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.
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 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.
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.
+ England
Flourish slides can be found here.
January 2024 summary:
Supplementary ECDS Analysis January 2024 final (12-hour length of stay data measured from the time of arrival) data shows:
The latest Emergency Department performance figures published by NHS England for January 2024 for show:
Beds data for January 2024 show:
Emergency Department performance data for Scotland, January 2024:
Flourish slides: https://public.flourish.studio/story/1848443/
Flourish slides can be found here.
We welcome the slight improvement in four and eight-hour performance figures for January. However, we are still well below pre-2017 performance.
Nearly half of patients waited four hours or longer in an Emergency Department, nearly one in four waited eight hours or longer, and more than one in seven people waited 12 hours or longer.
Between 2007 and 2016, performance levels were moderately consistent, four-hour performance rarely dropped below 80%. However, since January 2017, the numbers waiting four hours or more increased by 64%, the numbers waiting more than eight hours by 100%, and the numbers waiting more than 12 hours by 143%. This is despite attendance increasing by only 0.9% in the same period.
Flourish slides can be found here.
October to December 2023 was the worst quarter on record for four-hour and the second worst for 12-hour Emergency Department performance in Northern Ireland. On average, more than half of patients waited for four hours or more (59.8%) and over one in six patients waited for 12 hours or more (17.7%).
In December, the percentage who waited less than four hours in an Emergency Department dropped below 40% for the first time ever. The number of patients who waited 12 hours or longer has increased by 16 times compared to quarter three 2016.
The median time that admitted patients waited in an Emergency Department was 14 hours, three times longer than the time spent by discharged patients.
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.
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.
(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 17 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.)
Flourish slides can be found here.
Summary for week 17:
Beds
Ambulance Offloads
Beds Occupied by Long-Stay Patients
Criteria to Reside
Flu
Diverts
Absences