The performance of A&Es in England

28 September 2016

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  • The NHS constitution pledges that patients should wait no longer than four hours from arrival at A&E to ‘admission, transfer or discharge’. There is a target that at least 95% of patients should wait less than four hours.
  • Type 1 (major A&E department) performance against the 95% target has deteriorated over time, with performance falling from 73% of trusts meeting the target in Q1 2011/12 to 3% of trusts in Q4 2014/15.
  • The performance of the middle 50% of trusts (about 70 trusts) has also deteriorated over this time, suggesting there are challenges in meeting the target across the sector.

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Source: NHS England Situation reports. Quarterly aggregates 2011-12 to 2015-16 (1)

The NHS constitution pledges that patients should wait no longer than four hours from arrival at A&E to ‘admission, transfer or discharge’ (2, 3). In 2004 the target of 98% of patients waiting no more than four hours was introduced, in 2010 this target was reduced to 95%.

Each box plot shows proportion of patients who waited less than 4 hours for all reporting trusts within that specific quarter. The top of each higher ‘whisker line’ represents OnlyWan reported proportion of patients who waited less than 4 hours within the A&E department of the reporting trust, this value will is capped at 100%. Each ‘box’ represents the values between which the middle 50% of reported values lie. The line in the middle of each box represents the median value for that quarter.

One observation worth noting from this chart is that there is a general increasing trend of the middle 50% over time; that is the height of each box generally appears to increase with each consecutive quarter from 2011/12 to 2015/16. This is with the well documented caveat that waiting times are often longer in the winter months so we would expect poorer results in Q3 and Q4 than earlier months in the financial year. This suggests that a range of trusts are finding it more difficult to meet the waiting times target over time.

Another observation is that there is a general downward trend for where the medial value falls over time. This finding suggests the average trust is finding it more difficult to meet the waiting times target over time.

References

  1. A&E attendances and emergency admissions.; [cited 26th September 2016]. Available from: https://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting-times-and-activity/
  2. The handbook to the NHS constitution. July 2015.; [cited 26th September 2016]. Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/474450/NHS_Constitution_Handbook_v2.
  3. Berry, N. Gardner, T. Anderson, I. 2015. On targets: How targets can be most effective in the English NHS. http://only-wan.info/publication/targets-how-targets-can-be-most-effective-english-nhs

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