Emergency Care Waiting Time Statistics (April – June 2024)

The Department of Health (DoH) today published statistics on the time spent in emergency care departments (ED) throughout Northern Ireland during the months of April, May, and June 2024.

The statistical bulletin presents information on all new and unplanned review attendances during April, May, and June 2024. It details information on the time spent in EDs during each of these months including; the monthly performance against the DoH emergency care waiting times target for EDs and the time waited for key milestones during a patient’s journey through ED, whilst they are being cared for in an ED, including the time to triage and time to start of treatment.

Encompass is a new electronic patient record system that will create a single digital care record for every citizen in Northern Ireland who receives health and social care. It aims to create better experiences for patients, service users and staff by bringing together information from various existing systems that do not currently communicate effectively.

The programme was first introduced in the South Eastern Health and Social Care (HSC) Trust on 9th November 2023 and the Belfast HSC Trust on 6th June 2024, and will be rolled out on a phased basis across the remaining HSC Trusts in Northern Ireland by the end of 2025. Figures in the report for Belfast and South Eastern HSC Trust sourced from the Encompass system are considered to be ‘official statistics in development’.

Please note that this statistical release includes information on two new urgent care services (i) PhoneFirst and (ii) Urgent Care Centres, which were introduced in late 2020, to 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. These new services may in part help explain the reduction in the number of patients attending EDs.

This information release is published on the Emergency Care Waiting Times Website.

Key Points

Attendances at Emergency Care Departments:

Urgent and Emergency Care Attendances:

• In June 2024, 13,485 calls / attendances were received by PhoneFirst and Urgent Care Centre services, from patients who may previously have attended an ED. A total of 7,576 (56.2%) resulted in an attendance at an ED, whilst 5,909 patients did not go on to attend an ED.
• During June 2024, 63,980 patients in total attended an ED, and 1,275 attended an Urgent Care Centre without further referral to an ED; a total of 65,255 patients attended all urgent and emergency care services.

Emergency Care Attendances:

• During June 2024, there were 63,980 attendances at EDs in Northern Ireland, 2,373 (3.6%) less than in June 2023 (66,353).
• Of the 63,980 ED attendances during June 2024, 52,293 (81.7%) had attended a Type 1 ED, 3,184 (5.0%) attended a Type 2 ED and 8,503 (13.3%) attended a Type 3 ED.
• Between June 2023 and June 2024, attendances decreased at Type 1 EDs (5,407, 9.4%), and increased at Type 2 EDs (231, 7.8%) and Type 3 EDs (2,803, 49.2%).
• There were 197,434 attendances at EDs during the quarter ending 30 June 2024 (April, May, June), 0.4% (726) more than during the same quarter in 2023 (196,708).

Left before Treatment Complete:

• During June 2024, 7.4% of all ED attendances left before their treatment was complete, compared with 6.4% in June 2023.

Unplanned Re-Attendances within 7 Days:

• During June 2024, 4.3% of the 63,980 ED attendances were unplanned review attendances who had returned to the same ED within 7 days of their original attendance for the same condition.

Referrals by GP:

• During June 2024, almost one in seven (14.1%) attendances at EDs had been referred by a GP, compared with 16.8% in June 2023.

Time Spent in Emergency Care Departments:

Performance against Targets

• Almost two fifths (37.0%) of attendances at Type 1 EDs in June 2024 spent less than 4 hours in ED, compared with 85.6% at Type 2 EDs and 92.6% at Type 3 EDs.
• During the quarter ending 30 June 2024 (April, May, June), less than half (46.9%) of patients spent less than 4 hours at an ED, less than in the same quarter in 2023 (50.7%).
• Over four fifths (85.6%) of patients attending a Type 2 ED in June 2024 were treated and discharged, or admitted within 4 hours of their arrival, compared with 82.1% in June 2023.
• Over nine in ten (92.6%) patients attending a Type 3 ED in June 2024 were treated and discharged, or admitted within 4 hours of their arrival, a decrease from 98.2% in June 2023.
• Between June 2023 and June 2024, the number waiting over 12 hours increased from 8,867 to 10,793, accounting for 16.9% of attendances in June 2024.

Time to Triage:

• During June 2024, the median waiting time from arrival at an ED to triage (initial assessment) by a medical professional was 13 minutes, with 95 percent of patients having their care needs assessed for the first time by a medical professional within 1 hour 19 minutes of arrival.

Time to Start of Treatment:

• During June 2024, the median waiting time from triage to the start of treatment by a medical professional was 1 hour 19 minutes, with 95 percent of patients receiving treatment within 8 hours 14 minutes of being triaged.
• Over three fifths (61.4%) of patients attending EDs in June 2024 commenced their treatment within 2 hours of being triaged, less than in June 2023 (65.4%).

Total Time in Emergency Care Department:

• The median time patients who were discharged home (not admitted) spent in a Type 1 ED was 4 hours 32 minutes in June 2024, 53 minutes more than the time taken during the same month last year (3 hours 39 minutes).
• The median time patients who were admitted to hospital spent in a Type 1 ED was 15 hours 6 minutes in June 2024, 1 hour 54 minutes more than the same month last year (13 hours 12 minutes).

During June 2024, Craigavon Area reported the longest median time spent in ED from arrival to admission (19 hours 19 minutes), whilst the RBHSC reported the shortest time (5 hours 59 minutes).

Notes to editors: 

1. This statistical bulletin reports the total time spent in an ED from arrival until admission, transfer or discharge for all new and unplanned review attendances at emergency care departments across NI. The figures do not include planned review attendances.
2. Time is measured from when a patient arrives at the ED (time of arrival is recorded at registration or triage whichever is earlier (clock starts)) until the patient departs the ED (time of departure is defined as when the patient's clinical care episode is completed within the ED (clock stops)).
3. The current draft Ministerial targets for emergency care waiting times in 2024/25 state that:

‘From April 2024, 95% of patients attending any Type 1, 2 or 3 Emergency Care Department are either treated and discharged home, or admitted, within four hours of their arrival in the department; and no patient attending any Emergency Care Department should wait longer than 12 hours.’

‘By March 2025, at least 80% of patients to have commenced treatment, following triage, within 2 hours.’
 

4. 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 has been 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.
5. 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.
6. 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 are included in the ‘Emergency Care Waiting Time Statistics – Additional Guidance’ booklet. (link below)

Emergency Care Waiting Time Statistics – Additional Guidance

7. The DoH collaborated with the Office for National Statistics (ONS), together with colleagues in England, Scotland and Wales to produce a summary report of the cross-UK comparability of emergency care waiting time statistics from January 2013 to September 2023. The report can be viewed or downloaded using the link below.

Accident and Emergency wait times across the UK - Office for National Statistics (ons.gov.uk)

8. 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.
 

9. Figures incorporate all returns and amendments received from HSC Trusts up to Tuesday 6^th August 2024.

Further information on Emergency Care Statistics is available from:
Hospital Information Branch
Department of Health
Annexe 2, Castle Buildings
Stormont,
BT4 3SQ
Email:             statistics@health-ni.gov.uk
Internet:             DoH Statistics and Research

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.
 

10. For media enquiries please contact the DoH Press Office by email pressoffice@health-ni.gov.uk.
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12. 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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