Publication, Part of Hospital Accident & Emergency Activity
Hospital Accident & Emergency Activity 2021-22
Official statistics
Consultation: proposed improvements to the Hospital Accident and Emergency Activity publication
The data included within the 2022-23 release will remain the same or have minor changes to this publication and the publication series, details about the changes can be found within the consultation.
Please complete our consultation about the changes and share your feedback by 18th August 2023
Consultation for Hospital Accident and Emergency Activity
18 August 2023 17:00 PM
Summary Reports - Performance Times and Waits for Admissions
Background
This section focuses on the performance of time to departure against the 4 hour national standard, and patients waiting over 4 hours. The results are presented as:
• Percentage of attendances spending 4 hours or less in A&E
• Average number of attendances of 4 hours or less and over 4 hours
• Provider map of percentage of attendances spending 4 hours or less in A&E
• Total time in A&E from Hour of Arrival to Transfer, Admission or Discharge
Percentage of Patient Attendances Spending 4 Hours or Less in A&E
For 2021-22 77 per cent of patient attendances spent 4 hours or less in A&E. At a national level, the standard of 95 per cent has not been met annually since 2013-14, although it has been met in some individual months during this period.
Note: The standard set in the NHS Constitution is the percentage of attendances discharged, admitted or transferred spending 4 hours or less in A&E. This was 98% up to quarter 1 (end June) 2010; from quarter 2 (July) 2010 this was reduced to 95%.
Fourteen hospital trusts are excluded from the ‘Number and percentage attendances 4 hours or less / over 4 hours’ due to their involvement with testing new proposal standards for emergency care, which has made them exempt from this measure. More details can be found on the link below:
Average Number of Attendances of 4 Hours or Less
In March 2021 the reported monthly average number of attendances per day spending 4 hours or less in A&E was 41,766.
Between April and June 2021 this figure rose, reaching a high point of 51,993 in June 2021. Between then and December 2021 it then generally fell, reaching a low point of 39,519 in December 2021. Since December 2021 the numbers have started rising again and were 44,777 in March 2022.
During 2020-21, when the COVID-19 outbreak was impacting significantly on hospital activity, the 12 month rolling average decreased from 51,379 down to 36,731. Since April 2021 the average has gone up to 45,587 as at the end of March 2022, an increase of 8,856. However, this is still less than the position in March 2020.
Fourteen hospital trusts are excluded from the ‘Number and percentage attendances 4 hours or less / over 4 hours’ due to their involvement with testing new proposal standards for emergency care, which has made them exempt from this measure. More details can be found on the link below:
Average Number of Attendances Over 4 Hours
During 2020-21, when hospital activity was significantly impacted by COVID-19, the 12 month rolling average of number of attendances per day spending over 4 hours in A&E fell sharply to 5,586. Prior to this there had been a more or less continuous period of steady increase, reaching 9,774 in February 2020.
Since April 2021 there has been a steep increase in attendances lasting over 4 hours in A&E, with the 12 month rolling average reaching 13,817 in March 2022, and the figure for the month of March 2022 itself being 17,735.
Fourteen hospital trusts are excluded from the ‘Number and percentage attendances 4 hours or less / over 4 hours’ due to their involvement with testing new proposal standards for emergency care, which has made them exempt from this measure. More details can be found on the link below:
Percentage of Patient Attendances Spending 4 Hours or Less in A&E, by Provider
This displays a map of England with a coloured circle for every major A&E provider. There were zero providers that met the standard, measured across the whole year, in 2021-22.
Major A&E Departments only are included (Type 1).
Fourteen hospital trusts are excluded from the ‘Number and percentage attendances 4 hours or less / over 4 hours’ due to their involvement with testing new proposal standards for emergency care, which has made them exempt from this measure. More details can be found on the link below:
Table 7: Percentage of Patient Attendances Spending 4 Hours or Less in A&E, by Provider (Source: MSitAE)
Click on the link below to open the interactive map:
Total Time in A&E from Hour of Arrival to Transfer, Admission or Discharge
As a proportion of all patient attendances the two hours between 8:00 and 9:59 have the lowest percentage (24 per cent) of attendances spending over 4 hours in A&E.
This time period also has highest percentage (15 per cent) spending one hour or less in A&E.
For the hours between 22:00 and 05:59 around 1 in 2 patient attendances are spending over 4 hours in A&E.
Major A&E Consultant Led Departments only are included (Types 1 and 2).
Excludes unknown time in A&E and planned A&E attendances.
Performance Times and Waits for Admission
This section focuses on patients waiting over 12 hours. There are two different measures of A&E waiting times, which should not be confused. Total time spent in A&E from arrival to discharge, transfer or admission and waiting time from decision made by a clinician to admit the patient to their admission.
1. Total time spent in A&E from arrival to discharge, transfer or admission: This is collected in monthly MSitAE and is the official measure of the 4 hour total time standard. It can also be calculated from HES/ECDS which can be used to measure total time in A&E, for example 4 hours and 12 hours are shown in this report.
2. Waiting time from decision to admit a patient to admission to a ward: This is sometimes referred to as a ‘trolley wait’ and is collected in monthly MSitAE as over 4 hour and over 12 hour waits; any 12 hour waits may be subject to fines from commissioners. These numbers are much lower than total time waits as only patients who are admitted are included.
Patients Spending Over 12 Hours in A&E From Arrival
The number of patient attendances spending over 12 hours from arrival to being transferred, admitted or discharged is 976,284 in 2021-22. This is a 222 per cent increase since 2020-21, and an 87 percent increase since 2019-20. and is the highest number of patient attendances spending over 12 hours from arrival in A&E since this publication began.
Patients Waiting Over 12 Hours From Decision to Admit to Admission to a Ward
The number of patient admissions spending over 12 hours in A&E is 98,564 in 2021-22 (from decision to admit to being admitted). This is around seven times as many as in 2020-21.
These figures are not comparable to those presented in Table 9 as this measure is only applicable to admitted patients.
Last edited: 7 July 2023 11:55 am