[cirrus-clouds]

This twitter thread is excellent. Here are selected tweets to highlight the crisis from hospital and ambulance waiting times.

---

"England & Wales as the only part of Europe that has recorded sustained and rising excess mortality over the last few months with no obvious natural explanation."

"Patients who waited 8-12 hours had a 16% higher chance of dying in the subsequent 30 days than average."

"This was after adjusting for a huge range of possible confounders, i.e this was not due to those patients’ characteristics, conditions etc, but due to the length of the wait."

"You may have heard almost 30,000 people waited 12 hours in English A&Es in July, but that figure actually only refers to the wait after initial assessment"

"Thanks to @Rebeccasmt’s reporting, we know that if you include all time spent waiting, 100,000 people waited 12+ hours!!"

"Take ambulance delays, for example: for emergency situations including suspected strokes and heart attacks, the average wait for an ambulance to arrive on the scene is now one hour, and 40,000 people with these sorts of emergencies waited 2 hours last month."

"As before, the peaks in ambulance-related harms broadly coincide with peaks in England’s non-Covid excess mortality.

"It’s a grim picture, and an increasingly conclusive one."

[simonswords82]

As somebody else in this thread pointed out the numbers don’t stack up. This thread is subjective at best

[pas]

could you link to that pointing out? which parts don't stack up? the 12+ hour wait times, the hospital occupancy, the discharge rate, the aging population and the slashed spending are all seem to be hard numbers (dare I say facts?) ... what doesn't add up?

[dekhn]

If you can wait 12 hours, you didn't have an emergency.

[adolph]

And if you can't wait 12 hours you become excess mortality.

Sometime before the 12 hour period, one must make a choice whether to seek care or not.

[dekhn]

the 12 hour wait is once the person enters the doors of the facility. In a hospital, if you walk into the ER, people are observing you closely and expediting people at immediate risk of death. A person who can sit in a chair for 12 hours waiting didn't have an emergency. Instead, they were using the ER for non-urgent care.

[notahacker]

If the people triaged into 8-12 hour queues have a 16% higher chance of dying in the next month, that's a pretty obvious indication that many of them are, in fact, in critical condition.

[lkramer]

A few years ago I had an infected gallbladder. It was enormously painful, and I went to ER. It might not have been potentially fatal (I'm honestly not sure if you can die from it), but I didn't know that. I just knew I was in a ridiculously amount of pain.

Anyway, so I went to the ER and to begin I did sit in a chair like you said, however I don't think anyone was keeping an eye on the patients, since by the time someone came to look at me, I had been writhing in pain on the floor for an hour or so, and it had taken another patient to call a nurse over.

All and all it took 4 hours before I got to see a doctor, but this was pre-pandemic.

Still, I think you're probably right and people do show up to A and E for non-urgent issues, however it's probably also tied to how difficult it is to see a GP these days.

[eikenberry]

What is the situation of urgent care establishments in the UK? Places you can go for non life threatening but life stopping events, like say a broken leg?

[stordoff]

> Instead, they were using the ER for non-urgent care.

FWIW, this isn't always a call that person makes - I've had multiple family members advised to attend by the non-emergency service (111) and ended up with a 6-8 hour wait.

You also can face lengthy waits for something that needs treatment soon but isn't immediately life-threatening (grandfather fell and hit his head on a table, requiring stitches - ~4 hour wait for a handover from the ambulance, another 2-3 before he received an MRI and stitches).

[LorenPechtel]

A few years back the doctor sent me over to the ER. Had I gone home instead there would have been zero (above background average) risk of dying in the next 12 hours. That doesn't say the doc was wrong in sending me there--I had a kidney stone, the risk was kidney damage and infection, not dropping dead.

[Jtsummers]

> A person who can sit in a chair for 12 hours waiting didn't have an emergency. Instead, they were using the ER for non-urgent care.

Or the ER was crap. Like the time I waited 12 hours (because I had no choice, I needed a surgeon) to have my foot put back together.