Emergency Care Waiting Time Statistics (October - December 2020)

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 2020.

The statistical bulletin presents information on all new and unplanned review attendances during October, November and December 2020. 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 a number of new models of care and pathways have recently been introduced that seek to ensure that patients are able to access the right care, first time. These include Urgent Care Centres, a ‘Phone First’ clinical telephone assessment service and direct access pathways into services. These new pathways and models of care may in part explain the reduction in the number of patients attending ED by providing them with timely access to the care they require.

This information release is published on the Departmental website.

Key Points

Attendances at Emergency Care Departments:

Attendances:

• During December 2020, there were 45,427 attendances at EDs in Northern Ireland, 19,401 (29.9%) less than in December 2019 (64,828).
• Of the 45,427 ED attendances during December 2020, 38,903 (85.6%) had attended a Type 1 ED, 3,109 (6.8%) attended a Type 2 ED and 3,415 (7.5%) attended a Type 3 ED.
• Between December 2019 and December 2020, attendances decreased at Type 1 EDs (15,087, 27.9%), Type 2 EDs (1,901, 37.9%) and Type 3 EDs (2,413, 41.4%).
• There were 141,333 attendances at EDs during the quarter ending 31st December 2020, 31.9% (66,242) less than during the same quarter in 2019 (207,575).

Left before Treatment Complete:

• During December 2020, 2.8% of all ED attendances left before their treatment was complete.

Unplanned Re-Attendances within 7 Days:

• During December 2020, 3.1% of the 45,427 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 (20.5%) attendances at EDs in December 2020 had been referred by a GP, compared with 18.0 % in December 2019.

Time Spent in Emergency Care Departments:

Performance against Targets:

• Over half (55.1%) of attendances at Type 1 EDs in December 2020 were treated and discharged, or admitted within 4 hours of their arrival, compared with 54.9% in December 2019.
• Over eight in ten (87.4%) patients attending a Type 2 ED in December 2020 were treated and discharged, or admitted within 4 hours of their arrival, compared with 78.9% in December 2019.
• Almost all (99.5%) patients attending a Type 3 ED were treated and discharged, or admitted within 4 hours of their arrival, similar to 99.8% in December 2019.
• Between December 2019 and December 2020, the number waiting longer than 12 hours decreased from 5,272 to 5,150, accounting for 11.3% of all attendances in December 2020.
• Over eight in ten (87.0%) patients attending EDs commenced their treatment within 2 hours of being triaged, compared with 76.2% in December 2019.
• During the quarter ending 31 December 2020, over six in ten (62.8%) of patients waited less than 4 hours at an ED, similar to 62.3% during the same quarter in 2019

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 2020, with 95 percent of patients having their care needs assessed for the first time by a medical professional within 52 minutes of arrival.

Time to Start of Treatment:

• During December 2020, the median waiting time from triage to the start of treatment by a medical professional was 31 minutes, with 95 percent of patients receiving treatment within 3 hours 23 minutes of being triaged.

Total Time in Emergency Care Department:

• The median time patients who were discharged home (not admitted) spent in a Type 1 ED was 2 hours 54 minutes in December 2020, 13 minutes less than the time taken during the same month last year (3 hour 7 minutes).

• The median time patients who were admitted to hospital spent in a Type 1 ED was 10 hours 5 minutes in December 2020, 1 hour 5 minutes more than the same month last year (9 hours).

• During December 2020, Craigavon Area reported the longest median waiting time from arrival to admission (14 hours 47 minutes), whilst the RBHSC reported the shortest time (3 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 2020/21 state that:
   • From April 2020, 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 2021, 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. 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 Wednesday 27 January 2021.
    
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: https://www.health-ni.gov.uk/topics/doh-statistics-and-research
    
10. For media enquiries please contact DoH Press Office by email: pressoffice@health-ni.gov.uk. 
     
11. Follow us on twitter @healthdpt.
     
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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