Summary of Key Points
Flow Chart
This statistical brief presents information on the time waited in emergency care departments (EDs) in Northern Ireland, including information on a series of clinical quality indicators detailing the key milestones of a patients time in an ED. Further information on data included in this release is available at the link below:
https://www.health-ni.gov.uk/sites/default/files/publications/health/hs-niwts-ecwt-guidance.pdf
Key Points
- 62,882 attendances at emergency departments
- Median waiting time for patients to be triaged was 12 minutes from time of arrival
- Median waiting time from triage to start of treatment was 61 minutes
- 6.6% of attendances left ED before their treatment was complete
- Median waiting time for patients admitted to hospital was 11 hours 6 minutes
- Median waiting time for patients discharged home was 3 hours 2 minutes
- 14.5% of attendances had been referred by a GP
- 54.4% treated and discharged or admitted within 4 hours.
- 7,396 waited more than 12 hours
How many Attend ED
Attendances
During September 2021, 62,882 patients attended EDs in Northern Ireland, 4,665 (8.0%) more than September 2020 (58,217). Information is also detailed in the heatmap below on the number of attendances at EDs each month from April 2008.
Heatmap of Attendances at all EDs
During September 2021, the Ulster (8,695) reported the highest number of attendances at Type 1 EDs, whilst Mater reported the lowest (1,933).
Attendances at Type 1 EDs
Attendances by Super Output Area
Attendances Per 1,000 population
The interactive map below presents the number of ED attendances per 1,000-population for each Super Output Area (SOA) in Northern Ireland.1
During September 2021, the highest number of attendances at EDs per 1,000-population was in the New Lodge 1 super output area (71.6), whilst the lowest rate was in Stranmillis 3 super output area (8).
Standardised Attendance Rate
The interactive map below presents the standardised ED attendance rate (SAR) per 1,000 population for SOA in Northern Ireland by deprivation level, and is presented in 3 SAR categories.2
Admissions
The chart below presents information on the percentage of ED attendances which resulted in an emergency admission to hospital, during each month since April 2014.
During September 2021, 18.3% of the 62,882 attendances at EDs were admitted to hospital. Since April 2014, the percentage of ED attendances admitted to hospital ranged from 17.1% in June 2018 to 24.9% in January 2021.
Across Type 1 EDs, the Mater (25.0%) reported the highest percentage of attendances at ED being admitted to hospital.
Percentage of ED Attendances Admitted to Hospital from ED
Weekday
The number of attendances at EDs is presented below for each day of the week and hour during September 2021.
Overall, Monday was the busiest day of the week with an average of 2,480 attendances, whilst the lowest average number of daily attendances was on a Saturday (1,746).
The busiest hour of the week was between 11:00 and 11:59 on Monday.
Arrivals by Hour and Day of Week
GP Referrals
During September 2021, 14.5% of attendances at EDs had been referred by a GP. Across Type 1 EDs, Craigavon (25.4%) reported the highest percentage of ED attendances referred by a GP, whilst RVH (7.3%) reported the lowest.
Since April 2014, the percentage of ED attendances which had been referred by a GP ranged from 12.9% in July 2021 to 22.4% in January 2021.
GP Referrals to EDs
Left Before Treatment
During September 2021, 6.6% of attendances left an EDs before their treatment was complete. Across Type 1 EDs, RVH (15.3%) reported the highest percentage of ED attendances leaving before their treatment was complete, whilst Antrim (3.6%) reported the lowest.
Since April 2014, the percentage of ED attendances who had left before treatment ranged from 1.4% in April 2020 to 6.8% in July 2021.
Patients Leaving ED Before Treatment Complete
Waiting Times at ED
Four Hours
During September 2021, 48.0% of patients attending Type 1 EDs in Northern Ireland were treated and discharged or admitted within four hours compared to 60.5% in September 2020. Information is also detailed in the heatmap below on the monthly performance against the four hour ED waiting times target each month from April 2008.
Heatmap of Performance against Four Hour Target at Type 1 EDs
During September 2021, the RBHSC (65.1%) reported the highest performance of any Type 1 ED, whilst RVH (26.8%) reported the lowest.
The table below details the number of attendances and performance against the four hour target at Type 1 EDs during September 2021 compared with September 2020.
Four Hour Target at Type 1 EDs September 2021 v 2020
| Department | Attendances | Change Attend | % within 4 hrs | Change 4 hrs | Target Achieved |
|---|---|---|---|---|---|
| Mater | 1,933 | 457 | 54.3% | -1.3 | |
| RVH | 7,036 | -1,551 | 26.8% | -19.9 | |
| RBHSC | 4,490 | 1,070 | 65.1% | -16.3 | |
| Antrim | 7,971 | 762 | 53.8% | -8.2 | |
| Causeway | 3,594 | -146 | 63.0% | -11.5 | |
| Ulster | 8,695 | 555 | 49.7% | -11.7 | |
| Craigavon | 6,564 | -1,409 | 39.2% | -21.1 | |
| Daisy Hill | 4,716 | NA | 58.1% | NA | |
| Altnagelvin | 5,734 | 535 | 39.1% | -18.2 | |
| SWA | 3,129 | 104 | 49.9% | -11.2 |
Since April 2014, the percentage of patients treated and discharged or admitted within four hours ranged from 47.0% in August 2021 to 78.3% in July 2014.
Performance against Four Hour Target at Type 1 EDs
The figure below presents a further analysis of waiting times at EDs, by presenting the number of patients waiting in each 20 minute time period from zero to 24 hours. The four hour target is marked on the chart in red.
During September 2021, there is a notable fall in the percentage of patients attending EDs who were discharged / admitted in the 20 minute period immediately before breaching the 4 hour target (4.5%, 2,724) and the 20 minute period immediately after the 4 hour target (3.1%, 1,845).
Time Waited in ED from Arrival to Discharge, by 20 Minute Period
Twelve Hours
During September 2021, 7,393 patients waited over twelve hours in Type 1 EDs in Northern Ireland, 2,763 more than September 2020 (4,630).
In September 2021, the RVH (1,539) ED reported the highest number of patients waiting over 12 hours at any Type 1 ED, whilst the RBHSC reported the lowest (6).
The table below details the number of attendances and performance against the twelve hour target at Type 1 EDs during September 2021 compared with September 2020.
Twelve Hour Target at Type 1 EDs September 2021 v 2020
| Department | Attendances | Change Attend | Over 12 hrs | Change 12 hrs | Target Achieved |
|---|---|---|---|---|---|
| Mater | 1,933 | 457 | 237 | 55 | |
| RVH | 7,036 | -1,551 | 1,539 | 745 | |
| RBHSC | 4,490 | 1,070 | 6 | 4 | |
| Antrim | 7,971 | 762 | 1,073 | 523 | |
| Causeway | 3,594 | -146 | 427 | 347 | |
| Ulster | 8,695 | 555 | 1,268 | 327 | |
| Craigavon | 6,564 | -1,409 | 1,144 | 182 | |
| Daisy Hill | 4,716 | NA | 422 | NA | |
| Altnagelvin | 5,734 | 535 | 852 | 429 | |
| SWA | 3,129 | 104 | 425 | 151 |
Since April 2008, the number of patients waiting over 12 hours at Type 1 EDs ranged from 1 in September 2008 to 7,393 in September 2021.
Performance against Twelve Hour Target at Type 1 EDs
Time to Triage
The length of time patients waited from the time of their arrival at an ED to their triage by a medical practitioner, includes a brief history, pain assessment and early warning scores, for all patients. Two aspects of the time waited are reported, including:
- the 95th percentile, which is the time below which 95% of patients were triaged each month; and,
- the median waiting time, which is the time below which 50% of patients were triaged.
During September 2021, the median waiting time from arrival to triage was 12 minutes, 3 minutes longer than the time taken in September 2020 (9 minutes), whilst 95 percent of patients were triaged within 67 minutes, longer than the time taken in September 2020 (47 minutes).
Time from Arrival to Triage
The RVH (20 minutes) and SWA (20 minutes) reported the longest median waiting time of any Type 1 ED during September 2021, whilst Daisy Hill (10 minutes) reported the shortest median waiting time.
During September 2021, RVH (1 hour and 49 minutes) reported the longest time taken to triage 95 per cent of attendances, whilst Antrim (37 minutes) reported the shortest time.
Time to Start of Treatment
The length of time patients waited for their treatment to start following triage (initial assessment) by a medical practitioner is presented below. The start of treatment refers to the begining of a definitive treatment by a decision-making clinician. Two aspects of the time waited are reported, including:
- the 95th percentile, which is the time below which 95% of patients commenced treatment each month; and,
- the median waiting time, which is the time below which 50% of patients commenced treatment.
During September 2021, the median waiting time from triage to start of treatment was 61 minutes, 25 minutes longer than the time taken in September 2020 (36 minutes), whilst 95 per cent of patients were triaged within 5 hours 48 minutes, longer than the time taken in September 2020 (3 hours 36 minutes).
Time from Triage to Start of Treatment
Do Admitted Patients Wait Longer?
Information detailed below is presented on the total waiting time for patients, (i) admitted to hospital or (ii) discharged home. The time waited refers to the time from arrival in ED until the patient leaves the ED to be discharged home or admitted to hospital.
Patients admitted to hospital continue to wait longer in an ED than those discharged home. During September 2021, the median time patients admitted to hospital spent in an ED was 11 hours 6 minutes, 8 hours 4 minutes longer than the median time waited by patients discharged home (3 hours 2 minutes).
Median Time Spent in an ED for those (i) Admitted and (ii) Discharged Home
Guidance
Reader Information
This statistical report presents information on the time waited in emergency care departments (ED) in Northern Ireland. It also includes information on: time to triage, age and time of day of ED attendances, GP referrals, emergency admissions, patients leaving before treatment complete, triage level assessed, time to start of treatment, time waited for patients admitted and not admitted, though this information is not National Statistics, it has been included to provide users with a more comprehensive view of emergency care activity and waits.
Authors
- Sarah Brown
- Kieran Taggart
- Michael O’Donnell
- Siobhan Morgan
Statistical Quality
Information detailed in this release has been provided by HSC Trusts and was validated by Hospital Information Branch (HIB) prior to release. Further information on the data included in this statistical release is available at: technical notes and guidance
Target Audience
DoH, Chief Executives of HSC Board and Trusts in Northern Ireland, Health Care Professionals, Academics, HSC Stakeholders, Media & General Public.
Technical Notes
Readers should note technical notes and guidance available for the information detailed in this statistical brief. This includes information on the:
- Data collection
- General guidance on using the data
- Types and categorisation of EDs
- Data quality and contextual information
- Comparisons with UK and,
- Information on National Statistics publications
Footnotes
1Super Output Areas were developed by the Northern Ireland Statistics & Research Agency (NISRA) to improve the reporting of small area statistics.
2Due to small numbers the data presented in the standardised ED attendance map for SOAs in NI below refers to the 2019/20 financial year.
Hospital Information Branch
Information & Analysis Directorate
Department of Health
Email: statistics@health-ni.gov.uk