Publication, Part of Hospital Accident & Emergency Activity
Hospital Accident & Emergency Activity, 2023-24
Official statistics
Summary Report
Summary of A&E Attendances
In 2023-24 there were 26.3 million attendances in Accident and Emergency, an increase of 3.8 per cent compared with 2022-23 (source MSitAE)
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
• 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
In 2023-24, 72.1 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 were excluded from the ‘Number and percentage attendances 4 hours or less / over 4 hours from May 2019 up to May 2023 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 2023, the reported monthly average number of attendances per day spending 4 hours or less in A&E was 44,550.
Between April and June 2023 this figure rose, reaching a high point of 54,442 in June 2023. Between then and December 2023 it then generally fell slowly, reaching a low point of 48,989 in December 2023. Since December 2023 the numbers have started rising again and were 56,844 in March 2024.
During 2020-21, when the COVID-19 outbreak was impacting significantly on hospital activity, the 12 month rolling average decreased from 54,235 in February 2020 down to 36,474 in February 2021. Since April 2021, the average has gone up to 50,971 as at the end of March 2024, an increase of 12,262. 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 from May 2019 up to May 2023 due to their involvement with testing new proposal standards for emergency care, which has made them exempt from this measure. Adding data in for these providers from June 2023 onwards will have impacted on monthly averages. 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 5,602. Prior to this there had been a more or less continuous period of steady increase, reaching 10,040 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 19,689 in March 2024, and the figure for the month of March 2024 itself being 19,615 (though this is actually somewhat lower than the figures for the period October 2023 to February 2024, when individual monthly figures were typically around 21,500 per month).
Fourteen hospital trusts are excluded from the ‘Number and percentage attendances 4 hours or less / over 4 hours from May 2019 up to May 2023 due to their involvement with testing new proposal standards for emergency care, which has made them exempt from this measure. Adding data in for these providers from June 2023 onwards will have impacted on monthly averages More details can be found on the link below:
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: i) total time spent in A&E from arrival to discharge, transfer or admission, and ii) the time waited from a decision made by a clinician to admit the patient, until the 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 the 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 to Departure
The number of patient attendances spending over 12 hours from arrival to being transferred, admitted or discharged was 1,758,157 in 2023-24. This is a 77 per cent increase on 2021-22, but a 1.7 percent decrease on 2022-23.
In 2023-24, 7.13% of attendances lasted 12 hours or more, compared to 7.69% in 2022-23.
Patients Spending Over 12 Hours in A&E From Decision to Admit to Admission
The number of patient admissions spending over 12 hours in A&E is 439,411 in 2023-24 (from decision to admit to being admitted). This is a 7.1% increase on the figure for 2022-23.
Last edited: 26 September 2024 9:32 am