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NHS Performance Tracker

NHS Performance Tracker

Tracking the performance of the NHS in England, Scotland, Wales & Northern Ireland.

The NHS service across the four nations of the UK regularly publish important datasets relating to the performance of the urgent and emergency care system. The Royal College of Emergency Medicine  analyses this data which is used to inform our policy and campaigns work.

NHS Performance Tracker

Type 1 ED Attendances

Since May 2021, attendances have remained consistent with pre-COVID attendances. Although there have been fluctuations in demand, attendances have remained relatively stable and consistent with pre-COVID-19 levels.

The Four-Hour Standard

The four-hour standard is an operational standard pledged in the NHS constitution that 95% of patients should be admitted, transferred, or discharged from an ED within four hours. It is an indicator of patient outcomes and safety, and accountability. The standard has not been met in England since June 2013. In December 2022, the UK Government announced a threshold target of 76% to be hit in England by March 2024. Scotland last met the standard in June 2020; before this Scotland hadn’t met the target since July 2017. Since records began, Wales and Northern Ireland have not met the standard.

12- Hour Waits from Time of Arrival

Data from each UK nation on 12-hour waits from the patient’s time of arrival shows that more patients than ever before are experiencing extremely long waits in our EDs. In England, the NHS requirement is that no more than 2% of patients should wait 12 hours or more from their time of arrival. This pledge has not been met in England since April 2021.

Devolved Performance Figures

+ England


April 2023 performance figures

  • In April, there were 1.27m type 1 attendances, and 363k type 1 admissions.
  • Type-1 EDs saw 41,005 attendances per day during April. This meant that attendances decreased between March and April by 7.5% per this measure.
  • The type-1 4-hour target stood at 60.9%. This represents a 4.1 percentage point increase from March 2023 and 1.9 percentage point increase from April 2022.
  • There were 133k four-hour DTAs, and 26,899 12-hour DTAs.
  • Last month, there were 98,431 general and acute beds available, a decrease of 0.8% from March, but an increase of 1.8% from April 2022.
  • The bed occupancy rate was 92.6%, 1.5 percentage points lower than March.
  • Since September 2022, 2,555 G&A beds have been added. However, since it was announced in January this year that 5,000 new beds will be made available by next winter, the number of general and acute beds available at Type 1 acute trusts has fallen by 1,615 beds (-1.6%) between January and April 2023.
  • In February 2023, 102,445 patients waited 12 hours or more from their time of arrival (TOA), accounting for 8.2% of type 1 ED attendances. There were 3.8 times the number of TOA waits as DTA waits.
+ Scotland


Scotland Performance Data – Summary for March 2023

In March 2023, there were 110,446 attendances at major Emergency Departments in Scotland.

  • 64.5% of patients were seen within four-hours at major (Type 1) Emergency Departments
    • This is a decrease of 1.9 from the previous month, and a decrease of 3.9 compared with March 2022.
    • 39,253 patients waited over four-hours in major Emergency Departments, this is an increase of 22.3% from the previous month.
  • 13,750 (12.4%) patients waited eight-hours or more in an Emergency Department
    • This is an increase of 33.9% from the previous month, and the highest figure so far this year.
  • 5,739 (5.2%) patients waited more than 12-hours before being seen, admitted, discharged, or transferred
    • This figure has increased by 25.6% from the previous month, and an increase of 39.0% compared with March 2022.
+ Wales


Wales Performance Data Summary for April 2023

Visualisations can be found here

Key points

  • There were 63,272 attendances to major EDs, 4% less than the previous month (57,418) and 1.9% more than in April 2022 (62,048).
  • Overall, 60.1% of patients in major EDs were admitted, transferred, or discharged within 4 hours from arrival.
  • 22.5% of major ED attendances waited more than 8 hours (15,269 patients)
    • This means that nearly 1 in 4 patients were delayed 8 hours or more at a major emergency department.
  • 14% of major ED attendances waited more than 12 hours (9,924 patients).
    • This means nearly one in seven patients were delayed by 12-hours or more.
  • There was a daily average of 6473 general and acute beds in service, 8 less than the previous month. Average monthly bed occupancy was 95.05%.
  • When we compare April 2022 with April 2023, there has been an average increase of 3.5% in general and acute beds in service. By comparison there has only been an 0.8% increase in general and acute beds occupied.
    • This demonstrates that the number of beds in service is not keeping up with patient needs.
+ Northern Ireland

Northern Ireland

Excess Deaths

Using the best available evidence, a scientific study published in the Emergency Medicine Journal, we calculate an estimated number of excess deaths occurring across the United Kingdom associated with crowding and extremely long waiting times. These figures are based on modelling from the EMJ study which show that for every 72 patients waiting between eight- and 12-hours from their time of arrival in the Emergency Department there is one patient death.

You can read more information here.

UEC Winter Situation Report

Urgent and Emergency Care Daily Situation Reports (UEC SitReps) are a data collection system administered by NHS England. These daily reports on metrics provide us with a real-time understanding of on-the-ground pressure on NHS frontline services over the winter months.

UEC Winter Situation Report – Week 19

Flourish slides can be found here.


  • There was an average of 100,703 beds open across all acute trusts, and 99,008 open at type-1 acute trusts. Occupancy at type-1 acute trusts was 94.2%.
  • Of 137 trusts with general and acute beds, 126 recorded an occupancy of >85%, 3 more than in week 18. 64 recorded an occupancy of >95%, 10 more than in week 18.

Ambulance Offloads

  • There was an average of 11,381 arrivals by ambulance (total: 79,665). In total, 27.5% of handovers involved a delay, a 4.5 percentage point increase from the previous week.
  • An average of 2,088 hours were lost each day, for a total of 21,617 hours. This is an increase of 51.9% from week 18.

Beds Occupied by Long-Stay Patients

  • On average, 47,929 patients occupied a bed for over 7 days, for patients occupying a bed for 21 or more days, this figure was 18,862.


  • The average number of G&A beds occupied by flu patients was 300. This figure has fallen for 12 consecutive weeks and is the lowest figure recorded this winter.

Criteria to Reside

  • The average number of patients remaining in hospital while no longer meeting the criteria to reside was 13,300.
  • On average, 58.7% of patients who no longer met the criteria to reside remained in hospital.


  • The average number of diverts in week 18 was 2.6, a decrease of 0.3 from the previous week.

Total number of staff absent from work through sickness or self-isolation (Acute Trusts)

  • The average number of total absences was 47,993. Covid absences averaged 5,804, this figure has increased in 7 of the last 8 weeks.
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