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The estimated number of deaths linked to long waits in Emergency Departments across England has surged almost tenfold over the past decade.  That’s according to new analysis published in the Royal College of Emergency Medicine’s (RCEM) ‘State of Emergency Medicine in England’ report, which conservatively estimates that there were 15,860 excess deaths associated with long waiting times in English EDs in 2025.  That’s the lives of 305 people lost every week.  While the number of deaths is slightly lower than 2024 (16,644), further analysis reveals that the estimated mortality figure increased almost tenfold when compared to 2015 (1,657). RCEM’s report examines the scale of overcrowding in EDs and the impact this is having on patient safety and staff. Drawing on national data, research and frontline evidence from clinicians, it highlights how long waits, high bed occupancy and a lack of patient flow continue to lead to overcrowded emergency departments.  Long waits are closely linked to an increased chance of death within the following 30 days.   Further analysis for the previous year concerningly reveals nearly half a million people (489,138) waited 24 hours or more in EDs across England. This has increased by around 150,000 patients in just 3 years.  

On 30 July 2025 an investigation was commenced into the death of Pamela Ann Honeybone, who died at Scarborough General Hospital on 19 October 2024 aged 90. The investigation concluded at the end of the inquest on 23 September 2025.  The conclusion of the inquest was that: Pamela Ann Honeybone died as a consequence of naturally occurring disease. Diagnosis of her condition was delayed when another patient was scanned in error instead of Mrs Honeybone, but it has not been possible to determine on the balance of probabilities that this contributed to her death.  On the 19 of September 2024 Pamela Ann Honeybone was admitted to Scarborough General Hospital following a fall. She required CT scanning but another patient with the same first name underwent the investigation in error and its results were attributed to Mrs Honeybone. Mrs Honeybone’s condition continued to deteriorate and a CT scan undertaken on the 15 of October 2024 revealed the presence of an abdominal mass suggestive of lymphoma. Mrs Honeybone was moved to end of life care and she died at the hospital on the 19 of October 2024. Matters of concern: It was accepted in evidence that neither the doctor who escorted the wrong patient from the Emergency Department to radiology, nor the radiographer who undertook the CT scan on her, checked the identity of the patient in question. No transfer checklist was completed, and the patient was not asked to complete and/or sign the CT scanning questionnaire herself. No member of staff inquired as to the outcome of this patient’s CT scan prior to her discharge a few hours later. The scanning error was recognised by a radiologist on the 15th of October 2024, but was not conveyed to Mrs Honeybone’s treating team until late October, by which time she had died and her death had been scrutinised by the Medical Examiner and certified by her treating doctor as wholly natural and not requiring referral to the Coroner. As a result of the aforementioned delay, a Trust investigation did not commence until late November 2024. No prompt after action review therefore occurred in the hours and days after the error was recognised. When the Trust investigation did commence, staff directly involved either could not be identified or had no recollection of events. Despite hearing evidence that it was a doctor who would have escorted the wrong patient to scanning, the Trust Investigation focussed on nursing involvement with the patients in question and did not seek to identify and question medical team members. An Action Plan was drawn up as a result of the Trust Investigation, but for various reasons no audit of compliance with patient identification processes commenced until early August 2025, some ten months after Mrs Honeybone’s death. The results of the audit thus far were made available to me at inquest and indicate that 1 in 5 audited treatment encounters between staff of all grades and specialisms still occur without the patient being positively identified. The coroner heard evidence that while radiology transfer checklists are routinely completed ‘in hours’ at Scarborough Hospital when a dedicated HCA is on duty to perform this task, no such checklist is in use at the Trust’s York site at any time of the day. Mrs Honeybone’s misidentification occurred ‘out of hours’ at Scarborough when no designated person assumes responsibility for this task at that site. The coroner considers the above represent a continuing risk to others from misidentification and delayed responses to identified errors, with clear implications for patient safety.

There are huge pressures facing prison health services. This new report from the Nuffield Trust is the first to offer an in-depth assessment of A&E use by people in prison and adds to mounting evidence that health care is harder for prisoners to access. It finds a higher-than-expected number of A&E attendances by prisoners due to paracetamol overdose, seizures, and acute coronary syndrome, with opportunities for targeted intervention in these areas to avoid health crises.

This Health Services Safety Investigations Body (HSSIB) report is intended for healthcare organisations, policymakers and the public to help improve patient safety in relation to safety issues identified for people experiencing a mental health crisis who come into contact with urgent and emergency care services. This report focuses on the significant legal, policy and safety gap in the care of people in emergency departments (EDs) in mental health crisis. During consultation on this report, concerns were shared with HSSIB about the current challenges in relation to the resourcing and configuration of mental health services that exacerbate challenges faced in the ED. This is the first of two reports. In October 2025 HSSIB launched two investigations that explore the safety issues for people experiencing a mental health crisis who come into contact with urgent and emergency care services. This interim report was produced due to the early identification of a significant legal, policy and safety gap in the care of people in emergency departments (EDs) in mental health crisis. It is reported that around 3% of all ED attendances are mental health related. However, people experiencing mental health problems are twice as likely as other patients to remain in the ED for more than 12 hours. People in mental health crisis may need to be assessed for admission to a mental health hospital in line with the Mental Health Act 1983. Delays in these assessments being undertaken, and/or the lack of availability of mental health inpatient beds once a person has been recommended for admission, can lead to patients remaining in EDs for prolonged periods. Findings There is an absence of clear legal powers to lawfully prevent vulnerable individuals from leaving the ED while awaiting assessment or admission. This legal ambiguity exposes patients to increased risk of harm and/or being unlawfully deprived of their liberty, and places staff in a position of uncertainty when attempting to manage safety. For those requiring formal admission to a mental health hospital, an application under the Mental Health Act 1983 cannot be completed until a bed has been identified, which can take days. Staff and organisations reported they are often faced with choosing “the least harmful way to break the law” in order to try and keep patients safe. EDs are not designed to provide therapeutic mental health care and prolonged stays may worsen patients’ conditions and create challenges in maintaining a safe environment for everyone. HSSIB makes the following safety recommendations: HSSIB recommends that the Department of Health and Social Care urgently reviews the current legal framework and addresses the current legislative gaps in emergency care for people in mental health crisis and clarify the extension of legal powers for health professionals to hold someone in the emergency department. This will safeguard people who are currently arriving at the emergency department in a mental health crisis and the staff who care for them to support safe, consistent and legally compliant care. HSSIB recommends that the Care Quality Commission works with stakeholders to produce a position statement on existing legal powers, and the expectations for support for staff, for the care of people experiencing a mental health crisis in emergency departments (including mental health emergency departments and mental health crisis assessment services), who are not detained under a formal legal framework. This should include a review of current guidance and existing powers to help support safe, consistent, and legally compliant care in the absence of comprehensive legislation, while minimising harm and addressing the unique challenges of prolonged stays in the emergency department.

The NHS has seen a 6 percentage point increase in public satisfaction, the first rise since 2019, according to the latest findings from the gold-standard survey of public attitudes to the NHS and social care, analysed by the Nuffield Trust and The King’s Fund and surveyed by NatCen. Key findings Satisfaction with the NHS In 2025, 26% of British adults were ‘very’ or ‘quite’ satisfied with the way in which the NHS runs – a statistically significant 6 percentage point increase from 2024. Around half of respondents (51%) were dissatisfied with the NHS in 2025, a statistically significant fall of 8 percentage points compared to 2024 when it was 59%. This is the first increase in satisfaction since 2019, and the largest fall in dissatisfaction in more than 25 years. People under 35 (20%), supporters of Reform (20%) and people in Wales (18%) were significantly less satisfied with the NHS than the survey average. Despite the increase in satisfaction only 16% of respondents thought the standard of NHS care would improve in the next 5 years compared to 53% who said they expected care to get worse. Satisfaction with different NHS services Satisfaction with GP services was 35% and dissatisfaction was 45%. Neither was a statistically significant change on the previous year. Just over 1 in 5 respondents (22%) said they were satisfied with NHS dentistry, with 54% saying they were dissatisfied. These are similar results to the previous year. 22% of respondents said they were satisfied with A&E services. Dissatisfaction was 53%. In 2024, 19% said they were satisfied with A&E services, although the change is not statistically significant. 37% of respondents were satisfied with inpatient and outpatient hospital care, an increase of 5 percentage points since 2024, although not statistically significant. 29% were dissatisfied – no change on last year. Attitudes to NHS standards, access and staffing Half of respondents (50%) were satisfied with the quality of NHS care in 2025, and 28% were dissatisfied. There was no statistically significant change since 2024. Only a minority of respondents were satisfied with waiting times for GP appointments (27%), hospital appointments (16%) and in A&E (14%). There were no statistically significant changes compared to last year. Only 12% agreed that ‘there are enough staff in the NHS these days’. 71% disagreed. There was no significant change compared to 2024. Attitudes to NHS financing and efficiency 9% of respondents said that the government spent too much or far too much money on the NHS, 22% said that it spent about the right amount and 66% said that it spent too little or far too little. There were no statistically significant changes compared to 2024. Only 13% of respondents agreed that the NHS spends the money it has efficiently. 55% disagreed with this statement. There was no change compared to 2024. When asked about government choices on tax and spending on the NHS, the public remain closely divided between raising taxes and spending more on the NHS (45%) and keeping taxation and spending at the same level (43%). Only 8% would choose to cut taxes and spend less on the NHS. There was no statistically significant change since 2024. Supporters of the Green party (70%) and the Labour party (57%) were significantly more likely to support higher taxes and higher NHS spending than supporters of Reform (32%) and the Conservative party (30%). NHS priorities and principles On being asked what the top three most important priorities for the NHS should be, both making it easier to get a GP appointment and improving A&E waiting times were selected as top priorities by 46% of respondents, followed by 45% for waiting times for planned operations and 43% for increasing the number of NHS staff. People aged 18–64 were more likely than those aged 65 and over to prioritise A&E waiting times (48% vs 38%) and increasing NHS staff (46% vs 35%) whereas those aged 65 and over prioritised prevention and staying healthy (48% vs 36%). As in previous years, a large majority of respondents agreed that the founding principles of the NHS should ‘definitely’ or ‘probably’ apply in 2025: that the NHS should be free of charge when you need to use it (89%), the NHS should primarily be funded through taxes (81%) and the NHS should be available to everyone (74%). There has been some decrease across the past five years in the proportion who think these principles should ‘definitely’ or ‘probably’ apply since the questions were first asked in 2021. The greatest decrease over time has been support for the principle that ‘the NHS should be available to everyone’. Support for the principle that the NHS should be available to everyone varied significantly by supporters of different political parties, with 68% of Labour supporters agreeing this principle should ‘definitely’ apply compared to 45% of Conservative supporters and 30% of Reform supporters. Social care In 2025, 14% of respondents said they were satisfied with social care. 49% were dissatisfied with social care – a statistically significant decrease from 2024 when this figure was 53%. The top three priorities for social care were helping people stay independent at home for as long as possible (46%), making social care more affordable to those who need it (45%) and improving the quality of social care services (44%). When asked about government choices on tax and spending on social care, 51% said the government should keep taxes and spending on social care at the same level as now. 38% said the government should increase taxes and spend more on social care. 6% said the government should reduce taxes and spend less on social care. Support for increasing taxes and spending more on social care was lower than for the NHS – it was 45% for the NHS. The difference was statistically significant.

Terrence Frost’s death was verified at 00:26 on 18 July 2024, at the Ipswich Hospital, in Ipswich, Suffolk, although Terrence’s death had occurred earlier at approximately 22:20 on 17th July 2024. On the 11 July 2024 Terrence was admitted to the Ipswich Hospital for an elective surgery (angioplasty) to improve the blood flow to his left leg and foot. Terrence was discharged on the following day 12 July 2024. On the 14 July 2024 Terrence was admitted again to the Ipswich Hospital with abdominal pain and rectal bleeding. No diagnosis was made, and as this settled spontaneously, Terrence was discharged again on the 15 July 2024. On the 16 July 2024, due to concerns raised by his family, a GP’s Paramedic conducted a home visit, and following subsequent concerning blood test results Terrence was told to go back to Ipswich Hospital as a failed discharge. After a prolonged period in the Accident and Emergency department Terrence was readmitted to the Ipswich Hospital. Despite testing, no definitive diagnosis was made during Terrence’s final admission, and Terrence appeared reasonably stable until he suffered a sudden collapse and cardiac arrest at 21:22 on the 17th July 2024. A subsequent postmortem examination identified that Terrence suffered from significant cardiac disease (cardiomegaly and coronary artery disease) and significant vascular disease (systemic atherosclerosis). The pathologist identified that his clinical markers identified that sepsis played a factor in Terrence’s death, although evidence of any infection could not be found. MATTERS OF CONCERN Evidence was heard that prior to his attendance in the Accident and Emergency department on the 16 July 2024, Terrence had been seen at home by a paramedic from his surgery, who was concerned by Terrence’s presentation and wanted to admit him to hospital. However, Terrence was reluctant so it was agreed that urgent blood tests would be taken in the first instance. The results of these tests were seen by a GP, and due to the findings (which indicated a possible serious infection or inflammation) the GP called Terrence and told him to go straight to hospital, and whilst enroute she would speak to the Medical Assessment Unit. In evidence the GP said she then spent 30 minutes on the telephone trying to contact the Medical Assessment Unit as is the required procedure, to discuss Terrence’s admission. After being unable to contact the Medical Assessment Unit, the GP contacted Terrence, via a family member, and told him that as she could not contact the Medical Assessment Unit he should head to the Accident and Emergency department instead. The GP told Terrence she would pre- alert the Accident and Emergency department to his arrival. The GP then spent a further period of time telephoning the Accident and Emergency department but again could not get through. As such upon arrival, a patient who was considered by their GP to be significantly unwell enough to warrant either admission to the Medical Assessment Unit, or that Accident and Emergency should be pre-alerted to their arrival, was unable to speak to either unit prior to the patient’s arrival. Terrence endured a 5 hour wait in Accident and Emergency before being seen. Although observations taken at the time of his subsequent admission suggest he had not developed sepsis at this stage, I am concerned that the inability of a GP to be able to promptly communicate with either the Medical Assessment Unit or Accident and Emergency department may lead to future deaths in cases where suspected sepsis or other life threatening conditions have been differentially diagnosed, especially if those conditions have progressed further than Terrence’s had at the time of his arrival. I am further concerned that evidence was heard from a clinician based at the Ipswich Hospital itself, that they too found contacting the Medical Assessment Unit extremely difficult, with internal hospital telephone calls frequently going unanswered.