Emergency Care Waiting Time Statistics (October – December 2021)

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 2021.

The statistical bulletin presents information on all new and unplanned review attendances during October, November and December 2021. 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 Emergency Care Waiting Times Website.

Key Points:

Attendances at Emergency Care Departments:

Attendances:

• During December 2021, there were 58,791 attendances at EDs in Northern Ireland, 13,844 (30.8%) more than in December 2020 (44,947).
• Of the 58,791 ED attendances during December 2021, 51,872 (88.2%) had attended a Type 1 ED, 3,269 (5.6%) attended a Type 2 ED and 3,650 (6.2%) attended a Type 3 ED.
• Between December 2020 and December 2021, attendances increased at Type 1 EDs (12,833, 32.9%), Type 2 EDs (471, 16.8%) and Type 3 EDs (540, 17.4%).
• There were 183,415 attendances at EDs during the quarter ending 31 December 2021, 31.1% (43,494) more than during the same quarter in 2020 (139,921).

Left before Treatment Complete:

• During December 2021, 5.2% of all ED attendances left before their treatment was complete.

Unplanned Re-Attendances within 7 Days:

• During December 2021, 3.6% of the 58,791 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:

• In December 2021, one in six (15.8%) attendances at EDs had been referred by a GP, compared with 20.9% in December 2020.

Time Spent in Emergency Care Departments:

Performance against Targets

• Almost half (47.7%) of attendances at Type 1 EDs in December 2021 spent less than 4 hours in ED, compared with 86.8% at Type 2 EDs and 99.2% at Type 3 EDs.
• Over eight in ten (86.8%) patients attending a Type 2 ED in December 2021 were treated and discharged, or admitted within 4 hours of their arrival, compared with 86.0% in December 2020.
• Almost all (99.2%) patients attending a Type 3 ED were treated and discharged, or admitted within 4 hours of their arrival, compared with 99.5% in December 2020.
• Between December 2020 and December 2021, the number waiting over 12 hours increased from 5,149 to 7,508, accounting for 12.8% of attendances in December 2021.
• Over seven in ten (71.0%) patients attending EDs commenced their treatment within 2 hours of being triaged, compared with 86.9% in December 2020.
• During the quarter ending 31 December 2021, over half (54.9%) of patients spent less than 4 hours at an ED, compared to 62.4% during the same quarter in 2020.

Time to Triage:

• The median waiting time from arrival at an ED to triage (initial assessment) by a medical professional was 12 minutes during December 2021, with 95 percent of patients having their care needs assessed for the first time by a medical professional within 1 hour 4 minutes of arrival.

Time to Start of Treatment:

• During December 2021, the median waiting time from triage to the start of treatment by a medical professional was 1 hour, with 95 percent of patients receiving treatment within 5 hours 35 minutes of being triaged.

Total Time in Emergency Care Department:

• The median time patients discharged home (not admitted) spent in a Type 1 ED was 3 hours 30 minutes in December 2021, 38 minutes more than the time taken during the same month last year (2 hour 52 minutes).
• The median time patients who were admitted to hospital spent in a Type 1 ED was 11 hours 4 minutes in December 2021, 1 hour 5 minutes more than the same month last year (9 hours 59 minutes).
• During December 2021, the Craigavon Area reported the longest median time spent in ED from arrival to admission (14 hours 24 minutes), whilst the RBHSC reported the shortest time (5 hours 22 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 Northern Ireland. 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 2021/22 state that:

‘From April 2021, 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 2022, 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 Tuesday 18 January 2022.
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 the DoH Press Office by email at 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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