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NHS Performance Tracker
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NHS Performance Tracker

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

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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

Emergency Department performance data for England, March 2025:

Summary:

  • Busiest March on record for attendances across all EDs (2,389,064), while also being the busiest month in winter 2024/25 for Major EDs (1,450,686).
  • Four-hour performance stood at 60.9%
  • There were 551,129 admissions (all) and 404,354 type-1 admissions.
  • 9% of type-1 attendances were admitted.
  • 46,766 patients experienced a trolley wait of 12 hours or longer, the highest March on record.
  • There were 101,161 available general & acute beds in type 1 trusts, a decrease of 22 compared to March 2024
  • 10,246 beds needed to achieve the safe occupancy rate of 85%

 

Supplementary ECDS Analysis March 2025 (12-hour length of stay data measured from the time of arrival) data show:

  • There were 137,070 12-hour stays in type-1 EDs, a decrease of 4,423 compared to last month and a decrease of 7.2% compared to March 2024. This is equivalent to two fewer 12-hour stays in each department each day compared to last year.
  • Yet still, 9.7% of patients experienced a delay of 12-hours or more. This is equal to almost 1 in 10.

 

The latest Emergency Department performance figures published by NHS England for March 2025 show:

  • There were 2,389,064 attendances to EDs (all types), making it the busiest March on record and the busiest month in winter 2024/25.
  • There were 1,450,686 attendances to major EDs, making is the busiest month in winter 2024/25, but it is a decrease of 11,791 (0.8%) from March 2024.
  • 75% of patients were transferred, admitted, or discharged within four hours, an increase of 1.6 percentage points (pp) from the previous month and 0.8pp from March 2024.
  • In Major EDs, this figure stood at 60.9%, up 2.5pp from the previous month, but remaining unchanged from March last year.
    • It should be noted that this improvement comes in a month where NHSE unveiled the 2024/25 capital incentive scheme, offering £1m to 40 organisations that improved their four-hour performance the most, £20 million of which was based on March improvements alone.
  • There were 551,129 admissions (all), an increase of 55,034 from the previous month but a decrease of 16,045 from March last year.
  • There were 404,354 type 1 admissions an increase of 41,749 from the previous month but an decrease of 15,472 from March last year.
  • 9% of type-1 attendances were admitted, a decrease of 0.6pp from the previous month and a decrease of 0.8pp from March last year.
  • There were 133,957 four-hour trolley waits, an increase of 2,720 from the previous month and a decrease of 6,224 from March last year.
  • There were 46,766 12-hour trolley waits. This is the highest on record for March, and an increase of 3,798 from March 2024, the second highest.
  • 24% of admissions experienced a four-hour trolley wait.

 

Beds data for March 2025 show:

  • There were 101,161 available general & acute beds in type 1 trusts, a decrease of 22 compared to March 2024, and a decrease of 414 compared to the previous month.
  • Bed occupancy stood at 93.6%, 0.6 percentage points less than last month, and 0.4 percentage points less than March 2024
  • An additional 10,246 would be needed to achieve the safe occupancy rate of 85%
+ Scotland

 

 Emergency Department performance data for Scotland, April 2025:

Summary:

  • April 2025 saw modest improvements in 8 and 12 hour waits compared to last year, but a slight decrease in 4 hour performance.
  • 32.9% waited 4 hours, 10.3% waited 8 hours, and 4.2% waited 12 hours.
  • However, longer waits are far more common than they were 7 years ago. In April 2018, 1.3% of patients waited 8 hours, and only 0.3% waited 12 hours.
  • There was an average of 1,853 beds occupied per day due to delayed discharges, the highest for any April since guidelines changed in 2016.

Data:

  • In April 2025, there were 117,827 attendances at Type 1 Emergency Departments (EDs) in Scotland. This is a 2% decrease from the previous month.
  • 67.1% of patients were seen within four hours at Type 1 EDs.
  • This is 0.1 percentage points higher than April 2044
  • 38,818 of patients waited over four hours in Type 1 Emergency Departments.
  • This is 3% less than the previous month, but 4.8% higher than the same month last year.
  • 12,167 (10.3%) patients waited eight hours or more in EDs.
    • This is 2.4 percentage points lower than April last year.
    • In April 2018, only 1.3% of patients waited this long.
  • 4,998 (4.24%) of patients waited twelve hours or more in EDs.
    • This is 1.5 percentage points less than the same month last year
    • In April 2018, only 0.3% of patients waited this long.
  • There was an average of 1,54 beds occupied per day due to delayed discharges, a decrease of 71 from the previous month.
    • This is the second highest number of beds occupied per day due to people delayed for any April since guidelines changes in 2016.
    • There was a total of 55,620 days spent in hospital by people whose discharge was delayed. This is a 3.2% increase on April 2025 (57,433).

 

 

+ Wales

Wales NHS Emergency Department Performance Data – January 2025

Summary:

  • one in six patients were delayed by 12 hours or more
  • 44% of patients waited four hours or longer in an Emergency Department. 25.1% waited eight hours or longer. And 16.8% of patients waited 12 hours or longer – the highest percentage of 12 hour waits on record.
  • In the last 7 years, the numbers of patients waiting four hours and eight hours has increased by more than 1.5 times, and the number of patients waiting 12 hours or longer has more than doubled. This is despite attendance being only 3.8 less than the same period seven years ago.
  • The number of adults occupying a hospital bed who experienced a delay of more than 48 hours from the point when they were deemed ready to leave the hospital was 1,502. The most common reason for delay was assessment issues and care home placement delays.

Figures:

  • 61,782 people attended major emergency care facilities in January 2025. This is 6.6% lower than last month (66,148).
  • Overall, 56% of patients in major EDs were admitted, transferred, or discharged within four hours from arrival.
  • This is a 1.9 percentage point increase from last month.
  • 44% of patients in major EDs waited longer than four hours (27,191 patients). This is 2 percentage points more than the same month last year.
    • The number of patients waiting more than four hours has decreased by 10.5% from last month (30,384).
    • The number of people waiting more than four hours is 1.5 times higher (+54.8%) higher than January 2018 (17,567).
  • 25.1% of major ED attendances waited more than eight hours (15,477 patients). This means that a quarter of patients were delayed eight hours or more at a major emergency department.
    • This figure has decreased by 0.9 percentage points compared to last month, but is 1.2 percentage points more than the same month last year.
    • The number of people waiting more than eight hours has increased by more than half (+71%) compared with January 2018 (9,050).
  • 16.8% of major ED attendances waited more than 12 hours (10,384 patients). This means that one in six patients were delayed by 12 hours or more.
    • This is 1.3 percentage points more than the same month last year.
    • The number of people waiting more than 12 hours has more than doubled (+103.7%) compared with January 2018 (5,089).
  • The number of adults occupying a hospital bed who experienced a delay of more than 48 hours from the point when they were deemed ready to leave the hospital was 1,502
    • This is 46 less than the same month last year, but 67 more than last month.
+ Northern Ireland

Northern Ireland

 Quarter 4 2024/25 (January – March 25) Emergency Department data:

Summary:

  • While not the worst quarter on record for attendances waiting more than 12 hours, January 2025 saw the highest proportion of attendances on record waiting this long (23.1%)
  • 34.2% of patients were seen within 4 hours – 3.2 percentage points (pp) less than the same quarter last year
  • Quarter 4 2024/25 was the second worst on record for 4-hour performance
  • The median time patients admitted spent for the quarter was 15 hours 19 minutes, while the 95th percentile quarterly average was 65 hours.
  • The median time spent by patients discharged was 4 hours 45 minutes for the quarter. This is an increase of 13 minutes from the same quarter last year.

 

Quarterly Figures:

  • The average number of monthly attendances for this quarter was 50,244 – this is 4,741 fewer than the same quarter last year.
  • On average, 21.5% of patients waited more than 12 hours in an ED, an increase of 1.5pp compared to the same quarter of the previous year.
  • January 2025 saw the highest proportion of 12-hour delays on record, with 23.1% of attendances waiting this amount of time, or longer. This is an increase of 1.9pp from January 2024. This amounts to almost 1 in 4 patients.
  • The number of attendances waiting 12 hours or more in a type 1 ED for this quarter (32,314) was three times the number of the same quarter in 2019 (10,111).
  • For the quarter ending 31 March 2025, the median time patients admitted spent the longest in January 2025 (16 hours 34 minutes) and shortest in March 2025 (13 hours 23 minutes)
  • During this period, the median time spent by patients discharged home was longest in February (4 hours 49 minutes) and shortest in January (4 hours 40 minutes)
  • This quarter saw 4-hour performance reach new lows for this time of year. In February 2025, only 33.9% of patients were seen within 4 hours – the third worst month for 4 hour waits. This performance is worse than that of the average for winter 2023.
  • Quarter 4 2024/25 was the second worst quarter ever for 4-hour performance. It is only a slight improvement on the worst quarter (quarter 3 2024/25), being 0.4 percentage points higher.
  • In March alone, 575 patients waited at least 57 hours to be admitted to hospital from their time of arrival. January and February both had worse 95th percentiles of 72 hours 22 minutes and 65 hours 20 minutes respectively, but unfortunately the admission data is not provided for this month.

 

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.

NHS England UEC sitreps – week 19 2024/25 (17th March – 23rd March)

Summary for week 19:

  • Bed occupancy stood at 93.5% and it would require just under 10,000 available beds to bring this down to 85%.
  • 17,288 hours were lost to handover delays, bringing the total amount of time lost to over 50 years for the current winter period.
  • There was a daily average of 13,388 patients who no longer met the criteria to reside but still remained in hospital
  • There were 24 diverts in week 19, two fewer than last week
  • 46,653 staff were absences, 300 of these due to covid
  • 991 beds occupied by patients with flu in type-1 trusts
  • 47,678 patients staying 7 days or longer

Beds

  • There were 100,407 type-1 G&A beds available in week 19, an increase of 106 from both the previous week and the same week last year.
  • Type-1 bed occupancy stood at 93.5% for adults and paediatric, a decrease of 0.3 percentage points from the previous week and 0.7pp lower than week 19 last year.
  • It would require 9,988 beds to bring occupancy levels down to 85%

Ambulance Offloads

  • There were 93,129 offloads in week 19, an increase of 1,609 from the previous week.
  • 27.3% of ambulance handovers took over 30 minutes, a decrease of 0.1pp from the previous week.
  • The total amount of time lost to handover delays was 17,288. This is a decrease of 382 hours from last week, but still equivalent to just under two years’ worth of time.
    • Total amount of time lost to handover delays so far in this winter period (25 November 2024 – 23 March 2025) is now over 50 years’ worth.

Beds Occupied by Long-Stay Patients (Type 1 trusts)

  • There was a daily average of 47,678 patients staying 7 days or longer, which is 441 less than the same time last year.

Criteria to Reside

  • There was a daily average of 13,388 patients who no longer met the criteria to reside but still remained in hospital. This is down by 255 from the previous week.

Flu (Type 1 trusts)

  • There was a daily average of 991 beds occupied by patients with flu in type-1 trusts, which is 119 less than the previous week, and 7 less than the same time last year.
  • There was a daily average of 18,610 patients staying 21 days or longer, 170 more than the same time last year.

Diverts

  • There were 24 diverts in week 19, two fewer than last week.

Absences

  • In total, 46,653 staff were absent in week 19, with only 300 of these absences being because of covid.
  • This is a decrease of 444 compared to last week, but 1,174 more than the same week last year.

(NB. Over the past few years, the winter sitreps have commenced at different points in the winter season. To keep things consistent across calendar weeks, we have called this week’s analysis week 19 in our records, even though it is technically week 16 of publication. This helps us to sync our reporting to get a clearer picture of how winter is playing out, making it easier to spend trends over time.)

 

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