The Department of Health (DoH) today published statistics on the time spent in emergency care departments (ED) throughout Northern Ireland during the months of October, November and December 2018.
The statistical bulletin presents information on all new and unplanned review attendances during October, November and December 2018. 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.
This information release is published on the Departmental website.
Key Points
Attendances at Emergency Care Departments:
Attendances:
During December 2018, there were 66,640 attendances at EDs in Northern Ireland, 1,515 (2.3%) more than in December 2017 (65,125).
Of the 66,640 ED attendances during December 2018, 55,807 (83.8%) had attended a Type 1 ED, 4,878 (7.3%) attended a Type 2 ED and 5,955 (8.9%) attended a Type 3 ED.
Between December 2017 and December 2018, attendances increased at Type 1 EDs (983,1.8%) and Type 3 EDs (629, 11.8%), but decreased at Type 2 EDs (97, 1.9%).
There were 202,618 attendances at EDs during the quarter ending 31st December 2018, 2.4% (4,747) more than during the same quarter in 2017 (197,871).
Left before Treatment Complete:
During December 2018, 4.2% of ED attendances left before their treatment had been completed.
Unplanned Re-Attendances within 7 Days:
During December 2018, 3.4% of the 66,640 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:
Over one in six (17.2%) attendances at EDs in December 2018 had been referred by a GP, similar to December 2017 (17.2%).
Time Spent in Emergency Care Departments:
Performance against Targets
Over six in ten (62.2%) of attendances at Type 1 EDs in December 2018 were treated and discharged, or admitted within 4 hours of their arrival, 0.8 percentage points lower than December 2017 (63.0%).
Over eight in ten (82.7%) patients attending a Type 2 ED in December 2018 were treated and discharged, or admitted within 4 hours of their arrival, 1.8 percentage points lower than December 2017 (84.5%).
Almost all (99.9%) patients attending a Type 3 ED were treated and discharged, or admitted within 4 hours of their arrival.
Between December 2017 and December 2018, the number waiting longer than 12 hours decreased from 2,369 to 2,018, accounting for 3.0% of all attendances in December 2018.
Over three quarters (77.7%) patients attending EDs commenced their treatment within 2 hours of being triaged, 0.4 percentage points lower than December 2017 (78.1%).
During the quarter ending 31st December 2018, almost three quarters (69.4%) of patients were treated and discharged or admitted within 4 hours, 2.3 percentage points less than the same quarter in 2017 (71.7%).
Time to Triage:
The median waiting time from arrival at an ED to triage (initial assessment) by a medical professional was 9 minutes during December 2018, with 95 percent of patients having their care needs assessed for the first time by a medical professional within 37 minutes of arrival.
Time to Start of Treatment:
During December 2018, the median waiting time from triage to the start of treatment by a medical professional was 48 minutes, with 95 percent of patients receiving treatment within 4 hours 8 minutes of being triaged.
Total Time in Emergency Care Department:
The median time spent in a Type 1 ED by patients who were discharged home (not admitted) was 2 hours 47 minutes in December 2018, 3 minutes longer than the same month last year (2 hours 44 minutes).
The median time spent in a Type 1 ED for patients admitted to hospital was 6 hours 23 minutes in December 2018, 11 minutes less than the same month last year (6 hours 34 minutes).
During December 2018, the Ulster reported the longest median time spent in an ED from arrival to admission to hospital ED (7 hours 21 minutes), whilst the Downe reported the shortest median time of 3 hours 31 minutes.
Notes to editors:
- 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.
- 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)).
- The current draft Ministerial targets for emergency care waiting times in 2018/19 state that:
‘From April 2018, 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 2019, at least 80% of patients to have commenced treatment, following triage, within 2 hours.’ - 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.
- 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.
- 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.
- 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. - Figures incorporate all returns and amendments received from HSC Trusts up to Friday 18th January 2019.
Further information on Emergency Care Statistics is available from:
Hospital Information Branch
Department of Health
Annexe 2, Castle Buildings
Stormont
Belfast
BT4 3SQ
Email
Internet - For media enquiries please contact the Department of Health Press Office team on 028 9052 0575 or by email. For out of hours please contact the Duty Press Officer on 028 9037 8110.
- Follow us on twitter @healthdpt.