Hospital Accident & Emergency Activity 2020-21

In 2020-21 there were 17 million attendances in Accident and Emergency, a decrease of 30 per cent compared with 2019-20 and a decrease of 19 per cent since 2011-12.

This contrasts with the year on year increases in reported activity observed between the period 2011-12 to 2019-20.

Whilst changes in behaviours, both as individuals and also in regard to service provision driven by the response to the coronavirus pandemic, can be viewed as being the primary driver to this observed reduction, elements of this may also be related to longer term planned changes to NHS A&E services which saw existing type 3 and 4 A&E department types being reconfigured as either Urgent Treatment Centres (UTC) or alternatively changing their function to become other primary health care services. Activity related to the latter would cease to be reported within the data. This reclassification process commenced during Autumn 2020.

In 2020-21 73 per cent of all reported A&E attendances occurred in a Type 1 or Type 2 department type with 27 per cent occurring within a Type 3 or Type 4 department type. This has changed from 2019-20 where 65 per cent of all reported A&E attendances occurred in a Type 1 or Type 2 department type and 35 per cent occurred within a Type 3 or Type 4 department type.

Changes in behaviours both as individuals and also in regard to service provision driven by the response to the coronavirus pandemic can be viewed as being the primary driver to this change in composition of service activity. However observed changes may also may be influenced by implementation of  planned changes to NHS A&E services with existing type 3 & 4 A&E department types being reconfigured as either Urgent Treatment Centres (UTC) or alternatively changing their function to become other primary health care services. Activity related to the latter would cease to be reported within the data but would remain within historical data that has been reported. This reclassification process commenced during Autumn 2020.

Major A&E Consultant Led Departments are Types 1 and 2. Minor Injury Units and Walk In Centres are Types 3 and 4.

Whilst the age profile of patients attending A&E has remained relatively stable between 2011-12 to 2019-20 this has changed in 2020-21, with patients in reported aged bands under 35 years of age decreasing as a proportion of the overall reported activity and those in age bands 35 years and over increasing.

In 2020-21 patients aged under 35 years of age accounted for 41 per cent of all attendances (Source ECDS). This has decreased from 48 per cent in 2019-20.

Within specific age bands patients aged under 5 years of age accounted for 7 per cent of all attendances and has decreased from 10 per cent in 2019-20. Whereas patients aged 35-64 years of age accounted for 34 per cent of all attendances increasing from 31 per cent in the same period.

Changes in behaviours as individuals driven by the responses to the coronavirus pandemic and how their implications varied by age groups may have influenced this.

Excludes unknown ages and planned A&E attendances.

Statistical outputs accompanying this report utilise ECDS data. This 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.