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

The Department of Health today published its annual statistics on emergency department (ED) activity and waiting times in Northern Ireland for the year to 31 March 2024.

The statistical bulletin provides information on total activity in urgent care centres in Northern Ireland in 2023/24, including information on new, unplanned and planned examination attendances, waiting times in urgent care centres, ambulance response times, call-outs and incidents.

The Northern Ireland Hospital Statistics: Acute Care (2023/24) publication is the first in a series of three hospital statistics publications due to be released in the coming months, with the remaining two providing more detailed information on inpatient and outpatient activity.

The information release is available on the ministry website here.

Key Point

Latest positions (2023/24)

In 2023/24, 800,889 patients received urgent and emergency medical services, of which 758,645 (new and unplanned consultations) visited an emergency department (ED) and 136,140 called PhoneFirst or used the services of an urgent care centre without further referral to an ED. In 2023/24, 40.2% of new and unplanned consultation visits in type 1 EDs were treated and discharged or admitted within 4 hours of arrival, compared with 76.9% in type 2 departments and 96.3% in type 3 departments. Of the 758,645 new and unplanned consultation visits in EDs, almost one in six (16.0%, 121,043) waited more than 12 hours before being treated and discharged or admitted. More than three-fifths (61.4%) of patients who visited an emergency department in 2023/24 started treatment within 2 hours after triage. The NIAS Category 1 average (8 min) and 90th percentile (15 min) targets were not achieved for any month in 2023/24. The NIAS Category 1T average (19 min) target was achieved for every month in 2023/24, and the 90th percentile (30 min) target was achieved for every month except 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 consultations in the Emergency Department has increased by 7,973 (1.1%), increasing from 750,672 to 758,645 in 2023/24. While the number of consultations increased slightly from 2022/23 to 2023/24 (7,973), performance against the 4 hour waiting time target decreased from 50.1% to 47.1%. The number of patients spending more than 12 hours in the Emergency Department increased in 2023/24 (121,043) compared to 2022/23 (106,990).

Five-year trend (2019/20 2023/24)

Over the past five years, emergency department visits (new and unplanned visits) have decreased by 55,628 (6.8%), from 814,273 in 2019/20 to 758,645 in 2023/24. Although visits have decreased from 2019/20 to 2023/24, performance against the four-hour waiting time target has fallen from 65.1% to 47.1% in 2023/24. From 2019/20 to 2023/24, the number of patients spending more than 12 hours in the emergency department has increased significantly, from 45,401 to 121,043, with the Royal Victoria Hospital reporting the most notable increase over this period (from 6,508 to 24,095). Since 2019/20, the proportion of visits resulting from GP referrals has increased from 16.7% to 19.0% in 2023/24.

The information release has been published on the Department’s website: www.health-ni.gov.uk/articles/emergency-care-and-ambulance-statistics

Notes to editors: All information in this publication has been provided by HSC Trusts or downloaded by the Hospital Information Branch (HIB) within an agreed timeframe and verified and quality assured by the HIB before publication. At the end of each financial year, HIB checks with HSC Trusts to ensure that the information downloaded/submitted during the year is consistent and up to date. For further information, see the Technical Notes and Appendices 5, 6 and 7 of the Hospital Statistics: Emergency Care publication. Information outlining emergency care clinical quality indicators in Northern Ireland is also included in this release. This information is not a certified official statistic but has been included to provide a more comprehensive and balanced view of the care provided by the emergency care sector, reflecting the experience of patients and the timeliness of the care they receive. This includes data for the South Eastern Trust taken from Encompass since its go-live on 9 November 2023. Caution should be exercised when making direct comparisons between Northern Ireland and other UK jurisdictions as waiting times may not have been measured in a comparable way. It should also be noted that emergency care services are delivered differently across UK jurisdictions. This means that the numbers and types of patients included in the figures may vary between countries. In particular, the 12-hour waiting time information published for England and Northern Ireland is not equivalent and should not be compared. Further information on the comparison between Northern Ireland and other UK jurisdictions is provided in Appendix 5 of this statistical publication. Three different categories of emergency care facilities are included in this publication: Type 1 departments Consultant-led 24-hour services with full resuscitation facilities and designated accommodation to receive emergency care patients. Type 2 departments Consultant-led single-specialty emergency care services (e.g. ophthalmology, dentistry) with designated accommodation to receive patients. Type 3 departments Other types of emergency care/minor injury activity with designated accommodation to receive emergency care patients. Departments are doctor-led, general practitioner-led or nurse-led, treat at least minor injuries and illnesses and are routinely accessible without an appointment. Services that are primarily or entirely appointment-based (e.g. GP practices and outpatient clinics) are excluded even if they treat large numbers of patients with minor illnesses and injuries. Urgent care centres are also included. The Minister's targets for emergency care waiting times in 2023/24 are: From April 2023, 95% of patients presenting to a type 1, 2 or 3 emergency department should be treated and discharged or admitted within 4 hours of arriving at the department. Also, patients presenting to an emergency department should not wait more than 12 hours. By March 2024, at least 80% of patients will begin treatment within 2 hours after triage. Note that less severely injured patients can be better served in minor injury units (MIUs) and avoid potentially long visits in type 1 emergency departments (EDs). Before the introduction of MIUs, these patients would have presented to a type 1 ED and typically been discharged within 4 hours. This will result in an increase in the proportion of patients waiting more than 4 hours in type 1 EDs. This statistical report contains information on the new urgent care services (i) PhoneFirst and (ii) Urgent Care Centres, introduced in the second half of 2020 as part of the No More Silos action plan. These services assess patients' needs before they arrive at the ED, ensuring the right care gets received at the right time and in the right place (outside the ED where appropriate). The number of patients contacting or presenting to these urgent care services is reported alongside the number of patients presenting to the ED, providing readers with a comprehensive overview of urgent and emergency care services in Northern Ireland. NIAS implemented a new Clinical Response Model (CRM) on 12 November 2019. Information provided by NIAS after this date cannot be compared to the previous CRM. The new call categories and targets can be found in the attachment.

Call Categories

Call Definition

Average Target

90th percentile goal

Category 1

999 Immediately life threatening

8 minutes

15 minutes

Category 1 – Transport

999 Immediately life threatening

19 min

half an hour

Category 2

999 Urgent Potentially Serious Incident

18 min

40 minutes

Category 3

Urgent Issues

120 minutes

Category 4

Less urgent issues

180 minutes

The figures incorporate all returns and amendments received up to 9 June 2023. Further information on emergency care statistics is available from: Hospital Information Unit Department of Health Annexe 2, Castle Buildings Stormont, BT4 3SQ Telephone: 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 For media enquiries please contact the Department of Health Press Office by email pressoffice@health-ni.gov.uk Follow us on: x @healthdpt and on linkedIn: Department of Health Northern Ireland Branch | LinkedIn The Executive Information Service operates an out of hours service for media enquiries only, Monday to Friday from 18:00 to 08:00 and at weekends and public holidays. Duty press officers can be contacted on 028 9037 8110.

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