England's A&E departments are struggling under the weight of record demand and sluggish reform. A damning new report from the National Audit Office (NAO) reveals that in 2025, 1.2 million patients waited between 12 and 24 hours in emergency departments, and another 500,000 waited more than 24 hours — a direct violation of NHS England's own "red-line safety standard" of zero tolerance for waits exceeding a day.

The NAO found that A&Es have become "markedly more crowded" over the past 14 years, and that despite "significant investment," improvements have been "smaller and slower than hoped." Experts point to delayed discharges, lack of available beds, and insufficient community care as the root causes of the logjam. The government has pledged £450 million to improve urgent and emergency care and is expanding urgent care centres and mental health A&Es.

By the Numbers:

• 1.2 million patients waited 12–24 hours in A&E in 2025
• 500,000 patients waited more than 24 hours
• 3% of A&E attendees waited 24+ hours in both 2024/25 and 2025/26
• Patients waiting 12+ hours are twice as likely to die within 30 days vs. those waiting 2 hours
• Only 74.9% of patients met the 4-hour discharge/transfer/admission target in 2025/26 (vs. the 95% goal)

Why it matters: Long A&E waits aren't just an inconvenience — they're a patient safety crisis. With mortality risk doubling for those waiting 12+ hours, the NHS's failure to hit its own safety benchmarks has real, life-or-death consequences for millions of patients.