A predictable spike in demand for Emergency Departments in January has exposed the fragility of the entire hospital system, and reinforced the critical need for a long-term and sustainable plan for tackling the A&E crisis.
That’s the key message from the Royal College of Emergency Medicine (RCEM) has said following the publication of NHS England’s latest performance stats for January 2026, and situation report data for the week ending 8 February.
Today’s data showed that more than one in seven patients who attended a major ED in England last month were subject to a wait of more than 12 hours to be discharged, admitted or transferred: a total of 192,168 people.
This is the second-worst month for 12-hour waits in EDs on record.
The proportion of patients waiting less than four hours remained about the same as the previous January, from 57.7% to 57.3%.
A total of 71,517 of the sickest patients – those who were waiting for admission into a hospital bed – waited on trolleys in an ED for more than 12-hours after a decision to admit was made. That is the worst of any month on record.
Meanwhile, the average number of beds occupied by patients who were medically fit to be discharged stood at 13,823 across England, the second-highest of any month on record.
These figures are set against a backdrop of a significant increase in attendances at type-1 EDs compared to last January, with the number having risen by 76,701 to 1,435,727.
Dr Ian Higginson, RCEM President, said: “All of last year, and long before, we have demanded action to ensure our hospital system is ready for when demand for Emergency Departments would spike.
“This did not happen, we found ourselves in a particularly busy winter and now the wheels have come off.
“Demand spikes in the colder months; it always does. It cannot, should not, be the case that we have to pray for a quiet January for fear the system won’t cope. We should simply plan for a normal one.
“Today’s figures show this is exactly what happened. Almost 200,000 patients waiting more than 12 hours in a major A&E before they are moved on, with no beds available because hospitals are full. reluctant to grasp the nettle on the A&E crisis and tackle the root causes.
“The result is a month like this, where my colleagues and I arrive to our hospitals to begin a shift, only to see dozens of elderly and vulnerable people on trolleys lining the corridors, and our staff looking exhausted by it all.
“It’s a problem of priorities. Yes, it is great that the waiting lists for surgery are going down. Of course, we welcome these improvements. But our patients are just as important.
“Research published this week showed that focusing on overcrowding EDs could save lives, save beds, and save money. It’s so frustrating that this isn’t given the level of attention it deserves.
“Emptying our hospitals before Christmas helped – but wasn’t sustained. Imposition of procedures to rapidly handover patients from ambulances into full EDs can help get those ambulances back on the road, but may increase the problem of corridor care and doesn’t solve the underlying problem.
“We need to end short-termism and move get a sustainable, long-term, plan in place for addressing the real driver of long ED waits: the lack of access to beds.
“This week’s ‘Model ED’ document showed the government wants to improve the system, but I fear that by focusing too heavily on the front door, there is insufficient focus on where the material change could take place within our hospitals, and within the systems that support patients when they are able to leave.”
