Local people with an interest in the provision of our health care are interested in the latest statistics released by the Department of Health of waiting times for Emergency Care across Northern Ireland.

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 2018.

The statistical bulletin presents information on all new and unplanned review attendances during April, May and June 2018. 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. This information release is published on the Departmental website here.

Key Points:

Attendances.

Attendances at Emergency Care Departments:

*  During June 2018, there were 69,765 attendances at EDs in Northern Ireland, 2,897 (4.3%) more than in June 2017 (68,416).
*  Of the 69,765 ED attendances during June 2018, 55,915 (80.1%) had attended a Type 1 ED, 5,678 (8.1%) attended a Type 2 ED and 8,172 (11.7%) attended a Type 3 ED.
*  Between June 2017 and June 2018, attendances increased at Type 1 EDs (2,024, 3.8%), at Type 2 EDs (94, 1.7%), and at Type 3 EDs (779, 10.5%).
*  There were 208,342 attendances at EDs during the quarter ending 30 June 2018, 2.5% (5,040) more than during the same quarter in 2017 (203,302). Left before Treatment Complete:
*  During June 2018, 4.8% of ED attendances left before their treatment had been completed. Unplanned Re-Attendances within seven Days:
*  During June 2018, 3.8% of the 69,765 ED attendances were unplanned review attendances who had returned to the same ED within seven days of their original attendance for the same condition.

Referrals by GP:
*  Almost a sixth (15.6%) of attendances at EDs in June 2018 had been referred by a GP, 0.7 percentage points higher than June 2017 (16.3%). Time Spent in Emergency Care Departments:

Performance against Targets
* Over two thirds (67.7%) of attendances at Type 1 EDs in June 2018 were treated and discharged, or admitted within four hours of their arrival, 10.0 percentage points lower than June
2017 (77.7%).
* Over eight in ten (84.8%) patients attending a Type 2 ED in June 2018 were treated and discharged, or admitted within four hours of their arrival, 5.3 percentage points less than June
2017 (90.1%).
*  Almost all (99.6%) patients attending a Type 3 ED were treated and discharged, or admitted within four hours of their arrival.
*  Between June 2017 and June 2018, the number of attendances waiting longer than 12 hours increased from 294 to 1,358, accounting for 1.9% of all attendances in June 2018.
*  Almost eight in ten (79.7%) patients attending EDs commenced their treatment within two hours of being triaged in June 2018, 5.0 percentage points lower than June 2017 (84.7%).
*  During the quarter ending 30 June 2018, almost three quarters (72.6%) of patients were treated and discharged or admitted within four hours, 4.9 percentage points less than the same quarter in 2017.

Time to Triage:
*  The median waiting time from arrival at an ED to triage (initial assessment) by a medical professional was eight minutes during June 2018, with 95% of patients having their care needs assessed for the first time by a medical professional within 33 minutes of arrival.

Time to Start of Treatment:
*  During June 2018, the median waiting time from triage to the start of treatment by a medical professional was 46 minutes, with 95% of patients receiving treatment within three hours 51 minutes of being triaged.

Total Time in Emergency Care Department:
*  The median time spent in a Type 1 ED by patients who were discharged home (not admitted) was two hours 31 minutes in June 2018, 17 minutes longer than the same month last year (2
hours 14 minutes).
*  The median time spent in a Type 1 ED for patients admitted to hospital was five hours 57 minutes in June 2018, 1 hour 43 minutes longer than the same month last year (four hours 14
minutes).
*  During June 2018, the Ulster reported the longest median time spent in an ED (seven hours 44 minutes) from arrival to admission to hospital, whilst the RBHSC reported the shortest median time of three hours 52 minutes.

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.

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)).

The current draft Ministerial targets for emergency care waiting times in 2018/19 state that: ‘From April 2018, 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 2019, at least 80% of patients to have commenced treatment, following triage, within two hours.’

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.

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.