Health
Emergency departments are not failing: they are absorbing whole system failure
Key Points
The BMJ’s report that 13 386 patients waited over three days in England’s emergency departments in 2025 should not be framed as simply an “A&E crisis.”1 Emergency departments are where the failure becomes visible, but they are not where the failure begins. The problem is structural.
The BMJ’s report that 13 386 patients waited over three days in England’s emergency departments in 2025 should not be framed as simply an “A&E crisis.”1 Emergency departments are where the failure becomes visible, but they are not where the failure begins.The problem is structural. The King’s Fund reports that attendances at type 1 emergency departments rose by 15% over the past decade, reaching 16.8 million in 2024-25, and emergency admissions to major departments rose by 34% over a similar period.2 But bed capacity has not expanded in proportion. Emergency departments are therefore being asked to absorb demand created by inadequate flow, delayed discharge, limited staffed beds, and underpowered social care.Corridor care is the predictable result. The Royal College of Emergency Medicine’s 2025 work found that 19% of patients in sampled type 1 emergency departments were cared for on trolleys or chairs in corridors, and 34.5% of departments reported patients...