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 2023.
The statistical bulletin presents information on all new and unplanned review attendances during October, November and December 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.
Urgent and emergency care data for clinical care episodes completed on or after 9th November 2023 in South Eastern Health and Social (HSC) Trust was not available at the time of this publication due to the Trust’s transition to completely digitised health records following the launch of the ‘encompass’ programme. Therefore, South Eastern HSC Trust data has been excluded from all analysis to allow for comparisons to be made with the four remaining HSC Trusts at previous time points. As such, all Northern Ireland level figures presented throughout the report only include those for Belfast, Northern, Southern and Western Health and Social Care Trusts. Figures for South Eastern HSC Trust from before 9th November have been included at department level were possible but are for information purposes only.
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 December 2023, 9,717 calls / attendances were received by PhoneFirst and Urgent Care Centre services, from patients who may previously have attended an ED. A total of 1,369 (14.1%) resulted in an attendance at an ED, whilst 8,348 patients did not go on to attend an ED.
- during December 2023, 49,874 patients in total attended an ED, and 8,348 attended PhoneFirst / Urgent Care Centre services without further referral to an ED; a total of 58,222 patients attended all urgent and emergency care services.
Emergency Care Attendances:
- during December 2023, there were 49,874 attendances at EDs in Northern Ireland, 916 (1.8%) less than in December 2022 (50,790).
- of the 49,874 ED attendances during December 2023, 46,139 (92.5%) had attended a Type 1 ED, 630 (1.3%) attended a Type 2 ED and 3,105 (6.2%) attended a Type 3 ED.
- between December 2022 and December 2023, attendances decreased at Type 1 EDs (827, 1.8%), Type 2 EDs (32, 4.8%), and Type 3 EDs (57, 1.8%).
- there were 157,178 attendances at EDs during the quarter ending 31 December 2023 (October, November, December), 2.1% (3,162) more than during the same quarter in 2022 (154,016).
Left before Treatment Complete:
- During December 2023, 8.1% of all ED attendances left before their treatment was complete, similar to December 2022.
Unplanned Re-Attendances within 7 Days:
- during December 2023, 3.8% of the 49,874 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 December 2023, almost one in five (19.5%) attendances at EDs had been referred by a GP, compared with 19.0% in December 2022.
Time Spent in Emergency Care Departments:
Performance against Targets
- over one third (38.4%) of attendances at Type 1 EDs in December 2023 spent less than 4 hours in ED, compared with 78.4% at Type 2 EDs and 99.0% at Type 3 EDs.
- during the quarter ending 31 December 2023 (October, November and December), less than half (44.7%) of patients spent less than 4 hours at an ED, less than in the same quarter in 2022 (47.6%).
- over three quarters (78.4%) of patients attending a Type 2 ED in December 2023 were treated and discharged, or admitted within 4 hours of their arrival, compared with 83.8% in December 2022.
- almost all (99.0%) patients attending a Type 3 ED in December 2023 were treated and discharged, or admitted within 4 hours of their arrival, a decrease from 99.3% in December 2022.
- between December 2022 and December 2023, the number waiting over 12 hours increased from 8,243 to 8,613, accounting for 17.3% of attendances in December 2023.
Time to Triage:
- during December 2023, the median waiting time from arrival at an ED to triage (initial assessment) by a medical professional was 13 minutes, with 95 percent of patients having their care needs assessed for the first time by a medical professional within 1 hour 7 minutes of arrival.
Time to Start of Treatment:
- during December 2023, the median waiting time from triage to the start of treatment by a medical professional was 1 hour 34 minutes, with 95 percent of patients receiving treatment within 7 hours 45 minutes of being triaged.
- almost three fifths (57.1%) of patients attending EDs in December 2023 commenced their treatment within 2 hours of being triaged, less than in December 2022 (58.3%).
Total Time in Emergency Care Department:
- the median time patients who were discharged home (not admitted) spent in a Type 1 ED was 4 hours 23 minutes in December 2023, 12 minutes more than the time taken during the same month last year (4 hours 11 minutes).
- the median time patients who were admitted to hospital spent in a Type 1 ED was 14 hours 22 minutes in December 2023, 24 minutes more than the same month last year (13 hours 58 minutes).
- during December 2023, Altnagelvin Area reported the longest median time spent in ED from arrival to admission (21 hours 52 minutes), whilst the RBHSC reported the shortest time (5 hours 55 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.
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. Emergency Care Waiting Time Statistics – Additional Guidance
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 24 hour service with full resuscitation facilities and designated accommodation for the reception of emergency care patients.
Type 2 Department A consultant led mono specialty emergency care service (e.g. ophthalmology, dental) with designated accommodation for the reception of patients.
Type 3 Department Other type of A&E/minor injury activity with designated accommodation for the reception of emergency care patients. The department may be doctor led, general practitioner led or nurse led and treats at least minor injuries and illnesses and can be routinely accessed without appointment. A service mainly or entirely appointment based (for example a GP Practice or Out-Patient Clinic) is excluded even though it may treat a number of patients with minor illness or injury. Includes Urgent Treatment Centres. Excludes NHS walk-in centres.
8. Figures incorporate all returns and amendments received from HSC Trusts up to Monday 8 January 2024.
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
9. For media enquiries please contact DoH Press Office by e-mail: pressoffice@health-ni.gov.uk
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