Northern Ireland Hospital Statistics: Emergency Care (2021/22)

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 31 March 2022.

The statistical bulletin presents information on the total activity at EDs in Northern Ireland during 2021/22, 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 (2021/22) 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.

This information release is published on the Departmental website

Key Points

Latest Position (2021/22)

• During 2021/22, 848,629 patients attended urgent and emergency care services, of which 722,950 (new and unplanned review) attended an emergency care department (ED), and 125,679 attended PhoneFirst / Urgent Care Centre services without further referral to an ED.
• During 2021/22, 49.5% of new and unplanned review attendances at Type 1 EDs were treated and discharged, or admitted, within 4 hours of their arrival, compared with 81.8% at Type 2 departments, and 99.5% at Type 3 departments.
• Over one in ten (10.9%, 78,995) of the 722,950 new and unplanned review attendances at EDs waited longer than 12 hours to be either treated and discharged home, or admitted.
• Over seven in ten (70.6%) patients attending EDs in 2021/22 commenced their treatment within 2 hours of being triaged.
• The NIAS Category 1 Mean (8 minutes) and 90th Percentile (15 minutes) targets were not achieved in any month during 2021/22.
• The NIAS Category 1T Mean (19 minutes) and 90th Percentile (30 minutes) targets were achieved each month during 2021/22.

Comparison with Previous Year (2020/21 – 2021/22)

• Since 2020/21, the number of new and unplanned review attendances at EDs increased by 129,581 (21.8%), from 593,369 to 722,950 in 2021/22.
• Whilst the number of attendances increased notably between 2020/21 and 2021/22 (129,581), performance against the 4 hour waiting times target decreased from 65.0% to 54.8%.
• The number of patients spending over 12 hours in an ED increased in 2021/22 (78,995) compared with 2020/21 (37,884).

Five Year Trends (2017/18 – 2021/22)

• During the last five years, the number of ED attendances (new and unplanned reviews) decreased by 71,204 (9.0%), from 794,154 in 2017/18 to 722,950 in 2021/22.
• Whilst the number of attendances decreased between 2017/18 and 2021/22, performance against the 4 hour waiting time target declined from 73.4% to 54.8% in 2021/22.
• Between 2017/18 and 2021/22, the number of patients spending over 12 hours in an ED increased markedly from 17,347 to 78,995, with the Royal Victoria reporting the most notable increase during this period (1,888 to 16,474).
• Since 2017/18, the proportion of attendances referred by a GP decreased from 17.1% to 15.2% in 2021/22.

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 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 2021/22 stated that:

“From April 2021, 95% of patients attending any Type 1, 2 or 3 Emergency Department should be either treated and discharged home, or admitted, within four hours of their arrival in the Department; and no patient attending any Emergency Department should wait longer than 12 hours”.

“By March 2022, 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. Information on the new urgent care services; (i) PhoneFirst and (ii) Urgent Care Centres, introduced in late 2020 as part of the ‘No More Silos’ action plan, are included in this statistical report. These services assess patients’ needs before arrival at an ED, and ensure they receive the right care, at the right time, and in the right place, outside ED if appropriate. The number of patients contacting / attending these urgent care services are reported, alongside those attending an ED, to provide readers with a comprehensive view of urgent and emergency care services in Northern Ireland.
11. Figures incorporate all returns and amendments received up to 22 June 2022.
12. Further information on Emergency Care Statistics is available from:
    Hospital Information Branch
    Department of Health
    Annexe 2, Castle Buildings
    Stormont, BT4 3SQ
    Tel:      028 90 522504
    Fax:    028 90 523288
    Email: statistics@health-ni.gov.uk
    Internet: www.health-ni.gov.uk/articles/emergency-care-and-ambulance-statistics
13. For media enquiries please contact DoH Press Office by email: pressoffice@health-ni.gov.uk. 
14. Follow us on twitter @healthdpt.
15. 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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