England’s E.R. Crisis May Be Causing Hundreds Of Deaths A Week: Analysis

Ambulances in a queue outside the Royal London Hospital in January 2021. (Photo by Vuk Valcic/SOPA … [+] Images/LightRocket via Getty Images)

SOPA Images/LightRocket via Getty Images

Fresh analysis from the Financial Times has shone a light on the possible consequences of England’s emergency care crisis.

An article from chief data reporter John Burn-Murdoch suggests up to 500 deaths a week could be linked to this “collapse” in emergency healthcare.

Serious problems with the flow of patients in and out of hospitals has been causing massive ambulance and emergency room delays for months.

Burn-Murdoch argued these could be behind a rise in excess deaths in England reported by the Office of National Statistics in recent months.

Although many countries have reported increases in excess deaths over a similar period of time, results from England stood out when adjusted for age.

Natural demographic shifts such as an ageing population can cause fluctuations in rates of excess deaths. But in these places, something else seemed to be happening.

Taking into account cause of death from another government dataset, Burn-Murdoch subtracted covid mortality from his results. Diving deeper into into the data, he was able to show deaths from a wide range of causes were higher than expected.

“The increases in deaths across cardiovascular, liver and urinary diseases, diabetes and beyond suggests that rather than a single specific condition being exacerbated by e.g. prior Covid infection, we’re looking at a more broad-based mechanism here…” he wrote on Twitter.

This is where the emergency room comes into the picture. Recently-leaked data on E.R. waits show, for example, that 100,000 people waited more than 12 hours in England’s accident and emergency departments in July.

By subtracting pre-pandemic waits from these figures, Burn-Jones calculated “excess long waits” figures for the last year.

He then used a 2021 academic study on the correlation between emergency room waits and all-cause mortality to work out the possible contribution of long waits to excess death.

The study found that patients waiting 8-12 hours in A&Es had a 16% higher chance of dying over the next month than the general population.

When applied to recent emergency room data, Burn-Jones was able to estimate delays were linked to “as many as 500 non-Covid excess deaths every week in England.”

Other data, he added in a detailed Twitter thread, show more markers of the emergency crisis follow similar patterns to England’s recent levels of excess non-covid deaths

“The peaks in ambulance-related harms broadly coincide with peaks in England’s non-Covid excess mortality,” he wrote, adding that the data showed “a grim picture, and an increasingly conclusive one.”

Further analysis probing the possible causes of the crisis mirrored the concerns hospital bosses have been raising for months: that patient flow in and out of hospitals was contributing to major delays in emergency care.

Numerous factors, from a lack of adequate social care to outdated IT systems, are likely causing delays to discharge.

As Forbes has described before, these delays limit the amount of beds available for emergency patients, causing delays to admission and treatment, resulting in slow ambulance handovers and vehicles stuck waiting outside hospitals for space to open up.

Burn-Murdoch’s analysis is available in full on the FT website, or in bitesize form in a comprehensive Twitter thread.

Life Sciences, Forbes – Healthcare

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