Emergency Care Waiting Time Statistics (October - December 2019)

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 2019.

The statistical bulletin presents information on all new and unplanned review attendances during October, November and December 2019. 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 available to view on the Departmental website.

Attendances at Emergency Care Departments:

Attendances:

• During December 2019, there were 64,872 attendances at EDs in Northern Ireland, 1,764 (2.6%) less than in December 2018 (66,636).
• Of the 64,872 ED attendances during December 2019, 54,035 (83.3%) had attended a Type 1 ED, 5,009 (7.7%) attended a Type 2 ED and 5,828 (9.0%) attended a Type 3 ED.
• Between December 2018 and December 2019, attendances decreased at Type 1 EDs (1,768, 3.2%) and Type 3 EDs (127, 2.1%), but increased at Type 2 EDs (131, 2.7%).
• There were 207,715 attendances at EDs during the quarter ending 31^st December 2019, 2.5% (5,105) more than during the same quarter in 2018 (202,610).

Left before Treatment Complete:

• During December 2019, 4.8% of all ED attendances left before their treatment was complete.

Unplanned Re-Attendances within 7 Days:

• During December 2019, 3.5% of the 64,872 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 (18.0%) attendances at EDs in December 2019 had been referred by a GP, compared with 17.1% in December 2018.

Time Spent in Emergency Care Departments:

Performance against Targets

• Over half (54.8%) of attendances at Type 1 EDs in December 2019 were treated and discharged, or admitted within 4 hours of their arrival, compared with 62.2% in December 2018.
• Almost four in five (78.9%) patients attending a Type 2 ED in December 2019 were treated and discharged, or admitted within 4 hours of their arrival, compared with 82.7% in December 2018.
• Almost all (99.8%) patients attending a Type 3 ED were treated and discharged, or admitted within 4 hours of their arrival, compared with 99.9% in December 2018.
• Between December 2018 and December 2019, the number waiting longer than 12 hours more than doubled from 1,991 to 5,280, accounting for 8.1% of all attendances in December 2019.  
• Over three quarters (76.2%) of patients attending EDs in December 2019 commenced their treatment within 2 hours of being triaged, compared with 78.4% in December 2018.

• During the quarter ending 31^st December 2019, almost two thirds (62.3%) of patients were treated and discharged or admitted within 4 hours, compared with 69.4% in the same quarter in 2018.

Time to Triage:

• The median waiting time from arrival at an ED to triage (initial assessment) by a medical professional was 10 minutes during December 2019, with 95 percent of patients having their care needs assessed for the first time by a medical professional within 46 minutes of arrival.

Time to Start of Treatment:

• During December 2019, the median waiting time from triage to the start of treatment by a medical professional was 51 minutes, with 95 percent of patients receiving treatment within 4 hours 36 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 3 hours 7 minutes in December 2019, 20 minutes more than the same month last year (2 hours 47 minutes).
• The median time spent in a Type 1 ED for patients admitted to hospital was 9 hours in December 2019, 2 hours 39 minutes more than the same month last year (6 hours 21 minutes).
• During December 2019, Altnagelvin Area reported the longest median time spent in an ED from arrival to admission to hospital (10 hours 34 minutes), whilst the RBHSC reported the shortest median time of 4 hours 11 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 2019/20 state that:

‘From April 2019, 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 2020, 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. 

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.

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 17^th January 2020.

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

10. For media enquiries please contact DoH Press Office on 02890520579 or email pressoffice@health-ni.gov.uk . For out-of-hours please contact the Duty Press Officer on 028 9037 8110. 

11. Follow us on @healthdpt

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