Publication, Part of Hospital Accident & Emergency Activity
Hospital Accident & Emergency Activity, 2025-26
Official statistics
Summary Report
Summary of A&E Attendances
In 2025-26 there were 28.0 million attendances in Accident and Emergency, an increase of 2.2 per cent compared with 2024-25 (source: MSitAE)
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
• 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
In 2025-26, 74.9 per cent of patient attendances spent 4 hours or less in A&E. At a national level, the standard of 95 per cent has not been met annually since 2013-14, although it has been met in some individual months during this period (source: MSitAE) and since 2022-23 performance has been slowly improving from a figure of 70.8%.
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 it was reduced to 95%.
Fourteen hospital trusts were excluded from the ‘Number and percentage attendances 4 hours or less / over 4 hours from May 2019 up to May 2023 due to their involvement with testing new proposal standards for emergency care, which has made them exempt from this measure. Further details are available below:
Average Number of Attendances of 4 Hours or Less
The number of attendances per day spending 4 hours or less in A&E ('<4 hour attendances') fluctuates over the course of the year and generally tracks the total number of attendances.
In March 2025, there were on average 57,784 <4 hour attendances per day. This fell slightly in April 2025 but then rose up to July 2025, reaching a high point of 59,373 in June 2025. It then dropped to 55,476 in August 2025 before rising again to 58,063 in November 2025. The figure then fell again, reaching a low of 54,205 in January 2026, before rising again to 60,502 in March 2026.
Over the longer term, the 12 month rolling average of <4 hour attendances per day has trended upward from 38,709 in April 2021 to 57,426 as at the end of March 2026 (which equates to an increase of 18,717 attendances). However, activity remains slightly down on pre-pandemic levels, with the 12 month rolling average of <4 hour attendances having been 59,861 per day to the end of March 2019.
Fourteen hospital trusts are excluded from the ‘Number and percentage attendances 4 hours or less / over 4 hours from May 2019 up to May 2023 due to their involvement with testing new proposal standards for emergency care, which has made them exempt from this measure. Adding data in for these providers from June 2023 onwards will have impacted on monthly averages. Further details are available below:
Source: MSitAE
Average Number of Attendances Over 4 Hours
During the COVID-19 pandemic, the 12 month rolling average of attendances per day spending over 4 hours in A&E fell to 5,602 (as at March 2021). Prior to this, there had been a generally upward long term trend, with the average reaching 10,040 as at the end of February 2020.
Since April 2021, the total number of A&E attendances, and in turn, attendances lasting over 4 hours, have increased substantially. Total attendances continued to grow through 2024-25, but attendances lasting over 4 hours have remained largely unchanged in the first 6 months of 2025-26 and then slowly trended downward from a 19,574 12 month rolling average to September 2025, to 19,222 to the end of March 2026.
Note that fourteen hospital trusts are excluded from the ‘Number and percentage attendances 4 hours or less / over 4 hours from May 2019 up to May 2023 due to their involvement with testing new proposal standards for emergency care, which has made them exempt from this measure. Reinstating data for these providers from June 2023 onwards will have impacted on the monthly averages. Further details are available below:
Source: MSitAE
Over 12 Hour Waits
This section focuses on patients waiting over 12 hours, according to two distinct metrics:
1. Patients spending over 12 hours in A&E from arrival to admission, transfer or discharge (source: ECDS)
2. Patients spending over 12 hours from decision to admit to admission (sometimes referred to as a ‘trolley wait’) (source: MSitAE)
Patients Spending Over 12 Hours in A&E From Arrival to Admission, Transfer or Discharge
The number of patient attendances spending over 12 hours from arrival to being transferred, admitted or discharged was 1,835,378 in 2025-26. This represents a 2.4 percent decrease on 2024-25.
In 2025-26, 6.9% of attendances lasted 12 hours or more, compared to 7.3% in 2024-25.
Source: ECDS
Patients Spending Over 12 Hours in A&E From Decision to Admit to Admission
The number of patient admissions spending over 12 hours in A&E was 570,957 in 2025-26 (from decision to admit to being admitted). This is a 7.2% increase on the figure for 2024-25 (source: MSitAE).
Last edited: 24 September 2026 9:35 am