people suffering from coronavirus related breathing difficulties.

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Source: The Telegraph, 1 January 2021

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Eighteen deaths following Tees health trusts' safety lapses

Eighteen people died at two Teesside hospital trusts following patient safety lapses over a 12-month period.

Sixteen such deaths were recorded at the South Tees Hospitals NHS Foundation Trust, with two at the North Tees and Hartlepool NHS Foundation Trust.

Examples of patient safety lapses include a failure to provide or monitor care, a breakdown in communication, an out-of-control infection in a hospital, insufficient staffing or a missed diagnosis.

NHS England figures show that, between April 2021 and March this year, there were 16,557 incidents at the South Tees Trust, which operates James Cook University Hospital in Middlesbrough, and Northallerton's Friarage Hospital. Thirty-four resulted in "severe" harm.

Middlesbrough MP Andy McDonald told the Local Democracy Reporting Service the figures were a concern and that he planned to take them up with the South Tees Trust's chief executive.

He said NHS staff worked under "the most demanding of conditions" but added: "Every person going into hospital rightly expects to receive the best treatment. Patient safety is paramount and no family wants to see a loved one suffer."

Dr Mike Stewart, the trust's chief medical officer, said: "We encourage an open and transparent culture and promote the reporting of all patient safety incidents, even when there is uncertainty over a direct link between any problems in care and incidents of severe harm or death.

"In the last year there were no deaths graded as definitely preventable due to a problem in the care delivered by the trust.

"While our reporting has increased consistently over the last three years, the number of serious incidents has not risen, which is strong evidence of a positive safety culture."

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Source: BBC News, 30 October 2022

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Eight-year ADHD backlog at NHS clinics revealed

It would take more than eight years for the NHS to see all adult patients waiting for ADHD assessments in many parts of the UK, a BBC investigation has found.

Through Freedom of Information requests, the BBC has identified 24 services in that position, and nearly 200,000 people waiting.

The Royal College of Psychiatrists said no-one should be made to wait years for life-changing care. The new Labour government says delays to ADHD diagnosis are part of a “broken NHS” - which it is working to fix.

The long waits have been caused by rising demand - referrals have increased fourfold since 2019 - and three trusts have closed their waiting lists completely.

The BBC found one trust, Sheffield, has a waiting list of more than 6,000 people and assessed only three patients last year. Only two providers look able to work through their backlogs in less than a year. All four governments in the UK say they are working to improve matters.

There is no official list of adult ADHD service providers in the UK, but the BBC understands there are 70. Sixty-six responded to our request for information and 44 gave the BBC enough information to calculate their backlog.

“We’re seeing more people than ever seeking support from ADHD services which are struggling to meet this demand,” the Royal College of Psychiatrists told the BBC.

NHS England says it has “launched an independent expert taskforce which will investigate the challenges facing ADHD services and help them manage the rising numbers of referrals.”

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Source: BBC News, 25 July 2024

Further reading on the hub: Long waits for ADHD diagnosis and treatment are a patient safety issue

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Eight women developed cancer after smear test misread, says report

Eight women whose smear tests were misread by screeners went on to develop cancer, a major review into cervical screening at the Southern Health Trust has found.

A further 11 women's slides were found to have pre-cancerous changes in the cells when they were reviewed and had to receive treatment.

All these women had either pre-cancerous changes to their cervix or were diagnosed with another significant gynaecological condition when their smears were reviewed.

The review was triggered when the diagnoses of three women were investigated as a Serious Adverse Incident.

Two of the women, Lynsey Courtney and Erin Harbinson, have since died.

More than 17,000 were approached to have their smear tests rechecked.

The examination of cancer screening at the Southern Health Trust over 13 years found that many women were failed after some screeners underperformed and went unchecked by management for years.

Stella McLoughlin from the campaign group Ladies with Letters described what had happened as unforgivable and called for a public inquiry.

"This has been an absolute scandal from start to finish and was allowed to go on for 10 years," she added.

"Smears being misread, people not being held to account, screeners not being managed properly - all of this is affecting real people."

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Source: BBC News, 11 December 2024

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Eight trusts win place on elective recovery project

Eight trusts have been awarded roles trialling a new accreditation scheme for surgical hubs as part of an NHS England pilot that will run until March.

The creation of up to 140 surgical hubs, sites which are ring-fenced for surgical work only, is a key plank of the NHS England and government elective recovery plan for addressing the backlog.

The full benefits are still being finalised but accredited trusts will likely get better access to additional recovery funding and central support from the Getting It Right First Time team.

The hubs will focus mainly on providing high volume, low complexity surgery, as previously recommended by the Royal College of Surgeons of England, with particular emphasis on ophthalmology, general surgery, trauma and orthopaedics (including spinal surgery), gynaecology, ear nose and throat, and urology.

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Source: HSJ, 12 January 2023

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Eight trusts now have one in 10 beds filled by covid patients

Eight hospitals have reported that at least 1 in 10 beds are now occupied by a patient with coronavirus, HSJ can reveal. 

Operational information seen by HSJ showed the 8 Trusts were, Queen Elizabeth Hospital; Gateshead, South Tyneside and Sunderland Foundation Trust, North Tees and Hartlepool Foundation Trust, Barnsley Hospital, The Rotherham Foundation Trust, Pennine Acute Hospitals Trust, across several hospitals in north Manchester, Oldham and Bury, Whittington Health Trust, and Sandwell and West Birmingham. 

Having 10 per cent or more beds occupied by Covid patients has a big impact on how the hospital is able to run due to the need to ensure the patients are in appropriate wards and isolated from patients who are negative for the virus. Compared to previous waves, current patients are much younger and healthier and have been found to have a shorter length of stay in hospital. 

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Source: HSJ, 26 July 2021

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