Northern Ireland Hospital Statistics: Emergency Care (2020/21)

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 31st March 2021.

The statistical bulletin presents information on the total activity at EDs in Northern Ireland during 2020/21, including information on new, unplanned and planned review attendances, waiting times at EDs, ambulance response times, calls and incidents.

The Northern Ireland Hospital Statistics: Emergency Care (2020/21) 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.

Key Points

Latest Position (2020/21)

• During 2020/21, 60.5% of new and unplanned review attendances at Type 1 EDs were treated and discharged, or admitted, within 4 hours of their arrival, compared with 84.6% at Type 2 departments, and 99.7% at Type 3 departments (Table 6).
• Almost 38,000 (37,884, 6.4%) of the 593,369 new and unplanned review attendances at EDs waited longer than 12 hours to be either treated and discharged home, or admitted (Table 6).
• Over four fifths (85.9%) of patients attending EDs in 2020/21 commenced their treatment within 2 hours of being triaged (Table 11).
• The NIAS Category 1 Mean Target (8 minutes) and the 90th Percentile Target (15 minutes) was not also achieved in any month during 2020/21 (Table 26 & Table 27).
• The NIAS Category 1T Mean Target (19 minutes) and the 90th Percentile Target (30 minutes) was also achieved in each month during 2020/21 (Table 26 & Table 27).

Comparison with Previous Year (2019/20 – 2020/21)

• Since 2019/20, the number of new and unplanned review attendances EDs decreased by 220,904 (27.1%), from 814,273 to 593,369 in 2020/21 (Table 5).

• Whilst the number of attendances decreased notably between 2019/20 and 2020/21, performance against the 4 hour waiting times target remained similar 65.1% to 65.0%; with performance at Type 1, Type 2 and Type 3 departments increased (59.2% to 60.5, 80.2% to 84.6 and 99.6% to 99.7 respectively) (Table 9).
• Fewer patients waited longer than 12 hours in 2020/21 (37,884) compared with 2019/20 (45,401), with a decrease reported by all EDs with the exception of Antrim Area where the number waiting over 12 hours increased from 5,140 to 5,696 (Table 10) .

Five Year Trends (2016/17 – 2020/21)

• During the last five years, the total number of ED attendances (new and unplanned reviews) decreased by 176,854 (23.0%), from 770,223 in 2016/17 to 593,369 in 2020/21 (Table 5).
• Whilst the number of attendances decreased notably between 2016/17 and 2020/21, performance against the 4 hour waiting times target declined from 74.4% to 65.0% in 2020/21 (Table 5).
• Between 2016/17 and 2020/21, the number of patients waiting longer than 12 hours increased markedly from 6,494 to 37,884, with Craigavon Area  reporting the most notable increase during this period (621 to 7,638) (Table 10).
• Since 2016/17, the proportion of attendances referred by a GP increased from 16.6% to 17.7% in 2020/21 (Table 20).

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 4) and Appendices 6 & 7 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 6 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 2020/21 stated that: “By March 2021, at least 80% of patients to have commenced treatment, following triage, within 2 hours.”

8. 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.

9. The new call categories and targets are as follows:

10. Figures incorporate all returns and amendments received up to 23 July 2021.

11. 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
Email: statistics@health-ni.gov.uk

12. For media enquiries please contact DoH Press Office by email: pressoffice@health-ni.gov.uk.
13. Follow us on twitter @healthdpt.
14. 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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