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Publication, Part of

Hospital Accident & Emergency Activity 2019-20

Publication Date:
Geographic Coverage:
England
Date Range:
01 Apr 2019 to 31 Mar 2020

Summary Reports - Performance Times and Waits for Admissions

Background

This section focuses on the performance of time to departure against the 4 hour national standard, and patients waiting over 4 hours. The results are presented as:

• Percentage of attendances spending 4 hours or less in A&E

• Average number of attendances of 4 hours or less and over 4 hours

• Provider map of percentage of attendances spending 4 hours or less in A&E

• Total time in A&E from Hour of Arrival to Transfer, Admission or Discharge

Percentage of Patient Attendances Spending 4 Hours or Less in A&E

For 2019-20 84 per cent of patient attendances spent 4 hours or less in A&E. At a national level, the standard has not been met annually since 2013-14, although it has been met in some individual months during this period.

Note: The standard set in the NHS Constitution is the percentage of attendances discharged, admitted or transferred spending 4 hours or less in A&E. This was 98% up to quarter 1 (end June) 2010; from quarter 2 (July) 2010 this was reduced to 95%.

Fourteen hospital trusts are excluded from the ‘Number and percentage attendances 4 hours or less / over 4 hours’ due to their involvement with testing new proposal standards for emergency care, which has made them exempt from this measure. More details can be found on the link below:

https://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2019/06/Publication-of-May-AE-data.pdf

Table 4: Percentage of Patient Attendances Spending 4 Hours or Less in A&E (Source: MSitAE)
Table 4: Percentage of Patient Attendances Spending 4 Hours or Less in A&E (Source: MSitAE)

Average Number of Attendances of 4 Hours or Less

Over the last seven years the number of attendances per day spending 4 hours or less in A&E has ranged from 37,318 in March 2020 to 63,351 in June 2018.

However, users should note there was a reduction in attendances from March 2020, at the start of the COVID-19 outbreak.

Fourteen hospital trusts are excluded from the ‘Number and percentage attendances 4 hours or less / over 4 hours’ due to their involvement with testing new proposal standards for emergency care, which has made them exempt from this measure. More details can be found on the link below:

https://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2019/06/Publication-of-May-AE-data.pdf

Download the data for this chart Table 5: Average Number of Attendances of 4 Hours or Less (Source: MSitAE)

Average Number of Attendances Over 4 Hours

The number of attendances per day spending over 4 hours in A&E has been increasing steadily. There was a steady increase from April 2013 to April 2014 with a 12 month rolling average increasing from 2,479 to 2,589. However, in the last five years the increase has been more marked and the average number of attendances spending over 4 hours in A&E has more than trebled.

Users should note there was a reduction in attendances from March 2020, at the start of the COVID-19 outbreak.

Fourteen hospital trusts are excluded from the ‘Number and percentage attendances 4 hours or less / over 4 hours’ due to their involvement with testing new proposal standards for emergency care, which has made them exempt from this measure. More details can be found on the link below:

https://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2019/06/Publication-of-May-AE-data.pdf

Download the data for this chart Table 6: Average Number of Attendances of Over 4 Hours (Source: MSitAE)

Percentage of Patient Attendances Spending 4 Hours or Less in A&E, by Provider

This displays a map of England with a coloured pin for every major A&E provider. There were two providers that met the standard, measured across the whole year, in 2019-20.

Major A&E Departments only are included (Type 1).

Fourteen hospital trusts are excluded from the ‘Number and percentage attendances 4 hours or less / over 4 hours’ due to their involvement with testing new proposal standards for emergency care, which has made them exempt from this measure. More details can be found on the link below:

https://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2019/06/Publication-of-May-AE-data.pdf

 

Table 7: Percentage of Patient Attendances Spending 4 Hours or Less in A&E, by Provider (Source:MSitAE)
Table 7: Percentage of Patient Attendances Spending 4 Hours or Less in A&E, by Provider (Source:MSitAE)

Total Time in A&E from Hour of Arrival to Transfer, Admission or Discharge

As a proportion of all patient attendances the two hours between 8:00 and 9:59 have the lowest percentage (15 per cent) of attendances spending over 4 hours in A&E.

This time period also has highest percentage (also 15 per cent) spending one hour or less in A&E.

For the hours between 22:00 and 05:59 around 1 in 3 patient attendances are spending over 4 hours in A&E.

Major A&E Consultant Led Departments only are included (Types 1 and 2).

Excludes unknown time in A&E and planned A&E attendances.

Download the data for this chart Table 8: Total Time in A&E from Hour of Arrival to Transfer, Admission or Discharge (Source: HES)

Performance Times and Waits for Admission

This section focuses on patients waiting over 12 hours. There are two different measures of A&E waiting times, which should not be confused. Total time spent in A&E from arrival to discharge, transfer or admission and waiting time from decision made by a clinician to admit the patient to their admission.

1. Total time spent in A&E from arrival to discharge, transfer or admission: This is collected in monthly MSitAE and is the official measure of the 4 hour total time standard. It can also be calculated from HES which can be used to measure total time in A&E, for example 4 hours and 12 hours are shown in this report.

2. Waiting time from decision to admit a patient to admission to a ward: This is sometimes referred to as a ‘trolley wait’ and is collected in monthly MSitAE as over 4 hour and over 12 hour waits; any 12 hour waits may be subject to fines from commissioners. These numbers are much lower than total time waits as only patients who are admitted are included. The equivalent figures cannot be calculated from HES because the decision to admit time is not available.

Patients Spending Over 12 Hours in A&E From Arrival

The number of patient attendances spending over 12 hours from arrival to being transferred, admitted or discharged is 522,720 in 2019-20. This is a 58 per cent increase since 2018-19 and is the biggest year on year increase since 2013-14.

Download the data for this chart Table 9: Patients Spending Over 12 Hours in A&E From Arrival (Source: HES)

Patients Waiting Over 12 Hours From Decision to Admit to Admission to a Ward

The number of patient admissions spending over 12 hours in A&E is 12,435 in 2019-20 (from decision to admit to being admitted). This is nearly four times more than in 2018-19 and is the biggest year on year increase since 2013-14.

These figures are not comparable to the previous slide as this measure is only applicable to admitted patients.

Download the data for this chart Table 10: Patients Waiting Over 12 Hours From Decision to Admit to Admission to a Ward (Source: MSitAE)
Last edited: 7 September 2020 8:47 am