Surgeons say rising e-bike injuries are placing heavy burden on hospitals

Surgeons at the Royal London Hospital said emergency and orthopaedic teams are treating an increasing number of serious injuries caused by electric bicycles, placing a growing burden on the unit and the wider National Health Service.

Hospital clinicians described cases involving both riders and pedestrians, including a six-year-old girl who was struck and crushed by an e-bike in a London park and required surgery to insert pins in her lower leg. The Royal London’s trauma unit recorded about 150 e-bike–related cases in the past six months, surgeons said.

Surgeon Jaison Patel, who treats lower limb injuries on the trauma ward, said the volume of cases was "a massive burden on our department" and that reducing such admissions would ease pressure on hospital resources as well as benefit patients. His colleague, consultant orthopaedic surgeon Nick Aresti, said e-bike crashes often involve higher speeds and more severe injuries than traditional bicycles, leaving patients to "struggle to get back to normality." Aresti, a cyclist himself, said the team did not want to discourage cycling but was concerned by the severity of harm associated with electrically assisted vehicles.

The child, identified by her family as Frida, was playing in a park with friends when an e-bike rider lost control and fell onto her, breaking both the tibia and fibula in her lower leg. Surgeons operated to insert pins to stabilise the fractures; hospital staff said the healing and rehabilitation process could take around a year. Frida’s father, Ed, said the rider had no paperwork and was in the UK on a tourist visa with no local contact details. He said the weight of the electrically powered bike compounded the force of the impact and called for changes to how such vehicles are regulated.

Most rentable e-bikes in the UK are legally classed as bicycles and are allowed on roads, cycle paths and in many public parks. That classification means they are not subject to the same licensing, insurance and vehicle standards as motorised vehicles. Campaigning by some families and clinicians seeks tighter rules governing where rentable e-bikes can operate, mandatory safety measures and clearer operator responsibilities.

London’s Walking and Cycling Commissioner Will Norman said local regulation of rentable electric bikes could be on the way after the government signalled that the English Devolution Bill would give cities more powers over such vehicles. "We need to ensure that the vehicles are safe, that there's parking, they're not scattered all over the place, and that the batteries are safe," he said, adding that city-level controls could improve safety for both riders and pedestrians. The bill is progressing through Parliament but has not yet been passed, and no timetable for implementation was available.

Surgeons reported the recent rise in e-bike injuries has coincided with greater use of the vehicles in urban areas, including spikes in hire and ownership during periods of public transport disruption. They said patterns seen at the Royal London — which serves a densely populated area of east London — would likely be reflected in other city hospitals treating similar injuries.

Clinicians called for action from manufacturers, rental operators and local authorities to reduce risks. Suggestions included stricter vehicle standards, clearer parking and parking enforcement, speed-limiting technology, and measures to ensure riders are traceable in the event of collisions. Hospital staff said those changes would help prevent injuries, reduce long recovery times for patients and relieve pressure on emergency and orthopaedic services.

Police and local authorities have not issued new, nationwide rules on e-bike use, and the legal status of many rentable e-bikes remains that of a conventional bicycle. Hospital specialists said they would continue to collect data on injury patterns and work with public health and transport officials to inform any forthcoming regulation that aims to balance the benefits of cycling with pedestrian safety and public health concerns.