More than a million people have already waited 12 hours or more in England’s accident and emergency rooms this year.

That’s an increase of 20% on the same figure from last year, and represents about 10% of all emergency room waits.

The statistics, compiled by the House of Commons Library and shared by the Liberal Democrat political party, give an insight into the challenges facing England’s emergency services.

For more than two years, many of the country’s emergency rooms and have struggled to see patients in a timely manner. It’s no longer unusual for people to spend hours on trolley beds in the ER and even in corridors as they wait for beds to open up on regular wards.

It’s a huge patient safety issue, as long emergency care waits are linked to worse outcomes and higher rates of death.

The Royal College of Emergency Medicine thinks tens of thousands of excess deaths could be linked to the emergency care crisis — 14,000 in 2023 and 23,000 in 2022.

Why are emergency services in crisis?

There are many factors behind these extremely long waits. At the heart of the crisis is an under-resourced health and social care system that doesn’t have the capacity to meet growing demand rom an ageing population.

The bulk of the England’s healthcare is provided free at the point of use through the National Health Servicen, which oversees all public hospitals. But experts point out it hasn’t recieved the funding it needs to keep up with demand for years.

Staff shortages, outdated technology and crumbling buildings are relatively common problems for hospitals across the country.

A lack of adequate social care provision is putting extra pressure on hospitals. Frail and vulnerable patients often need extra support to leave hospital. When it’s not available, they can end up waiting on wards for days and even weeks.

These keeps bed occupancy rates high and makes it harder for staff to move patients out of the ER and into other parts of hospital. Patients languish for hours in overcrowded emergency rooms, and ambulances struggle to handover new patients.

“The knock-on effect of rising patient demand and constrained capacity is being felt across the health and care system with long waits for patients not just in emergency departments but across mental health, community and ambulance services, too,” said Saffron Cordery, deputy chief executive of industry group NHS Providers.

I recently revealed some mental health patients in crisis face days-long waits in emergency departments, in an investigation for British publication, The Lead.

“Trust leaders are doing everything they can to prevent patients waiting too long for care in A&E, particularly as the NHS heads into what’s expected to be another tough winter,” Cordery added in a statement. “But the challenges they face are huge.”

Long waits are “literally a matter of life and death,” said Liberal Democrat deputy leader Daisy Cooper and needed to be fixed as a priority.

On Wednesday, the U.K. government will detail its health spending plans as part of a national budget announcement.

“The government must take urgent action to break the cycle of the annual winter crisis and that starts by making the NHS and social care their top priorities in the Budget,” added Cooper in an emailed statement. “We need to see urgent action to winterproof the NHS, alongside reforms to shore up social care, so our health and care services no longer lurch from crisis to crisis.”

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