More than 800 deaths linked to long A&E waits in Scotland, RCEM says

Scotland’s emergency departments faced longer waits in 2024, a rise that the Royal College of Emergency Medicine (RCEM) ties to more than 800 deaths last year. In a manifesto released ahead of the Scottish Parliament elections, the RCEM estimated 818 excess deaths were linked to patients waiting more than 12 hours before being admitted to a ward, using a standard mortality ratio that equates one death for roughly every 72 patients who waited 8–12 hours.

The RCEM said 76,510 people waited more than 12 hours, up 26% from the previous year, with 58,906 of them waiting to be admitted to a bed on a ward. Health Secretary Neil Gray acknowledged the link between long A&E waits and increased risk of harm and said the government is investing £200 million to reduce wait times.

This year, the RCEM also reported that between 1 June and 31 July, about one in 24 people (9,881) waited 12 hours or more in A&E. The figures accompany the RCEM manifesto, which calls for ending A&E overcrowding by boosting social care and ensuring staffing levels are adequate, while focusing on reducing the 12-hour wait and meeting the four-hour target.

"Behind this statistic are stories of heartbreak. Because these are people," Dr Fiona Hunter, a senior emergency medicine consultant, said. "Mums, dads, brothers, sisters, grandparents — their deaths shattering the lives of families and friends. They are patients who are sick and need further care on a ward, and they are forced to endure extreme wait times for an inpatient bed to become available for them. It doesn’t have to be this way — the crisis is fixable and it comes down to patient flow in hospitals — getting people out of ED and into a ward bed and out of hospital when they are well enough to go home."

The RCEM’s manifesto also highlights the need for social care investment to relieve pressure on hospitals and stresses that attention to 12-hour waits must be paired with progress toward the four-hour target, along with ensuring staffing levels capable of managing patient demand.

Health Secretary Neil Gray said the government has made progress on recent A&E figures and that the £200 million investment will support specialist frailty teams in every core A&E. He stressed that the link between long waits and harm is real and said the focus is shifting from acute care to community-based care where appropriate, aiming to improve outcomes and reduce hospital stay lengths.

Reaction to the RCEM’s findings was swift from opposition parties. Scottish Conservative health spokesman Dr Sandesh Gulhane described the situation as a national emergency and said ministers should “hang their heads in shame” over preventable deaths. He noted frontline staff were working hard but argued that a credible plan from government remains elusive.

Scottish Labour’s deputy leader, Jackie Baillie, said Scots have been dying due to dangerously long waits and accused the SNP of inaction. The Liberal Democrat’s Alex Cole-Hamilton lamented ongoing excruciating waits and pointed to a revolving door of health secretaries that has failed to dent the problem.

The RCEM’s manifesto and the new figures intensify scrutiny of Holyrood’s approach to urgent care, as policymakers balance investments in acute services with reforms aimed at reducing crowding and improving patient flow. Advocates say timely access to care and robust social and community services are essential to stabilizing A&E performance, while critics contend that broader system-wide changes are needed to prevent this crisis from recurring.