BED shortages in London hospitals will lead to more unnecessary patient deaths, a coroner has warned following an inquest into the death of a 93-year-old woman.

Inner London assistant coroner Melanie Lee wrote to NHS England and the Department of Health and Social Care following a ruling in the case of Lina Piroli, who died at the ­Whittington in February.

Ms Piroli, who lived in Archway, went to the Highgate Road hospital on February 2 after falling down the stairs and fracturing her spine.

She faced a long wait in A&E before receiving the specialist care she needed, because there were no beds available on an elderly care ward, said the coroner.

Ms Lee said: “She was accepted by the medical team but there were no beds available.

“This meant that she remained in A&E at a time when she was experiencing pain, confusion and delirium due to her injury, infection, pain, pain medication and dementia.

“She was not seen by the geriatric team (who do not work in A&E) and had delayed access to specialist nurses. She remained in a busy, noisy and frightening environment. It was not until she was moved to a ward that advice was sought on the best management of her spinal fracture. The delay in transferring her to a ward was detrimental to optimising her chances of recovery.”

Ms Piroli had dementia, but while there is guidance for how to treat patients with the condition in hospital, the coroner noted that the recom­mended steps are “simply not achievable” in a “busy and overcrowded emergency department”.

Ms Lee said: “I heard evidence that this is not uncommon at the Whittington and is a problem across all London hospitals (and hospitals throughout the UK). When there are no ward beds to transfer patients to, they stay in A&E and A&E is not set up to deliver the care that, particularly elderly and complex medical, patients require.”

Nursing staff in the Whittington “are having to treat double the number of patients the department is designed to accommodate” and treat “patients who require care and treatment outside of their expertise”, the coroner added. “This means that patients are not receiving the appropriate level of care. In my opinion, there is a risk that future deaths will occur unless action is taken.”

The coroner ruled that Ms Piroli’s death was caused by a multifactorial fall contributed to by naturally occurring age-related disease processes and an E.coli infection.

At a meeting of campaign group Defend the Whittington Hospital Coalition (DWHC) last month, hospital chief Selina Douglas said she was in talks about expanding the A&E, which was “too small” – 15 years ago NHS chiefs were proposing closing the A&E.

DWHC chair Shirley Franklin told how “bed blocking” on hospital wards is contributing to overcrowding in A&E.

Ms Franklin said: “They can’t send people home because they don’t have a care plan, which blocks beds in the hospital so they can’t send people from A&E up to the wards.”

Delays in formulating patient care plans – personalised strategies required to ensure a safe transition from hospital to home, which are co-managed by the NHS and local authority – are “because of Tory cuts”, said Ms Franklin, adding: “Austerity is still happening, that’s the problem. Things are getting worse.”

The Whittington’s NHS trust is having to make a cut of £27m by April, which Ms Franklin fears will force the Whittington to share patient treatment with other surrounding hospitals, rather than be a major district hospital in its own right.

This week, resident doctors across the country began five days of strike action amid record numbers of patients in hospital with flu.

But while health secretary Wes Streeting accuses striking doctors of putting patients at risk and refusing to compromise, Ms Franklin said: “The doctors’ strike isn’t making the situation worse, the situation is already bad. It’s Wes Streeting who is making it worse – he just wants somebody to blame. They’re on strike because there aren’t enough doctor jobs being advertised. We’ve got doctors who are unemployed because they’ve cut jobs.”

An NHS spokesperson said: “NHS England extends its deepest sympathies to the family and friends of Lina Piroli. We are carefully con­sidering the Prevention of Future Deaths Report sent to us by HM Coroner and will respond in due course.”