A new report from the National Audit Office (NAO) has found that whilst NHS England (NHSE) has targeted funding and efforts to improve Accident & Emergency (A&E) waiting times and patient flow, the growth in spending has not been matched with proportionate improvement for patients.
‘Managing the Flow of Patients through Hospital from A&E’ reports that crowding in A&E has increased in the last 14 years, making it harder for patients to flow through hospital as normal. The annual numbers of A&E attendances have increased by 6.5 million since 2011-12, and in May 2026, during any 24-hour period in England, there was an average of 2,241 patients waiting in corridors in A&E, and 669 patients waiting in corridors in hospital wards. Costs per A&E attendance have increased by a third to £280 per patient in 2024-25, compared with 2018-19.
Whilst the four-hour waiting target for 95% of patients to be discharged, transferred or admitted has not been met since 2013/14, there has been a gradual improvement since 2022/23. However, the percentage of people waiting 12 or more hours in A&E has tripled since before the pandemic.
Other factors at play
The increase in A&E resources, including the number of staff has also failed to correlate to a proportionate improvement in performance. The NAO suggests that other factors, such as bed occupancy, may be limiting progress.
In 2025/26, 14.2% of hospital stays involved a delayed discharge. NHSE estimates that delayed discharge has cost an estimated £2 billion between August 2025 and April 2026. Age UK and the Royal College of Nursing have both highlighted the negative impact on patients of delayed discharge.
Despite achieving many of the aims of its 2023 plan to improve A&E care, NHSE has evaluated that many of the desired outcomes have not materialised and is now aiming to speed up the rate of improvement by establishing a stronger system of accountability, financial incentives and placing more focus on local leadership.
Gareth Davies, Head of the NAO says: “Despite significant efforts to improve A&E performance, patients continue to experience long waits and delays in care. NHS England and DHSC need to understand more fully why improvements have been slow and ensure successful approaches are adopted more consistently across the system.
“A stronger focus on patient flow, timely discharge and patient experience will be vital to improving outcomes for patients.”
