Northern Ireland Hospital Statistics: Emergency Care (2019/20)

The Department of Health today published annual statistics on activity and waiting times at emergency care departments (ED), in Northern Ireland during the year ending 31 March 2020.

The statistical bulletin presents information on the total activity at EDs in Northern Ireland during 2019/20, including information on new, unplanned and planned review attendances, and waiting times at EDs.

The Northern Ireland Hospital Statistics: Emergency Care (2019/20) 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 here.

Please note this statistical release does not include Ambulance statistics as NIAS have not provided DoH with 2019/20 figures. Once the 2019/20 figures have been received and validated a revision will be released to include this data.

Key Points

Latest Position (2019/20)

• During 2019/20, 59.2% of new and unplanned review attendances at Type 1 EDs were treated and discharged, or admitted, within 4 hours of their arrival, compared with 80.2% at Type 2 departments, and 99.6% at Type 3 departments.
• Over 45,000 (45,401, 5.6%) of the 814,273 new and unplanned review attendances at EDs waited longer than 12 hours to be either treated and discharged home, or admitted.
• Over three quarters (76.7%) of patients attending EDs in 2019/20 commenced their treatment within 2 hours of being triaged.

Comparison with Previous Year (2018/19 – 2019/20)

• Since 2018/19, the total number of attendances (new, unplanned and planned reviews) at EDs decreased by 10,816 (1.3%), from 850,522 to 839,706 in 2019/20.
• Between 2018/19 and 2019/20, performance against the 4 hour waiting times target declined from 69.9% to 65.1%; with performance at Type 1, Type 2 and Type 3 departments declining (64.7% to 59.2%, 83.8% to 80.2% and 99.8% to 99.6% respectively)
• A higher number of patients waited longer than 12 hours in 2019/20 (45,401) compared with 2018/19 (25,326), with the most notable increases at Craigavon Area (4,609 to 9,356).

 Five Year Trends (2015/16 – 2019/20)

• During the last five years, the total number of ED attendances (new, unplanned and planned reviews) has increased by 76,521 (10.0%), from 763,185 in 2015/16 to 839,706 in 2019/20.
• Since 2015/16, performance against the 4 hour waiting times target declined from 76.1% to 65.1% in 2019/20.
• Between 2015/16 and 2019/20, the number of patients waiting longer than 12 hours increased markedly from 3,875 to 45,401, with Craigavon Area  reporting the most notable increase during this period (75 to 9,356).
• Since 2015/16, the proportion of attendances referred by a GP increased from 16.4% to 16.7% in 2019/20.

The information release is published on the Departmental website at:

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

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 4) 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 1st 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 2019, 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 2020, at least 80% of patients to have commenced treatment, following triage, within 2 hours.”

8. The Ministerial target for ambulance response times during 2019/20 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. NIAS implemented a new Clinical Response Model (CRM) on 12 November 2019. Information provided by NIAS from this date is not comparable to the previous CRM. New targets have been implemented.

10. Figures incorporate all returns and amendments received up to 17 June 2020.

11. For media enquiries please contact DoH Press Office by email: pressoffice@health-ni.gov.uk. 

12. Follow us on twitter @healthdpt.

13. The Executive Information Service operates an out of hours service for media enquiries 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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