Welsh Government warned it faces ‘mountain to climb’ on A&E crisis

Mark Mansfield

The Royal College of Emergency Medicine has warned the new Welsh Government faces “a mountain to climb” to tackle record emergency department waiting times after more than 10,000 patients waited longer than 12 hours in A&E last month.

The College said overcrowding, prolonged delays and patients being left on trolleys for hours had become routine in Welsh hospitals and urged ministers to make fixing emergency care their top priority.

New NHS figures for April 2026 show around one in seven patients attending a major emergency department in Wales waited more than 12 hours from arrival to being admitted, discharged or transferred.

That amounted to more than 10,000 patients waiting over half a day in emergency departments, including people who were seriously ill or injured.

Performance against the NHS target also remained well below expected levels.

The NHS target is for 95% of patients to be admitted, discharged or transferred within four hours of arriving at A&E.

The Royal College said the figures highlighted deep-rooted pressures across the system rather than problems within emergency departments alone.

Dr Rob Perry, Vice President of RCEM Wales, said: “Welsh Emergency Departments are in a state of total disrepair.

“Patients line our departments each and every day, many of them stuck on trolleys for hours.

“This is not what an ED should be for. In a functioning system, patients would be able to come to our departments with confidence they will flow through in good time – either ending up in a bed, sent home or transferred elsewhere.

“But we do not operate in a functional system right now. For many years, the wrong solutions, such as trying to reduce demand, have been pursued by successive governments and the impact on patients has been catastrophic.”

‘Exit block’

The College said one of the biggest causes of overcrowding was “exit block” – when patients who are medically fit to leave hospital remain in beds because discharge arrangements are not in place.

According to the latest figures, an average of 1,275 hospital beds every day in Wales last month were occupied by patients ready to leave but unable to be discharged.

RCEM said freeing those beds would allow patients to move out of emergency departments more quickly and ease pressure across hospitals.

Dr Perry said: “The new Welsh Government has a mountain to climb and the challenge of fixing our EDs should not be underestimated – there is no single cure-all.

“But the good news is it is not impossible. Focusing on the flow of patients throughout their entire journey in the hospital, from arrival at the front door to discharge at the back, would massively ease the problem.

“RCEM looks forward to working with the new government to help it dig our system out of the hole it is currently in.”

‘A key focus’

Health and Care Minister Mabon ap Gwynfor acknowledged the scale of the challenge and said improving emergency care would be a key focus.

He said: “Too many people are waiting too long for NHS treatment. That is the reality and it is an issue we are determined to fix.

“It is people’s lives we are talking about – and my job is to make sure the Welsh Government works closely with the NHS to ensure people who need treatment get it much quicker.

“It is vital we see improvements in the waiting list, waiting times and access to ambulance and emergency department services, and I want to recognise the dedication of NHS Wales staff who are working to drive the progress we all need to see.”

The Welsh Government added: “Building a health and care service fit for the future is part of the First Minister’s six key priorities for government and finding sustainable solutions to improving access to ambulance and emergency department services are key elements of this.”