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Data & Statistics

Data & Statistics

Data, Statistics and Data Sets for England, Scotland, Wales & Northern Ireland.

Data & Statistics

The healthcare 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 closely monitors and analyses this data.

Our analysis is used to inform our policy and campaigns work and is published here on a monthly basis.

We use various datasets from all of the four UK nations to inform our work. Below you’ll find links to the main datasets and interactive charts that show how they’ve changed over time.

Performance Figures

+ England

England

  • There were 1.44m type 1 attendances, and 378k type 1 admissions.
  • The 4-hour target stood at 49.6%, the lowest figure on record.
  • There were 170k four-hour DTAs, and 55k 12-hour stays, both of which are the highest figures on record.

Attendances and admissions:

  • There were 1,439,432 type 1 attendances at EDs in December 2022. This represents a 15.1% increase compared with December 2021, and a 4.7% increase compared with pre-pandemic levels (i.e. December 2019).
    • Type-1 EDs saw 46,433 attendances per day during December, 119 fewer per day than in November.
  • 49.6% of patients were admitted, transferred, or discharged within 4 hours from arrival – this is a 4.9 percentage point decrease from the previous month, and an 11.6 percentage point decrease from December 2021 (61.2%).
  • Type 1 admissions stood at 378,267 (12,202 per day). Compared to pre-pandemic levels (i.e. December 2019), the number of type-1 admissions has fallen by 9.3%.
  • The percentage of type 1 attendances admitted was 26.3%, this is a 0.1 percentage point decrease from November, but 3.99% percentage points lower than December 2019.
  • The number of patients waiting more than 12 hours from the decision to admit to admission stood at 54,532, the highest figure on record and 10,740 more than the second highest figure on record (October 2022). December 2022’s figure is 320% higher than December 2021, and 2223% higher than December 2019.
    • There was a total of 347,703 12-hour stays recorded in 2022.
  • 170,283 patients experienced DTA waits of at least 4 hours. This is a 41.6% increase from December 2021.
  • As a percentage of admissions, four-hour delays to admission stood at 32.9%, this is the highest figure on record and an 8.8 percentage point increase from December 2021.

HES Data (November)

  • Patients leaving the department before being seen stood at 6.0%. This is an increase of 0.2 percentage points from October 2022, and an increase of 1.2 percentage points from November 2021.
  • Unplanned reattendance rate was 8.4%. This is 0.3 percentage points higher than November 2021.
+ Scotland

Scotland

In September 2022:

  • There were 113,522 attendances at major Emergency Departments in Scotland.
  • 65.6% of patients were seen within four-hours
    • This is the lowest four-hour performance since records began and is 8.2 percentage points lower than September 2021.
  • 13,506  patients waited more than eight-hours before being seen, admitted, discharged, or transferred
    • This is the highest number of eight-hour waits since records began
    • It means that more than one in 10 patients were waiting eight-hours or more in a major Emergency Department.
    • Double the number of patients have waited eight hours or more in 2022 so far (January – September) than in all of 2021.
  • 5,296 patients waited more than 12-hours before being seen, admitted, discharged, or transferred
    • This is the highest number of 12-hour waits since records began
    • This is an increase of 172% compared to September 2021.
+ Wales

Wales

Wales Performance Data

Summary for December 2022

Key points

  • Both 8- and 12-hour waits were the worst figures on record.
  • 27.4% of major ED attendances waited more than 8 hours (18,666 patients) and 17.5% of major ED attendances waited more than 12 hours (11,972 patients).
  • Overall, 53.7% of patients in major EDs were admitted, transferred, or discharged within 4 hours from arrival.
  • Average monthly bed occupancy was 92.39%.
  • When we compare December 2022 with December 2021, there has been an average increase of 2.4% in general and acute beds in service. By comparison there has been an 8.4% increase in general and acute beds occupied.
    • The maximum percentage of bed occupancy recorded in December was 94.89% and the minimum was 87.69%.
    • This demonstrates that general and acute bed capacity is not being increased in line with the scale of patient needs, a clear mismanagement of capacity failing to meet demand.

Attendances and patient waits

  • In December 2022, there were 88,262 total attendances across all emergency care facilities in Wales 19.6% more than in December 2021 (73,809 attendances).
  • There were 68,225 attendances to major EDs, 6.7% more than in November 2022 (63,225) and 18.1% more than in December 2021 (57,761).
  • 53.7% of patients in major EDs were admitted, transferred, or discharged within 4 hours from arrival. This is 4.5 percentage points lower than in December 2021 (58.2%) and 11.6 percentage points lower than in December 2019 (65.3%).
  • 18,666 patients were delayed by 8 hours or more in a Major ED, equivalent to one in four patients. This is the highest figure on record for this measure, and 18.8% more than the previous month (15,710 patients).
  • 11,972 patients spent 12 hours or more in an ED, 20.4% more than the previous month.
    • In December 2022, 1 in 6 patients spent 12 hours or more in an ED, this is the highest figure on record.

General and acute bed occupancy

  • In December 2022, there was a daily average of 6,540 general and acute beds in service, 10 more than the previous month. There was an average of 6,043
  • general and acute beds occupied, 81 less than the previous month.
    • In December 2021, there was a daily average of 6,389 general and acute beds in service and an average of 5,774 beds occupied.
  • A monthly average of 93.39% of all general and acute beds were occupied in December 2022.
    • This is 0.39 percentage points lower than the previous month (93.78%). This figure is 6.18 percentage points higher than in December 2021 (87.21%).
  • In December 2022, the highest percentage of bed occupancy recorded on a given day was 94.89%.
    • The minimum level of occupancy reported on a given day in December was 87.69%, 2.2 percentage points above the 85% recommendation to ensure patient flow and hospital capacity.
  • When we compare December 2021 with December 2022, there has been an average increase of 2.4% in general and acute beds in service. By comparison there has been an 8.4% increase in general and acute beds occupied, demonstrating that the number of beds in service is not being managed to match up with patient needs.
+ Northern Ireland

Northern Ireland

Tip of the Iceberg Campaign

The current 12-hour performance figures published by NHS England represent just the tip of the iceberg as they are measured from when the decision to admit (DTA) the patient was made rather than their time of arrival (TOA) at the Emergency Department (ED). Although TOA data is collected throughout England, there has been no indication of when this data will be published.

To better understand these long waits masked by the DTA metric, RCEM submits monthly Freedom of Information (FOI requests) to NHS England and NHS Digital to campaign on the extent of extremely long stays in EDs in England.

We will continue to campaign to ensure NHS England publishes the 12-hour length of stay data on a monthly basis so that local health systems and policymakers understand the problem of long waits in their EDs and use this data to improve the quality of care for patients.

For further information, please see our Tip of the Iceberg report. Alternatively, you can contact RCEM’s Policy and Public Affairs team at policy@rcem.ac.uk.

Excess Deaths

Using the best available evidence, a scientific study published in the Emergency Medicine Journal: http://press.psprings.co.uk/emj/january/emj211572.pdf. We have been calculating an estimated number of excess deaths occurring across the United Kingdom associated with crowding and extremely long waiting times.

The Royal College of Emergency Medicine estimates that there are at least 300-500 excess deaths occurring across the UK associated with crowding and extremely long waiting times in Emergency Departments.

This figure is based off 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.

Emergency care waiting times data for Wales, Northern Ireland and Scotland are recorded from the time of arrival in the Emergency Department, so it is possible to calculate an estimated associated mortality figure for these three nations using their monthly published 12-hour data measured from time of arrival and the one in 72 ratio/calculation.

However, NHS England only routinely publish monthly 12-hour waiting time data measured from the decision to admit to admission. In order to routinely calculate a monthly estimate of excess deaths associated with long waits, we need to have ready access to 12-hour waiting time data measured from the time of arrival.

NHS Digital annually publish Hospital Episodic Statistics which does record 12-hour waiting times from the time of arrival in the Emergency Department. We have previously used NHS Digital Hospital Episodic Statistics to calculate an estimated figure of associated excess deaths for England.

However, we have 12-hour data measured from time of arrival through freedom of information requests. The graph above under the Tip of the Iceberg section shows 12-hour waits from time of arrival for 2018, 2019, 2020, 2021 and up to October 2022 (2022 in red) so far. We can use this data obtained through FOIs to calculate an estimated excess deaths figure for England by dividing the number of 12-hour time of arrival waits by 72 (the mortality ratio).

The 300-500 figure is an estimate, but it is based on sound scientific research.  If or when 12-hour waiting time data measured from time of arrival is made publicly available monthly, we could calculate a more accurate estimate of excess deaths associated with long waiting times in Emergency Departments. RCEM believes in transparency of data and has been campaigning for NHS England to make 12-hour time of arrival data part of their monthly A&E statistics to understand the true number of 12-hour waits in England and associated harm and death.

The Financial Times has conducted calculations around excess deaths and has come up with a similar estimate: https://www.ft.com/content/f36c5daa-9c14-4a92-9136-19b26508b9d2.

The Independent has also investigated this and concluded a similar estimate: https://www.independent.co.uk/news/health/a-e-hosptial-trolley-waits-patient-deaths-b2135801.html and here: https://www.independent.co.uk/news/health/crisis-emergency-department-deaths-b2248844.html.

Lane Clarke & Peacock LLP have conducted research and concluded a similar estimate: https://www.lcp.uk.com/our-viewpoint/2023/01/are-nhs-waiting-times-contributing-to-excess-deaths/

UEC Winter Situation Report

UEC Winter Situation Report

Week 11

Beds

  • There was an average of 101,048 beds open across all acute trusts, and 99,354 open at type-1 acute trusts.  The latter figure represents a 0.43% decrease from the previous week, and a 4.3% increase from the same week last winter.
  • Occupancy at type-1 acute trusts was 94.1%, a 0.2 percentage point increase from the previous week, and a 1.8 percentage point increase from week 11 in 2021/22.
  • Of 137 trusts with general and acute beds, 127 recorded an occupancy of >85%. 61 recorded an occupancy of >95%.

Ambulance Offloads

  • There was an average of 11,204 arrivals by ambulance (total: 78,431), an increase of 0.6% from week 10. Compared to the same week last year, this is a decrease of 8.81%.
  • 12.5% of arrivals involved a delay of 30-60 minutes (0.9 percentage point decrease from week 10); 5.6% involved a delay of over 60 minutes (1.0 percentage point decrease from week 10).
  • In total, 18.2% of handovers involved a delay. This is the lowest figure recorded so far this winter and a 2.0 percentage point decrease from week 10 (the previous lowest figure this winter).
  • An average of 1,271 hours were lost each day, for a total of 8,889 hours (a 12.5% decrease from week 10). On average, 6.8 minutes were lost per ambulance offload, the lowest figure this winter.

Beds Occupied by Long-Stay Patients

  • On average, 48,631 patients occupied a bed for over 7 days, a 1.6% decrease from week 10. This figure is 10.3% higher than the same week in 2021.
  • For patients occupying a bed for 21 or more days, this figure was 19,218, a 2.4% decrease from week 10, and a 10.7% increase from week 11 in 2021.

Flu

  • The average number of G&A beds occupied by flu patients was 1,196, a decrease of 36.4% from week 10.
  • Compared to week 11 in 2021, this represents an increase of 1288.7%.

Criteria to Reside

  • The average number of patients remaining in hospital while no longer meeting the criteria to reside was 13,983, an increase of 3.1% from week 10 (13,566).
  • On average, 59.9% of patients who no longer met the criteria to reside remained in hospital, a 0.4 percentage point increase from the previous week.

Diverts

  • The average number of diverts in week 11 was 1.4, 1.3 fewer than week 10 and 1.9 fewer than week 11 in 2021/22.

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

  • The average number of total absences was 48,485, 1.6% lower than week 10, and 31.1% lower than week 11 in 2021.
  • The average number of COVID absences was 4,062, this is the lowest figure recorded so far this winter, a decrease of 2.0% from week 10, and an 85.7% decrease from week 11 in 2021.
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