Scottish A&E Excess Mortality Tracker What causes crowding? Exit Block Game

Total estimated excess deaths (since Jan 2021)

Weekly trend, 2021–present

Data: Public Health Scotland A&E open data. Updated weekly. Excludes paediatric-only hospitals. Shaded band shows the approximate uncertainty range; line shows the point estimate.

Advanced sensitivity controls

For users wishing to test how admission-rate assumptions change the estimate. Defaults are pre-set using the approximate relative proportion of actual hospital admissions for each waiting-time category in Scotland, 2023–2025.

4 to 8 hours, % admitted

8 to 12 hours, % admitted

Over 12 hours, % admitted

DISCLAIMER
This is a modelled estimate, not a confirmed count of deaths. It combines national waiting-time data with the best current research on the risks of long waits, but it involves assumptions and approximations at several steps. It should be used to help understand the scale of a problem and support discussion — not treated as a precise or verified figure, and not used to draw conclusions about any individual patient or case.

What this is for

This tool gives an estimate of how many extra deaths might happen because patients are waiting too long in Scottish A&E departments (also called Accident and Emergency, or Emergency Departments). It turns official waiting-time data into a simple, visual estimate, so people can see the possible human cost of long waits.

It is meant to help people understand and talk about the problem of A&E crowding. It is not an exact count of real deaths.

However, the numbers update using real national data on how many patients wait that long each week, and use the current best estimate of harm from A&E waits.

Methods for the Public

We used research by Jones and colleagues (2022) which worked out how many extra deaths happen for every set number of patients who wait too long in A&E. This is called “Number Needed to Harm” (NNH) — for example, an NNH of 72 means: for every 72 patients who wait that long, we’d expect one extra death that might not have happened otherwise. The numbers we use are:

Wait time	NNH	Likely range
4–8 hours	191	144–287
8–12 hours	72	55–96
Over 12 hours	72	55–96

We apply these figures to actual weekly Scottish A&E waiting-time data to produce the estimates.

Two things to know about how we did this:

The ranges shown are our own estimate, worked out from the original study’s figures. The original researchers did not publish an expected range for NNH, only the main estimate.
For the 4–8 hour band, we had to use the study’s 4–6 hour figure, because Scottish data doesn’t separate out 6–8 hour waits. This is almost certain to understate the danger for 6–8 hour waiters, since the original study suggests that specific group is at higher risk (1 extra death per 82 patients).

Methods for Professionals

Estimates apply Number Needed to Harm (NNH) coefficients from Jones et al. (2022) , Table 3, to weekly counts of patients waiting beyond each Emergency Department (ED) time threshold.

Wait band	NNH	Approx. 95% range
4–8h	191	144–287
8–12h	72	55–96
>12h	72	55–96

On the ranges: Jones et al. publish a 95% confidence interval for the Standardised Mortality Ratio (SMR) but not for NNH directly. The ranges above are approximated from the SMR and are not the original authors' own CI.

On banding: the 4–8h band applies the published 4–6h coefficient across the full window, as the underlying Public Health Scotland (PHS) data does not separate 6–8h waits. This may understate the true effect for 6–8h waiters, who carry a higher NNH-implied risk per Table 3 (NNH 82).