11 December 2025
The Royal College of Emergency Medicine (RCEM) is warning that fractional improvements to some “dismal” A&E performance metrics should not mask the “worryingly high” number of people waiting for over 12 hours on trolleys.
RCEM is calling for urgent action after the latest Emergency Department (ED) performance figures published by NHS England for November 2025 showed that 12-hour ‘trolley waits’ at their highest-ever levels for the month of November – a warning of what lies ahead in the depths of winter.
In November, 50,468 people waited 12 hours or more after the decision to admit them to hospital was made. These stays are referred to as ‘trolley waits’.
However, the definition only relates to the time the patient stays in the ED after it was decided they needed inpatient care – it does not include any time a person may have waited before that.
President of the Royal College of Emergency Medicine, Dr Ian Higginson, said:
“While it is always welcome to see any performance graphs that were going in the wrong direction stop plummeting, there is still significant cause for concern about the state of our Emergency Departments as winter kicks in, and what lies ahead for our patients. I would be cautious about reading too much into any individual set of data given what we know is the state of our departments. The baseline is still awful.
“The number of people waiting for admission on trolleys is worryingly high as winter gets fully underway, with patients being treated in corridors and other inappropriate places. This is both dangerous and undignified.
“We cannot let this situation worsen, especially with the recent rise in flu cases, as we brace ourselves for the pressures and challenges the worst of this cold weather will bring on our nation’s health. But flu is not the cause of these deep-rooted problems – lack of capacity is.
“We must face up to the intense demands this winter will make on our amazing ED staff, who will always continue to do their best for patients in these very difficult days.
“Hospitals must do all they can to ensure all critical services – especially those relating to flow or discharge – work beyond the standard 9-5 Mondays to Fridays. This would mean that patients have a better chance of being admitted to a bed when they need it, or a better chance of being discharged when they are ready to leave hospital.
“And, while the government’s commitment to ending corridor care by 2029 is very welcome, we need to see a short-term plan and resources to mitigate the situation.
“This data comes in the same week that a study from the Trainee Emergency Research Network (TERN) found that one in five patients now experience corridor care, and we know that last year there were over 16,600 patient deaths associated with long waits. We cannot wait for 2029 to tackle this.”
Notes to editors
The NHS England performance figures data, covering November 2025, also show:
- At major EDs, 60.3% of patients were seen, treated and discharged within four hours – an increase of 0.2 percentage points from previous month and an increase of 3.3 percentage points from November 2024.
- Attendances at Type-1 departments stood at 1,448,958, a decrease of 32,264 from last month but an increase of 20,908 from November 2024.
- In major EDs, 12-hour waits from time of arrival have decreased by 17,384 from the previous month, and by 3,200 compared to November 2024 (150,696).
- On any given day in November 2025, 13,179 bed days were lost due to patients remaining in hospital who were medically fit to leave. This is an increase of 62 bed days from the previous month, and an increase of 749 beds from November 2024, making it the second worst November on record.
- 50,648 attendances waited over 12 hours on a trolley following a decision to admit. This is the worst November on record for 12-hour trolley waits.
- NHS Sitrep data for the week commencing 1 December showed that bed occupancy at type 1 emergency departments was 94.5% – well above the recommended 85% level for hospitals to operate effectively.
The full data set for November 2025 can be found here: Statistics » A&E Attendances and Emergency Admissions
Winter Sitrep data can be found here: Statistics » Urgent and Emergency Care Daily Situation Reports 2025-26