Emergency care waiting time statistics (July – September 2023)

The Department of Health (DoH) today published statistics on the time spent in emergency care departments (ED) throughout Northern Ireland during the months of July, August and September 2023.

The statistical bulletin presents information on all new and unplanned review attendances during July, August and September 2023. It details information on the time spent in EDs during each of these months including; the monthly performance against the DoH emergency care waiting times target for EDs and the time waited for key milestones during a patient’s journey through ED, whilst they are being cared for in an ED, including the time to triage and time to start of treatment.

Please note that this statistical release includes information on two new urgent care services (i) PhoneFirst and (ii) Urgent Care Centres, which were introduced in late 2020, to assess patients’ needs before arrival at an ED, and ensure they receive the right care, at the right time, and in the right place, outside ED if appropriate. These new services may in part help explain the reduction in the number of patients attending EDs.

This information release is published on the Emergency Care Waiting Times Website.

Key Points

Attendances at Emergency Care Departments:

Urgent and Emergency Care Attendances:

• in September 2023, 14,594 calls / attendances were received by PhoneFirst and Urgent Care Centre services, from patients who may previously have attended an ED. A total of 2,105 (14.4%) resulted in an attendance at an ED, whilst 12,489 patients did not go on to attend an ED.
• during September 2023, 64,693 patients in total attended an ED, and 12,489 attended PhoneFirst / Urgent Care Centre services without further referral to an ED; a total of 77,182 patients attending all urgent and emergency care services.

Emergency Care Attendances:

• during September 2023, there were 64,693 attendances at EDs in Northern Ireland, 1,852 (2.9%) more than in September 2022 (62,841).

• of the 64,693 ED attendances during September 2023, 55,803 (86.3%) had attended a Type 1 ED, 2,395 (3.7%) attended a Type 2 ED and 6,495 (10.0%) attended a Type 3 ED.
• between September 2022 and September 2023, attendances increased at Type 1 EDs (1,088, 2.0%) and Type 3 EDs (1,151, 21.5%), and decreased at Type 2 EDs (387, 13.9%).
• there were 194,274 attendances at EDs during the quarter ending 30 September 2023, 2.4% (4,605) more than during the same quarter in 2022 (189,669).

Left before Treatment Complete:

• during September 2023, 6.9% of all ED attendances left before their treatment was complete, compared with 6.6% in September 2022.

Unplanned Re-Attendances within 7 Days:

• during September 2023, 3.4% of the 64,693 ED attendances were unplanned review attendances who had returned to the same ED within 7 days of their original attendance for the same condition.

Referrals by GP:

• during September 2023, over one in six (17.0%) attendances at EDs had been referred by a GP, similar to September 2022.

Time Spent in Emergency Care Departments:

Performance against Targets

• over two fifths (43.4%) of attendances at Type 1 EDs in September 2023 spent less than 4 hours in ED, compared with 80.1% at Type 2 EDs and 97.6% at Type 3 EDs
• during the quarter ending 30 September 2023 (July, August and September), more than half (50.5%) of patients spent less than 4 hours at an ED, similar to the same quarter in 2022.
• over four fifths (80.1%) of patients attending a Type 2 ED in September 2023 were treated and discharged, or admitted within 4 hours of their arrival, compared with 81.4% in September 2022.
• almost all (97.6%) patients attending a Type 3 ED were treated and discharged, or admitted within 4 hours of their arrival, a decrease from 99.0% in September 2022.
• between September 2022 and September 2023, the number waiting over 12 hours increased from 8,832 to 9,357, accounting for 14.5% of attendances in September 2023.

Time to Triage:

• during September 2023, the median waiting time from arrival at an ED to triage (initial assessment) by a medical professional was 12 minutes, with 95 percent of patients having their care needs assessed for the first time by a medical professional within 1 hour 13 minutes of arrival.

Time to Start of Treatment:

• during September 2023, the median waiting time from triage to the start of treatment by a medical professional was 1 hour 12 minutes, with 95 percent of patients receiving treatment within 6 hours 25 minutes of being triaged.
• almost two thirds (65.5%) of patients attending EDs in September 2023 commenced their treatment within 2 hours of being triaged, similar to September 2022.

Total Time in Emergency Care Department:

• the median time patients discharged home (not admitted) spent in a Type 1 ED was 3 hours 53 minutes in September 2023, 8 minutes more than the time taken during the same month last year (3 hours 45 minutes).
• the median time patients who were admitted to hospital spent in a Type 1 ED was 13 hours 33 minutes in September 2023, 3 minutes less than the same month last year (13 hours 36 minutes).
• during September 2023, Daisy Hill reported the longest median time spent in ED from arrival to admission (21 hours 10 minutes), whilst the RBHSC reported the shortest time (4 hours 43 minutes).

Notes to editors: 

1. This statistical bulletin reports the total time spent in an ED from arrival until admission, transfer or discharge for all new and unplanned review attendances at emergency care departments across NI. The figures do not include planned review attendances.

2. Time is measured from when a patient arrives at the ED (time of arrival is recorded at registration or triage whichever is earlier (clock starts)) until the patient departs the ED (time of departure is defined as when the patient's clinical care episode is completed within the ED (clock stops)).

3. The current draft Ministerial targets for emergency care waiting times in 2023/24 state that:

‘From April 2023, 95% of patients attending any Type 1, 2 or 3 Emergency Care Department are either treated and discharged home, or admitted, within four hours of their arrival in the department; and no patient attending any Emergency Care Department should wait longer than 12 hours.’

‘By March 2024, at least 80% of patients to have commenced treatment, following triage, within 2 hours.’

4. Information which presents a summary of the emergency care clinical quality indicators for Northern Ireland has also been included in this release. This information is not National Statistics but has been included to provide a more comprehensive and balanced view of the care delivered by EDs and reflects the experience of patients and the timeliness of the care they receive.

5. Readers are advised to be cautious when making direct comparisons between Northern Ireland and other UK Jurisdictions as waiting times may not be measured in a comparable manner.  It should also be noted that the way in which emergency care services are delivered differs between UK jurisdictions. This means that the number and types of patients included in the figures may differ between countries. In particular, the 12-hour waiting time information published by England and Northern Ireland is not equivalent and should not be compared. Further information on comparability between Northern Ireland and other UK Jurisdictions are included in the ‘Emergency Care Waiting Time Statistics – Additional Guidance’ booklet available on our website.

6. The DoH have liaised with colleagues in England, Scotland and Wales to clarify differences between the emergency care waiting times reported for each administration and have produced a guidance document to provide readers with a clear understanding of these differences Emergency Care UK Comparative Waiting Times PDF (25KB).

7. There are three separate categories of emergency care facility included in this publication:

Type 1 Department     A consultant-led service with designated accommodation for the reception of emergency care patients, providing both emergency medicine and emergency surgical services 24 hours a day.

Type 2 Department     A consultant-led service with designated accommodation for the reception of emergency care patients, but which does not provide both emergency medicine and emergency surgical services and/or has time-limited opening hours.

Type 3 Department     A minor injury unit with designated accommodation for the reception of patients with a minor injury and/or illness. It may be a doctor or nurse-led. A defining characteristic of this service is that it treats at least minor injuries and/or illnesses and can be routinely accessed without an appointment.

8. Figures incorporate all returns and amendments received from HSC Trusts up to Friday 20 October 2023.

9. Further information on Emergency Care Statistics is available from:

Hospital Information Branch
Department of Health
Annexe 2, Castle Buildings
Stormont,
BT4 3SQ
Email:              statistics@health-ni.gov.uk
Internet:              DoH Statistics and Research

10. For media enquiries please contact DoH Press Office by e-mail pressoffice@health-ni.gov.uk  

11. Follow us on X @healthdpt and linkedIn Department of Health NI | LinkedIn

12. The Executive Information Service operates an out of hours service for Media Enquiries Only between 1800hrs and 0800hrs Monday to Friday and at weekends and public holidays. The Duty Press Officer can be contacted on 028 9037 8110.

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