Hospital Accident & Emergency Activity 2020-21

This is a series of high-level summary reports of NHS Accident and Emergency activity and performance of hospitals in England, during 2020-21 and as a comparison over time.

This is a joint report between NHS Digital and NHS England providing a collective and coherent message between the two organisations. This enables a wider set of breakdowns and measures in the detailed reports. This annual publication is available in advance of the winter period.

The data sources for this publication are:

• Emergency Care Database (ECDS) / Hospital Episode Statistics (HES) A&E and
• A&E Attendances and Emergency Admissions Monthly Situation Reports (MSitAE)

Both sets of data are submitted by NHS providers, ECDS is expected daily to NHS Digital, and MSitAE monthly to NHS England and NHS Improvement. The MSitAE data is an aggregate dataset submitted shortly after month end and is used to monitor activity and performance levels. The ECDS data is patient level record-based data which is aggregated and thus anonymised for subsequent analysis. We explore within this report both the similarities and differences between the two data sources.

Planned A&E attendances are excluded, unless otherwise stated.

Statistical outputs accompanying this report utilise ECDS data. This contains several new and additional reporting fields not previously available in HES A&E enabling new insights to be identified from data. Reported information based on these new splits and metrics presented within the report are presented as Experimental Statistics and should be used with caution. Experimental statistics are new official statistics undergoing evaluation.

This publication includes detailed tables at a national level with further breakdowns included in each table.

The tables include:

• data completeness and comparison with other data sources
• attendance by category
• attendance by investigation, diagnosis, treatment and chief complaint
• duration and discharge
• attendance by Index of Multiple Deprivation (IMD) and ethnicity
• clinical quality indicators
• comparison of attendances with previous year due to COVID-19

In addition to national aggregations of activity a provider-level analysis is supplied; this allows users to select hospital providers and compare activity with peer organisations, regions or the England total.

One of the purposes of the provider-level analysis is to contribute to the improvement of both the quality and coverage of the data submitted to ECDS.

This provides information at provider level (where submitted) relating to:

• gender
• age group
• hour of arrival
• day of arrival
• mode of arrival
• discharge destination
• duration in department
• comparison with attendances recorded in A&E MSitAE
• Full time equivalent (FTE) figures for NHS Trust Staff (Workforce data)
• Stability Index for Staff for NHS Trusts (Workforce data)
• attendance by investigation, diagnosis, treatment and chief complaint

A&E CQI Report - This report, generated from Emergency Care Data Set (ECDS), sets out data coverage, data quality and performance information for the following five A&E indicators:

• Left department before being seen for treatment rate
• Re-attendance rate
• Time to initial assessment
• Time to treatment
• Total time in A&E

National Weekly Comparison Report- This report generated from ECDS & HES A&E data for 2020-21 & 2019-20 data respectively displays the overall weekly attendance figures for both reporting years and also displays the percentage difference between the two. It seeks to understand how overall attendance varied throughout the duration of the pandemic.

An additional file has been published providing supplementary information to this report that provides a comparison of the number of unplanned A&E attendances, 4 hour and 12 hour waiting time performance for each of the four home nations (England, Scotland, Wales and Northern Ireland). To compare across all nations this comparison is for Type 1 or Major A&E departments within each nation.

See separate section 'Home Nations Comparative Analysis' for further details.