Hospitals in England are facing dangerous overcrowding this winter as even more patients are “stuck” in beds than last year, according to an analysis of NHS data.
The findings come as the health service struggles to cope with the early onset of the usual winter crisis caused by… paralyzing “flu” NHS England is preparing for a five-day strike by resident doctors starting on Wednesday.
Hospitals will have fewer beds than usual this winter because “deferred discharges” – beds occupied by people who are medically ready to leave but have nowhere else to go – are even worse ahead of the cold season than they were last year, according to a study Health Found the fund.
Senior doctors and National Health Service Leaders said the bed shortage identified by the think tank would further complicate an already “truly shocking” situation for hospitals this winter. They say it will lead to queues in ambulances outside emergency departments, long waits for patients to be seen, widespread “hallway care”, increased spread of the flu virus – and an even greater risk of death for seriously ill patients due to delays in finding them a bed.
The Health Foundation analyzed delays in hospital discharges England from July to September last year and the same period this year. It was found that:
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The percentage of bed days used by patients whose discharge was delayed rose from 10.1% in 2024 to 11% this year, an increase of 9% or 19,000 bed days.
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This growth was driven by an 8% year-on-year increase in discharges, equivalent to approximately 3,800 patients per month.
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The total number of NHS beds of around 100,000 general and acute beds occupied by delayed discharge patients last winter peaked at 14%, but is likely to be even higher this winter.
“Winter has already begun, but the NHS is already under severe strain from an unprecedented surge in flu cases for this time of year,” said Francesca Cavallaro, senior analytics manager at the fund, which carried out the analysis.
“The growing pressure is compounded by a growing number of patients stuck in hospital beds despite being medically fit for discharge compared to last year.
“Our new analysis shows that 19,000 more bed days were lost due to delays in discharging patients in July-September compared to the same period last year. These delays are harming patients and increasing pressure on overstretched emergency departments.
“Last winter saw record numbers of patients wait 12 hours or more in emergency departments, so this suggests this winter could be even more debilitating than the last.”
The failure of cash-strapped local councils to provide the right social care package for patients who are medically likely to leave hospital is a key reason for the rising number of delayed discharges, but doctors and NHS chiefs say an aging population and advances in medical science that are allowing people to live longer are also important factors.
Society of Emergency Medicine president Dr Vicky Price said a chronic shortage of beds would lead to patient deaths this winter. The Royal College of Emergency Medicine estimates that 16,600 people died preventably last winter due to delays in getting emergency care or a bed.
“These results are consistent with our clinical experience and, if anything, underestimate the problem,” Price said. “This is a complex problem that has been escalating for years, increasing the burden both in hospitals and in the community.”
A record number of older adults and breakthroughs in treatments that extend life have increased the overall need for care, she said.
She said NHS England's ability to withstand winter pressures was also compromised by a cost-cutting “reset” of the service's finances for 2025-26 ordered by its chief executive Sir Jim McKee.
“Many hospitals have reduced their number of beds to cope with the financial pressure they are under.
“It was predictable that any additional stress would cause this effect. This is an extremely serious situation. For patients who end up in the emergency department, there is significant mortality associated with this,” she said.
Delayed discharge costs NHS England around £200 million a month, or around £2 billion a year. According to Health Service Journal estimates in October. This is a small increase on the £1.7bn The Royal Fund's health think tank has calculated the cost will be in 2023.
McKee recently predicted that up to 8,000 of the 100,000 NHS beds could soon be filled with flu patients given the severity of the outbreak.
Rory Deighton, director of acute and community care at the NHS Confederation, which represents NHS trusts, said: “Given the ever-increasing demand the NHS has seen over the last few years – often from older patients or those with more complex conditions – it is unfortunately unsurprising that this analysis highlights the ongoing impact of delayed discharge on services.
“Discharge delays are a long-standing problem for the NHS and could add to winter pressure.
“The lack of social and community care can often lead to delays in medically healthy patients being discharged from hospital, which in turn can create bottlenecks in the A&E system, resulting in longer ambulance handovers and emergency department waits.”
Hospital bosses were also “very concerned that the upcoming resident doctors' strikes would put even more pressure on the NHS and could jeopardize patient safety”, he said.
The Department of Health and Social Care has been contacted for a response.
