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Publication, Part of

Hospital Accident & Emergency Activity 2020-21

Official statistics

Current Chapter

Hospital Accident & Emergency Activity 2020-21


This is a publication on Accident and Emergency (A&E) activity in English NHS hospitals and English NHS-commissioned activity in the independent sector. This annual publication covers the financial year ending March 2021. It contains final data and replaces the provisional data that are published each month.

This is a joint publication between NHS Digital and NHS England. This collaboration enables data to be brought together from different sources enabling inclusion of a wider set of breakdowns and measures and a more complete picture to be presented.

The data sources for this publication are the Emergency Care Data Set (ECDS) for 2020-21, HES A&E for activity prior to 2020-21 and the A&E Attendances and Emergency Admissions Monthly Situation Reports (MSitAE). This is the first year this report has been produced using ECDS in its submitted format, replacing the use of Hospital Episode Statistics (HES). Further information is available in the Data Quality Statement.

The ECDS data set contains several new and additional reporting fields not previously available in HES A&E enabling new insights to be identified from data. Reported information based on these new splits and metrics presented within the report are presented as Experimental Statistics and should be used with caution. Experimental statistics are new official statistics undergoing evaluation.

They are published in order to involve users and stakeholders in their development and as a means to build in quality at an early stage. More information about experimental statistics can be found on the UK Statistics Authority website.

This publication releases some high level analyses of both ECDS/HES and MSitAE data relating to A&E attendances in NHS hospitals, minor injury units and walk-in centres. It includes analysis by patient demographics, time spent in A&E, distributions by time of arrival and day of week, arriving by ambulance, performance times, waits for admission and re-attendances to A&E within 7 days.

The following additional analyses are also included in this report:

• Comparison of 4 hour and 12 hour waits between the four home nations, England, Scotland, Northern Ireland and Wales

• A&E attendances by Index of Multiple Deprivation (IMD)

• A&E attendances by ethnicity

• Weekly variation in attendance activity during the pandemic, by department type

In order to respond to the challenges posed by the coronavirus pandemic NHS hospitals in England were instructed to suspend all non-urgent activity for patients for parts of the 2020/21 reporting period. This may have impacted upon how and the extent to which these types of non-urgent care activities provided that are in scope of the collection during this time. In addition it is possible that behaviours around activities relating to the completion, return and processing of certain data have also been impacted when compared to earlier years data where behaviours and processes related to managing the current pandemic were not in place. Therefore at various points in the pandemic fewer patients presented at A&E than in previous years despite services being open.

Total A&E attendances

In 2020-21 there were 17.4 million attendances in Accident and Emergency (Source: MSitAE)

This is a decrease of 30.3 per cent compared with 2019-20 and a decrease of 18.9 per cent since 2011-12

Total time spent in A&E

For 2020-21, 86.8 per cent of patient attendances spent 4 hours or less in A&E (Source: MSitAE)  

This is an increase compared to 2019-20 where 84.2 per cent of patient attendances spent 4 hours or less in A&E.

A&E attendances in deprived areas

Rates of A&E attendances per head of population for people living in the most deprived areas are nearly double that of those in the least deprived (Source: ECDS)

There were around twice as many attendances to A&E departments in England for the 10% of the population living in the most deprived areas (2.2 million), compared with the least deprived 10% (1.1 million)

Home Nations Comparison

England had the second highest reported Type 1 A&E attendance rate amongst the home nations (Source: MSitAE)

England had 21,728 attendances per 100,000 population. Northern Ireland were the highest with 27,037 attendances per 100,000 population

A&E Attendances by Age Band

In 2020-21 patients aged under 35 years of age accounted for 41.2 per cent of all attendances. (Source: ECDS)  

This has decreased from 47.8 per cent in 2019-20

A 2020-21 finalised annual position of the Accident and Emergency Quality Indicators for England are also published as part of this publication helping to 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.

Click here to access the interactive report


Last edited: 1 March 2022 1:11 pm