NHS Performs - weekly update of emergency department activity and waiting time statistics
Week ending 30 April 2023

About this release

From Tuesday 31 January a new publication format is available that combines the monthly and weekly publication. It also includes additional monthly data on demographics and patterns of attendance. The aim is for this to eventually replace the current monthly and weekly publication so that all the A&E information can be found in one place.

This release by Public Health Scotland (PHS), provides a weekly update of key statistics on attendances at Emergency Departments (EDs) across Scotland. The information includes trends in the number of attendances and proportion waiting over 4, 8 and 12 hours.

Please note that the data in this publication is based on unplanned attendances only. It does not include Recall/Return Planned data and the New Planned category that was introduced as part of the Redesign of Urgent care.

The statistics in this weekly update cover Emergency Departments only, and include new data for the week ending 30 April 2023. Formal performance monitoring is based on attendances at all A&E sites and is published by PHS on a monthly basis.

Comparability of A&E Statistics: Various urgent and emergency care services run alongside A&E departments across Scotland, including assessment units. A&E data submitted to PHS should include activity in trolleyed areas of assessment units, but it is not possible to separately identify this in the data. This means that A&E statistics reported for an Emergency Department or Minor Injuries Unit (MIU) at a hospital can also include activity from trolleyed areas of assessment units at the same hospital.

How these different urgent and emergency care services operate and the way space such as trolleyed areas are used can vary both by hospital (depending on the facilities available and how services have been set up to meet local demand) and also over time (depending on how many people need urgent or emergency care at different times). These differences could impact on the consistency and comparability of A&E statistics and it is important to bear this in mind when comparing statistics for different areas or hospitals, or looking at trend data over time.

PHS is working collaboratively with NHS Boards and the Scottish Government to monitor, review and improve recording guidance. This will also include working to improve the way we present and explain our A&E statistics.

Main points

Large decreases in Emergency Department (ED) attendances in NHSScotland were observed in spring 2020, winter 2020/21 and early 2022 due to the measures put in place to respond to COVID-19. Current ED attendances are similar to pre-COVID levels.

From the summer of 2021 the proportion of ED attendances being seen within four hours has dropped below 80% and has remained at this rate for a prolonged period of time.

Note that the length of wait at EDs is generally higher than for all types of A&E site combined, reflecting the fact that EDs see patients with more complex conditions.

During week ending 30 April 2023:

• There were 24,746 attendances at Emergency Departments in NHSScotland.
• 69.7% of ED attendances were seen and resulted in a subsequent admission, transfer or discharge within 4 hours.
• 1,950 patients spent more than 8 hours in an Emergency Department.
• 623 patients spent more than 12 hours in an Emergency Department.

Percentage within 4 hours

Attendance

Number over 4, 8 and 12 hours

Comparison table

In this interactive table the data for Scotland and NHS Boards or the hospitals can be compared. In the table settings the location type and variables in the table can be selected and filtered by locations, years and months.

Background

Patients attending Emergency Departments are first triaged to assess the seriousness of their condition. Depending on the patient’s condition, diagnostic tests may be carried out, and treatments given within the Emergency Department, before the patient is admitted to hospital, directed to another service or discharged home. There are 91 locations providing A&E services across Scotland. Of these, 30 are classed as Emergency Departments - larger A&E services that typically provide a 24 hour consultant led service. The 30 Emergency Departments are responsible for more than 8 out of every 10 A&E attendances, 19 out of 20 breaches of the four hour standard, and 19 out of 20 admissions from A&E to hospital.

A National Statistics publication on A&E Activity and Waiting Times is released on the first Tuesday of every month. The statistics in the monthly publication cover attendances to all A&E services in Scotland and are derived from the A&E datamart.

Please note that since the publication on Tuesday 6 October 2020 the data for this publication also comes from the A&E datamart. Prior to that the data was submitted to PHS via an aggregate return.

Since 2007, the national standard for A&E is that new and unplanned return attendances at an A&E service should be seen and then admitted, transferred or discharged within four hours. This standard applies to all areas of emergency care, including attendances in trolleyed areas of an Assessment Unit as well as Emergency Departments, community A&E and casualty departments and minor injury units. PHS produce a monthly report for all A&E sites showing compliance with the four hour standard. This weekly update on activity covers Emergency Departments only.

A list of sites providing emergency care and their classification can be found online at Emergency Care - Hospital Site List. For information on how the Scottish Government (SG) monitors NHS boards’ performance within A&E Services, please see the NHS Local Delivery Plan standards.

Changes to the way people access A&E were implemented on 3 December 2020 help people get the right care in the right place. For more information see: https://www.gov.scot/policies/healthcare-standards/unscheduled-care/

This new approach will keep people and NHS Scotland safe by ensuring A&E provides the fastest and most appropriate care for people when they really need it.

While people should continue to call 999 or go directly to A&E in emergencies, those with non-life threatening conditions who would usually visit A&E should call NHS 24 on 111 – day or night. People can also continue to call their GP practice for urgent care or access help online from NHSinform.scot. NHS 24 assess people by telephone and can refer them to the right care by the right healthcare professional and as close to home as possible. If A&E is the most appropriate service to provide that care, NHS 24 will make a referral to A&E where a telephone or video consultation may be offered by A&E staff. This will help keep people safe and avoid unnecessary travel to hospital. If a face-to-face consultation is necessary, the nearest A&E may arrange an appointment to avoid waiting in crowded areas wherever possible.

This means that the data presented in the weekly and monthly publications will change over time. PHS will include information on planned attendances as a separate analysis. These planned attendances will not be included in the 4 hour standard statistics.

Further information

Further information can be found on the Emergency Care (external website) pages of the Data and Intelligence website. The data tables and metadata and other releases can be found under the Data files and Other releases sections on this page. See the Weekly statistics excel file for notes on this publication.

NHS Performs

A selection of information from this publication is included in NHS Performs (external website) which is a website that brings together a range of information on how hospitals and NHS boards within NHSScotland are performing.