A&E: The number of deaths after waiting four hours has increased by 164 percent

Figures released under Freedom of Information show that last year at least 743 people died within 24 hours of waiting for more than four hours in the emergency room.

In 2018 there were still 281.

However, the actual figures will be higher as a number of major health authorities – including Grampian, Lanarkshire, Highland and Ayrshire and Arran – were unable to provide data. NHS Greater Glasgow and Clyde did not respond.

The motions were tabled by the Scottish Conservatives.

READ MORE: ER delays and excess deaths – is this the new normal?

Overall, the responses show that between 2018 and 2022, nearly 2,000 patients died after spending more than four hours in the emergency room.

More than half of those deaths – 1,181 – occurred in NHS Lothian, which is home to some of Scotland’s busiest emergency departments.

These cases include patients who have died in the emergency room after already waiting more than four hours, as well as patients who have died on hospital wards or in the community up to 24 hours after being in the emergency room for more than four hours.

The deaths weren’t necessarily preventable, but research shows that delays in the emergency department are associated with an increased risk of dying within 30 days.


Research from the Royal College of Emergency Medicine (RCEM) has previously estimated that there will be 765 additional deaths in Scotland in 2022 due to eight to 12 hour waits in the emergency department.

The four-hour goal calls for 95% of people who visit the emergency room to be seen, treated, and then discharged, admitted to a ward, or transferred to another hospital within four hours, but the latest stats — for June 2023 – showing that this was achieved for only 72.6% of visitors.

Bottlenecks have increased over the past five years.

READ MORE: The truth about A&E comparisons between Scotland and England

HeraldScotland: The percentage of patients treated within four hours has fallen sharply since 2021The proportion of patients treated with four hours has fallen sharply since 2021 (Image: PHS)

In June 2018 there were 146,639 patients in emergency departments in Scotland, of whom 10,547 people (7%) waited more than four hours and 115 stayed in the department for more than 12 hours.

In June of this year, attendance was lower – 137,138 – but 37,546 of the people (27%) spent more than four hours in the emergency room and 3,028 more than 12 hours.

The main cause of delays is the lack of available beds in the infirmaries, resulting in patients being stuck in the ER who need to be admitted for treatment.

The situation has been exacerbated in part by a lack of social care in the community, meaning patients willing to be discharged home are “blocking” beds that might otherwise become vacant.


However, the FOI data also suggest that the number of patients who actually died increased during this time In A&E departments appear to be roughly flat or falling.

In NHS Lothian, the total number of patients who died in emergency departments – regardless of how long they were there – fell from 233 in 2018 to 94 in 2022.

In the Forth Valley, emergency department deaths remained stable at 121 in 2018 and 126 in 2022.

READ MORE: Scotland’s overcrowded emergency departments ‘like Russian roulette’

Sandesh Gulhane, health spokesman for the Scottish Conservatives, said the NHS was “permanently overwhelmed”.

He said: “Drastic staffing by several SNP Health Ministers has had a devastating impact on the Scottish public health system and, despite the best efforts of my dedicated frontline colleagues, our Emergency Departments are bearing the brunt of these omissions.”


dr John-Paul Loughrey, RCEM Vice-President for Scotland, said: “While it would be wrong to conclude that all of these people died directly from the wait, long stays and extreme delays have been shown to be associated with increased mortality.”

“Deaths from excessive wait times are the very human cost of overcrowded emergency rooms staffed by dedicated but overworked physicians who are dealing with the impact of working in such difficult circumstances.”

READ MORE: Tayside and Forth Valley – Why are their A&E performances so far apart?

A Scottish Government spokesman said performance against the four-hour A&E target improved for the third straight month in June.

He added, “We fully recognize that longer ED wait times are detrimental to patient outcomes, so we continue to strive to improve ED performance.”

“The performance against the four-hour target has stabilized.

“However, we know that performance is still not where it needs to be, and we are working closely with health authorities who face the greatest challenges in the emergency department to reduce wait times and improve services to patients and staff.” to improve.”

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