24 Hours in A&E - What that really means today.

When 24 Hours in A&E first aired on Channel 4 in 2011, the average length of stay in a UK emergency department was just over two hours.

In 2026, “24 hours in A&E” is no longer a television concept. For many patients, it is a painful reality. NHS figures show that last year alone, nearly half a million people spent more than 24 hours in A&E.

Just this week, BBC News shared the story of a 77-year-old lady (I waited 46 hours in A&E on a plastic chair, says Skegness woman - BBC News). Forty-six hours. It’s hard to imagine what that must have felt like: discomfort, fear, pain, hunger, cold, a creeping sense of abandonment.

What is perhaps most sobering is how little shock such stories now generate. We may be becoming desensitised.

But we also need to talk about the staff who were there.

In a department where waits stretch beyond a day, every clinical space is full. Trolleys line corridors. Ambulances queue outside. There is no slack in the system — only backlog.

In those 46 hours, that patient would have seen six or seven shift changes. Each new team arriving, each noticing she was still there. Each feeling the same sinking recognition: she is still waiting.

Most doctors and nurses enter healthcare because they care deeply about relieving suffering. They are not immune to what they witness. When they see patients in prolonged distress and feel powerless to change the situation — because of corridor care, bed shortages, exit block and chronic staffing gaps — it clashes with their professional and moral code.

That clash has a name: moral distress.

Moral distress occurs when clinicians know the right thing to do but cannot do it because of systemic constraints. When this becomes chronic, it leads to emotional exhaustion, detachment, loss of empathy and poor performance. Not because staff do not care — but precisely because they do care and are repeatedly prevented from acting in line with their values.

When politicians are challenged about these conditions, the pattern is familiar: apology, explanation of pressures, promise of investment. The cycle continues.

Meanwhile, there are hundreds of people sitting in plastic chairs in emergency departments across the country right now.

Paediatrician Rachel Remen put it perfectly when she said, “The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet.” If we continue to ignore the emotional cost of this work, we should not be surprised when experienced clinicians and nurses leave, when empathy erodes, or when performance suffers. Moral distress is not a sign of weakness. It is evidence that values remain intact.

If we want a functioning health service, we must treat staff wellbeing as essential, not an optional extra. Until we name moral distress openly and address it structurally, we will continue to lose good people — not because they stopped caring, but because they were asked to care in conditions that made it impossible to practise the way they were trained.