Northern Ireland Hospital Statistics: Emergency Care (2018/19)

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) in Northern Ireland during the year ending 31 March 2019.

The statistical bulletin presents information on the total activity at EDs in Northern Ireland during 2018/19, including information on new, unplanned and planned review attendances, waiting times at EDs, patient transport and emergency response.

The Northern Ireland Hospital Statistics: Emergency Care (2018/19) 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 (2018/19)

• During 2018/19, 64.7% of new and unplanned review attendances at Type 1 EDs were treated and discharged, or admitted, within four hours of their arrival, compared with 83.8% at Type 2 departments, and 99.8% at Type 3 departments.
• Over 25,300 (25,326, 3.1%) of the 822,847 new and unplanned review attendances at EDs waited longer than 12 hours to be either treated and discharged home, or admitted.
• Over four in five (79.2%) patients attending EDs in 2018/19 commenced their treatment within two hours of being triaged.
• During 2018/19, 37.2% of Category A (Immediately Life Threatening) Calls received by the NIAS were responded to within eight minutes.

Comparison with Previous Year (2017/18 - 2018/19)

• Since 2017/18, the total number of attendances (new, unplanned and planned reviews) at EDs increased by 27,286 (3.3%), from 823,236 to 850,522 in 2018/19.
• Between 2017/18 and 2018/19, performance against the four hour waiting times target declined by 3.5 percentage points from 73.4% to 69.9%; with performance at Type 1, Type 2 and Type 3 departments declining (68.7% to 64.7%, 87.9% to 83.8% and 99.9% to 99.8% respectively)
• A higher number of patients waited longer than 12 hours in 2018/19 (25,326) compared with 2017/18 (17,347), with the most notable increases at the Ulster (4,553 to 6,486) and Craigavon Area (2,570 to 4,604).
• Since 2017/18, the proportion of Category A Calls responded to within eight minutes decreased by 8 percentage points, from 45.2% to 37.2% in 2018/19.

Five Year Trends (2014/15 – 2018/19)

• During the last five years, the total number of ED attendances (new, unplanned and planned reviews) has increased by 111,857 (15.1%), from 738,665 in 2014/15 to 850,522 in 2018/19.
• Since 2014/15, performance against the four hour waiting times target declined by 7.6 percentage points from 77.5% to 69.9% in 2018/19.
• Between 2014/15 and 2018/19, the number of patients waiting longer than 12 hours increased markedly from 3,170 to 25,326, with the Ulster reporting the most notable increase during this period (689 to 6,486).
• Between 2014/15 and 2018/19, the number of Category A calls resulting in an emergency response arriving at the scene of an incident increased by 3.5% (1,973), from 56,934 to 58,907, whilst the percentage responded to within eight minutes during this period decreased by 20.5 percentage points, from 57.7% to 37.2%.
• Since 2014/15, the proportion of attendances referred by a GP increased by 1.4 percentage points, from 15.3% to 16.7% in 2018/19.

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 is 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.

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 & Eye Casualty) 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 2018/19 stated that:

“From April 2018, 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 2019, at least 80% of patients to have commenced treatment, following triage, within 2 hours.”

8. The Ministerial target for ambulance response times during 2018/19 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 30 May 2019.

10. Further information on Emergency Care Statistics is available from:

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

Tel: 028 90 522504

Email: statistics@health-ni.gov.uk

Internet

11. For media enquiries please contact the DoH Press Office team on 028 9052 0575 or by email to: pressoffice@health-ni.gov.uk. For out-of-hours please contact the Duty Press Officer on 028 9037 8110.

12. Follow us on Twitter @healthdpt

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