9 September 2026
Responding to the publication of the National Audit Office (NAO) report ‘Managing the flow of patients through hospital from A&E’, Dr Ian Higginson, President of the Royal College of Emergency Medicine, said:
“We welcome this useful report on flow in hospitals, and sadly its findings will come as little surprise to those working in Emergency Departments – or anyone that has been paying attention to the data over the past few years. It confirms what we’ve been saying for years.
“The system is in a state of permacrisis. Our hospitals do not work efficiently 7 days a week, and services aren’t open when they are needed. Delayed discharges – where patients who have no medical need to stay in hospital cannot be discharged, largely due to the unavailability of follow-on services – result in a log jam affect that causes overcrowding in Emergency Departments and puts lives at risk.
“Yet despite the problems largely lying at the back door of our departments and hospitals, policy makers and NHS England have consistently focused on the wrong area – the front door of emergency departments and schemes to direct patients away from it – and the wrong patients – the low acuity ‘quick wins.’
“Far too often we have seen, and argued against, resource being allocated to initiatives that would only ever facilitate temporary or marginal gains – including at the front door (which is out of scope of this report). Whilst the small improvements are commendable and a testament to the hard work of staff, they were never going to fix the problem.
“And while staffing in EDs has rightly increased to more appropriate levels to cope with demand and overcrowding, it’s the system around emergency care that needs bolstering.
“We need to see the funding, resources and workforce in wider supporting services to mirror the 24/7 availability of EDs. We need to see greater availability of community and social care services, and a focus on key patient groups such as the elderly and those with mental health problems.
“Overall, the recommendations of the NAO are very sensible, and backed by evidence. We especially support the use of tools that make the flow of patients a whole hospital problem rather than an A&E one. However, without wholesale change in the way hospitals and the wider systems work, and the way our sickest and most vulnerable patients move through and out of hospitals, the problems will remain, and patients will continue to suffer and die unnecessarily.”
-ENDS-