In April 2011 a new set of clinical quality indicators was introduced to replace the previous four-hour waiting time standard, and measure the quality of care delivered in A&E departments in England. Further details on the background and management of the quality indicators are available from the Department of Health (DH) website.
This is the sixth publication of data on the Accident and Emergency (A&E) clinical quality indicators, drawn from A&E data within provisional Hospital Episode Statistics (HES). These data relate to A&E attendances in September 2011 and draw on 1.37 million detailed records of attendances at major A&E departments, single speciality A&E departments (e.g., dental A&Es), minor injury units and walk-in centres in England.
This report sets out data coverage, data quality and performance information for the following five A&E indicators:
- Left department before being seen for treatment rate
- Re-attendance rate
- Time to initial assessment
- Time to treatment
- Total time in A&E
Publishing these data will help share information on the quality of care of A&E services to stimulate the discussion and debate between patients, clinicians, providers and commissioners, which is needed in a culture of continuous improvement.
These A&E HES data are published as experimental statistics to note the shortfalls in the quality and coverage of records submitted via the A&E commissioning data set. The data used in these reports are sourced from Provisional A&E HES data, and as such these data may differ to information extracted directly from Secondary Uses Service (SUS) data, or data extracted directly from local patient administration systems. Provisional HES data may be revised throughout the year (for example, activity data for April 2011 may differ depending on whether they are extracted in August 2011, or later in the year). Indicator data published for earlier months have not been revised using updated HES data extracted in subsequent months.
The data presented here represent the output of the existing A&E Commissioning Dataset (CDS V6 Type 010). It must be recognised that these data will not exactly match the data definitions for the A&E clinical quality indicators set out in the guidance document A&E clinical quality indicators: Implementation guidance and data definitions.
The DH is currently working with Information Standards Board to amend the existing CDS Type 10 Accident and Emergency to collect the data required to monitor the A&E indicators. A&E HES data are collected and published by the Health and Social Care Information Centre. The data in this report are secondary analyses of HES data produced by the Urgent & Emergency Care team, Department of Health.
A&E HES data are published as experimental statistics to note the known shortfalls in the quality of some A&E HES data elements. The published information sets out where data quality for the indicators may be improved by, for example, reducing the number of unknown values (e.g., unknown times to initial assessment) and default values (e.g., the number of attendances that are automatically given a time to initial assessment of midnight 00:00).
The quality and coverage of A&E HES data have considerably improved over the years, and the Department and the Information Centre are working with NHS Performance and Information directors to further improve the data.