Northern Ireland Hospital Statistics: Emergency Care (2016/17)

The Department of Health today published annual statistics on activity and waiting times at emergency care departments (ED), and activity of the Northern Ireland Ambulance Service (NIAS) within Northern Ireland during the year ending 31 March 2017.

The statistical bulletin presents information on the total activity at ED’s in Northern Ireland during 2016/17, including information on new, unplanned and planned review attendances, waiting times at ED’s, patient transport and emergency response.

The Northern Ireland Hospital Statistics: Emergency Care (2016/17) publication is the first in the series of three ‘Hospital Statistics’ statistical publications due for release in the coming months, with the further two detailing information on: inpatient activity and outpatient activity.

This information release is published on the Departmental website.

Key Points

Latest Position (2016/17)

• During 2016/17, 69.8% of new and unplanned review attendances at Type 1 ED’s were treated and discharged, or admitted, within 4 hours of their arrival, compared with 90.1% at Type 2 departments, and 100.0% at Type 3 departments.
• Almost 6,500 (6,494, 0.8%) of the 770,223 new and unplanned review attendances at ED’s waited longer than 12 hours to be either treated and discharged home, or admitted.
• Over four in five (81.6%) patients attending ED’s in 2016/17 commenced their treatment within 2 hours of being triaged.
• During 2016/17, 51.0% of Category A (Immediately Life Threatening) Calls received by the NIAS were responded to within 8 minutes.

Comparison with Previous Year (2015/16 - 2016/17)

• Since 2015/16, the total number of attendances (new, unplanned and planned reviews) at ED’s increased by 34,481 (4.5%), from 763,185 to 797,666 in 2016/17.
• Between 2015/16 and 2016/17, performance against the 4 hour waiting times target declined by 1.7 percentage points from 76.1% to 74.4%; with performance at Type 1 and  Type 2 departments declining (71.7% to 69.8% and 92.7% to 88.9% respectively), whilst performance at Type 3 departments remained at 100.0% (Table 17 & 18).
• A higher number of patients waited longer than 12 hours in 2016/17 (6,494) compared with 2015/16 (3,875), with the most notable increase at the RVH (577 to 1,124).
• Since 2015/16, the proportion of Category A Calls responded to within 8 minutes decreased by 2.5 percentage points, from 53.5% to 51.0% in 2016/17.

Five Year Trends (2012/13 – 2016/17)

• During the last five years, the total number of ED attendances (new, unplanned and planned reviews) has increased by 81,917 (11.4%), from 715,749 in 2012/13 to 797,666 in 2016/17.
• Since 2012/13, performance against the 4 hour waiting times target declined by 4.1 percentage points from 78.5% to 74.4% in 2016/17.
• Between 2012/13 and 2016/17, the number of patients waiting longer than 12 hours increased from 5,560 to 6,494, with the RVH reporting the most notable increase during this period (267 to 1,124).
• Since 2012/13, the proportion of Category A Calls responded to within 8 minutes decreased by 17.3 percentage points, from 68.3% to 51.0% in 2016/17.
• Since 2014/15, the proportion of ED attendances referred by a GP increased by 1.3 percentage points, from 15.3% to 16.6% in 2016/17. (This data is only available on a comparable basis for the last three years).

The information release is published on the Departmental website.

Notes to editors: 

1. All information presented in this publication has been provided by HSC Trusts or downloaded by Hospital Information Branch (HIB) within an agreed timescale and validated and quality assured by HIB prior to release. At the end of each financial year HIB verify with HSC Trusts that the information downloaded / submitted during the year is consistent and up to date. Further information can be found in Technical Notes (page 8) and Appendices 5 & 6 of the Hospital Statistics: Emergency Care publication.
2. 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 ED’s and reflects the experience of patients and the timeliness of the care they receive.
3. 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 is detailed in Appendix 5 of this statistical publication.
4. 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 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 appointment.

5. It should also be noted that from 2014/15 the way in which waiting times information is presented for the Royal Victoria ED changed, with information for the Royal Victoria ED and the Royal Victoria (ENT & RAES) service being reported separately.
6. The Belfast HSC Trust indicated that the Ear, Nose & Throat (ENT) service at the Royal Victoria Hospital should no longer be reported within the ED waiting times information, as this service is no longer operating as an unscheduled service. As this came into effect from 1 April 2016, where possible we have removed all information for the RVH (ENT) from this publication to aid comparisons with previous years.
7. The Ministerial targets for emergency care waiting times during 2016/17 stated that:

   “From April 2016, 95% of patients attending any Type 1, 2 or 3 Emergency Department should be either treated and discharged home, or admitted, within four hours of their arrival in the Department; and no patient attending any Emergency Department should wait longer than 12 hours”.

   “By March 2017, at least 80% of patients to have commenced treatment, following triage, within 2 hours.”

8. The Ministerial target for ambulance response times during 2016/17 stated that:

   ‘‘An average of 72.5% of Category A (life threatening) calls should be responded to within eight minutes, 67.5% in each Local Commissioning Group (LCG) Area.”

9. Figures incorporate all returns and amendments received up to 17 June 2017.
10. Further information on Emergency Care Statistics is available from:

    Hospital Information Branch
    Department of Health
    Annexe 2, Castle Buildings
    Stormont, BT4 3SQ

    Telephone:      028 9052 2504

    Fax:                 028 9052 3288

    Internet:           https://www.health-ni.gov.uk/articles/emergency-care-and-ambulance-statistics

11. Media enquiries about this press release to DoH Press Office 028 9052 0505, or out of office hours contact to Duty Press Officer via pager number 07623 974383 and your call will be returned. Follow us on Twitter @healthdpt

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