Northern Ireland Hospital Statistics: Emergency Care (2023/24)

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 2024.

The statistical bulletin presents information on the total activity at EDs in Northern Ireland during 2023/24, 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 (2023/24) 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 here.

Key Points

Latest Position (2023/24)

• During 2023/24, 800,889 patients attended urgent and emergency care services, of which 758,645 (new and unplanned reviews) attended an emergency care department (ED), and 136,140 called PhoneFirst or attended Urgent Care Centre services without further referral to an ED.
• During 2023/24, 40.2% of new and unplanned review attendances at Type 1 EDs were treated and discharged, or admitted, within 4 hours of their arrival, compared with 76.9% at Type 2 departments, and 96.3% at Type 3 departments.
• Almost one in six (16.0%, 121,043) of the 758,645 new and unplanned review attendances at EDs waited longer than 12 hours to be either treated and discharged home, or admitted.
• Over three fifths (61.4%) of patients attending EDs in 2023/24 commenced their treatment within 2 hours of being triaged.
• The NIAS Category 1 mean (8 minutes) target and 90th percentile target (15 minutes) were not achieved in any month during 2023/24.
• The NIAS Category 1T mean (19 minutes) target was achieved in each month during 2023/24, whilst the 90^th percentile (30 minutes) target was also achieved in each month with the exception of August, October and December 2023, and January and February 2024.

Comparison with Previous Year (2022/23 – 2023/24)

• Since 2022/23, the number of new and unplanned review attendances at EDs increased by 7,973 (1.1%), from 750,672 to 758,645 in 2023/24.
• Whilst the number of attendances increased slightly between 2022/23 and 2023/24 (7,973), performance against the 4 hour waiting times target decreased from 50.1% to 47.1%.
• The number of patients spending over 12 hours in an ED increased in 2023/24 (121,043) compared with 2022/23 (106,990).

Five Year Trends (2019/20 – 2023/24)

• During the last five years, the number of ED attendances (new and unplanned reviews) decreased by 55,628 (6.8%), from 814,273 in 2019/20 to 758,645 in 2023/24.
• Whilst the number of attendances decreased between 2019/20 and 2023/24, performance against the 4 hour waiting time target declined from 65.1% to 47.1% in 2023/24.
• Between 2019/20 and 2023/24, the number of patients spending over 12 hours in an ED increased markedly from 45,401 to 121,043, with the Royal Victoria reporting the most notable increase during this period (6,508 to 24,095).
• Since 2019/20, the proportion of attendances referred by a GP increased from 16.7% to 19.0% in 2023/24.

The information release is published on the Departmental website at: www.health-ni.gov.uk/articles/emergency-care-and-ambulance-statistics

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 5, 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 Accredited Official 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. This includes data for South Eastern Trust sourced from Encompass since go live on 9 November 2023.
4. 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 5 of this statistical publication.
5. There are three separate categories of emergency care facility included in this publication:

• Type 1 Department    A consultant led 24 hour service with full resuscitation facilities and designated accommodation for the reception of emergency care patients.
• Type 2 Department    A consultant led mono specialty emergency care service (e.g. ophthalmology, dental) with designated accommodation for the reception of patients.
• Type 3 Department    Other type of ED/minor injury activity with designated accommodation for the reception of emergency care patients. The department may be doctor led, general practitioner led or nurse led and treats at least minor injuries and illnesses and can be routinely accessed without appointment. A service mainly or entirely appointment based (for example a GP Practice or Out-Patient Clinic) is excluded even though it may treat a number of patients with minor illness or injury. Includes Urgent Treatment Centres.

6. The Ministerial targets for emergency care waiting times during 2023/24 stated that: “From April 2023, 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 2024, at least 80% of patients to have commenced treatment, following triage, within 2 hours.”
7. Please note, patients with lower acuity can attend more appropriate services available at Minor Injury Units (MIU) and avoid potentially longer attendances at a Type 1 Emergency Department (ED). Prior to the introduction of MIUs, these patients would have otherwise attended a Type 1 ED and would have generally been discharged within 4 hours. As such, this will result in an increase to the percentage of patients at Type 1 EDs who wait longer than 4 hours.
8. 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.
9. 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.

10. The new call categories and targets are on attachment.

11. Figures incorporate all returns and amendments received up to 9 June 2023.

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: https://www.health-ni.gov.uk/articles/emergency-care-and-ambulance-statistics
13. For media enquiries please contact the DoH Press Office by email pressoffice@health-ni.gov.uk.
14. Follow us on X @healthdpt and linkedIn Department of Health NI | LinkedIn
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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