Hospitals across England are facing a heightened risk of dangerous overcrowding this winter as growing numbers of patients remain stuck in beds despite being medically fit to leave, according to a new analysis of NHS data.
The warning comes as the NHS grapples with an early and intense winter surge, fuelled by a sharp rise in flu cases and the prospect of a five-day strike by resident doctors starting this week.
Research by the Health Foundation shows that “delayed discharges” – where patients cannot leave hospital due to a lack of onward care – have worsened compared with last year, reducing the number of beds available just as winter pressures intensify. Senior clinicians and NHS leaders say this will exacerbate already severe pressures, leading to longer ambulance queues, overcrowded A&E departments, widespread corridor care and a higher risk of preventable deaths.
The thinktank examined delayed discharge data from July to September this year and compared it with the same period in 2024. It found that:
- * The proportion of bed days taken up by patients whose discharge was delayed rose from 10.1% to 11%, a 9% increase equivalent to around 19,000 additional bed days.
- * This was driven by an 8% year-on-year rise in delayed discharges, amounting to roughly 3,800 extra patients a month.
- * Last winter, delayed discharge patients occupied up to 14% of England’s 100,000 general and acute hospital beds, a figure expected to be higher this winter.
Francesca Cavallaro, senior analytical manager at the Health Foundation, said: “Winter has already begun but the NHS is already under intense strain, with an unprecedented surge in flu cases for the time of year.
“The mounting pressures are compounded by the rising number of patients stranded in hospital beds despite being medically fit to be discharged compared with last year.
“Our new analysis shows that 19,000 more hospital bed days were lost due to delays in discharging patients during July-September compared with the same period last year. These delays harm patients and increase pressures on overstretched A&E departments.
“Last winter saw a record number of patients forced to wait for 12 hours or more in A&E, so this suggests this winter could be even more gruelling than the last.”
A shortage of social care provision, particularly at council level, remains a key factor behind discharge delays. NHS leaders also point to an ageing population and medical advances that keep people alive for longer, increasing demand for complex care.
Dr Vicky Price, president of the Society of Acute Medicine, warned that chronic bed shortages could prove fatal. The Royal College of Emergency Medicine estimates that 16,600 people died avoidably last winter due to delays in receiving emergency care or securing a hospital bed.
“These findings fit with our clinical experience and if anything underestimate the problem,” Price said. “This is a complex problem which has been escalating for years, increasing the strain both in hospitals and in the community.”
She added that NHS England’s ability to cope had been weakened by financial constraints imposed under the 2025–26 budget reset. “Many hospitals have had the number of beds reduced in order to comply with the penalising financial pressures they are placed under.
“It was predictable that any additional strain would cause this effect. This is an extremely serious situation. For patients stranded in the emergency department, there is a significant mortality associated with this.”
Delayed discharges are estimated to cost the NHS around £200 million a month, or £2 billion a year, according to figures cited by the Health Service Journal. NHS England chief executive Sir Jim Mackey has warned that up to 8,000 beds could soon be occupied by flu patients alone.
Rory Deighton, acute and community care director at the NHS Confederation, said: “Given the ever-increasing demand that the NHS has seen over the last few years – often from patients who are older or have more complex conditions – it is sadly not surprising to see this analysis highlighting the continued impact delayed discharges are putting on services.
“A lack of social and community care can often result in delays getting medically fit patients out of hospital, which in turn can create bottlenecks in the urgent and emergency care system that result in longer ambulance handovers and A&E waits.”
He added that NHS leaders were “very concerned the upcoming resident doctor strikes will pile yet more pressure on to the NHS and could put patient safety at risk”.
The Department of Health and Social Care was contacted for comment.
