A&E deaths 25% higher on a Monday

New figures have revealed that the number of deaths recorded in A&E are 25% higher on a Monday compared to any other day of the week.

Between 2020 and 2023, roughly 126 individuals died every Monday in A&E, NHS England data has identified.

Meanwhile, the average number of people who died in A&E on a Saturday between 2020 and 2023 was around 90.

This is down to discharge numbers being lower at the weekend compared to during the week, as well as people avoiding going to A&E at the weekend, the review has revealed.

According to the study, there are 2,000 more people waiting in A&E for longer than 12 hours on a Monday compared to any other day.

The Government is trying to make the NHS a seven-day service, but these figures show that this plan is not yet working.

Adrian Boyle, president of the Royal College of Emergency Medicine (RCEM), stated: “Staff will be very, very busy on a Monday afternoon.

“There will also be more attendances on a Monday because GPs, who largely haven’t worked over the weekend, will find things and then patients will get referred up to the hospital.”

He added: “You feel anxious and increasingly worry about the patients who are waiting because there are so many patients.”

More than 180 “needless” A&E deaths were recorded every Monday in 2023, compared to 28 in 2020, the figures have shown.

Needless A&E deaths include people who die after waiting for more than 12 hours before seeing a healthcare professional.

NHS England data has also revealed that ambulance handovers take the longest at the beginning of the week, with an average of 4,145 hours lost to ambulances waiting outside of A&E on Mondays, compared to 2,569 hours on Saturdays.

Kathleen Booth, 91, was admitted to the Royal Stoke Hospital with a hip fracture and died while she was there.

The 91-year-old was hospitalised on a Friday but did not have an operation until the following Tuesday.

Limited care over the weekend and a surge of patients on the Monday contributed to her death, a senior coroner has reported.

His report stated: “The operation was due on Monday 12 June 2023 but was delayed until the following day due to a large amount of trauma patients in the hospital.

“The injury happened on a Friday, meaning less staff and experience were available. Patients can be disadvantaged by not receiving treatment if an injury is sustained on a Friday as cover over the weekend is limited.”

Professor Steve Black, from RCEM, said: “In 2005, analysis showed there were far fewer discharges at the weekend, leaving too few free beds on Mondays – the busiest day of the week for attendance – for A&E admissions.

“As discharges happened, more beds became free and A&E performance improved later in the week. We advised trusts to manage discharges differently to improve A&E.”

He added: “Twenty years later the same pattern exists in A&E as the advice on discharges seems to have been long forgotten.

“Overall A&E performance is hugely worse, but the daily pattern shows that hospitals have forgotten to fix the worst cause: how they manage discharges.”

Siva Anandaciva, Chief Analyst from Think Tank the King’s Fund, said: “The sharp rise in deaths on Mondays showed an A&E running constantly in the red zone.

“If you have enough capacity in the system – from beds to staff – you can flex up or down to deal with surges of demand. But if your health system doesn’t have the resources it needs to face demand, it will also feel like it is on the back foot.”

He added: “We know that A&E waiting times increase during ‘rush hour’. And these rush hours can occur because of a peak in the demand for care.

“For example, patients might not seek out services on the weekend or might not have been able to access services over the weekend, so their conditions deteriorate and they present on Monday. And for some services, when you do eventually get in on a Monday, they might refer on to A&E, so there is a ‘batch’ of patient demand that hits A&E.”