Combined Performance Summary: August–September 2019

Our monthly round-up of the latest NHS performance data.

Latest data

Published: 10/10/2019

Today, NHS England published its Combined Performance Summary, which provides data on key performance measures for August and September of this year. Here we show some of these statistics and how they compare with previous years.

In March, the Clinically-Led Review of NHS Access Standards Interim Report was released that proposed some significant changes to many of the targets reported on here.

For urgent and emergency care, field testing of the proposed new standards began in 14 hospital trusts on 22nd May. The first stage of testing has focused on measuring the “mean time in A&E”, when compared to the existing four hour target. The field test sites have not been submitting four hour performance data since May, so the national time series omits these sites’ A&E performance. The time series data presented here excludes the field testing sites and so is comparable across months and years.

For elective care, field testing of the proposed new standards began in 12 hospital trusts in early August. These trusts are testing the use of an average (mean) wait measure for people on the waiting list as a potential alternative to the current 18-week threshold target. Performance of the field test sites will continue to be included in the national time series, so the data is fully comparable over time.
For interactive charts showing the quality of health and social care over time, please refer to our 200+ indicators.

A&E

  • In September 2019, 14.6% of people attending A&E spent more than 4 hours from arrival to admission, transfer or discharge – the worst performance for any September on record.
  • The total number of A&E attendances exceeded 2.1 million in September 2019, which is 7% higher than September of last year. There was an average of over 71,000 A&E attendances per day.
  • For major A&E departments (type 1), there were over 1.3 million attendances in September 2019 – the highest for any September since records began. This equates to an average of almost 45,000 type 1 A&E attendances per day – an increase of 6% compared to September 2018.
  • Emergency admissions via A&E have been increasing year-on-year, reaching almost 400,000 in September 2019. There were on average 13,324 emergency admissions via A&E per day, which is 3.6% higher than September of last year. The increase could be related to the rise in same-day emergency care, where patients are treated and discharged on the same day as admission.
  • 64,921 patients spent more than 4 hours waiting on a trolley from a decision to admit to admission in September 2019. This is 46% higher than September of last year. 455 patients had a trolley wait of over 12 hours, which is three-fold higher than September of last year.
  • Only two out of 119 major A&E departments that submitted performance data met the four-hour A&E waiting time target in September 2019.

Per cent spending >4 hours in A&E, Monthly data,NHS EnglandPer cent spending >4 hours in A&E, Monthly data,NHS EnglandAverage Type 1 A&E attendances per day, Monthly data, NHS EnglandAverage emergency admissions via A&E per day, Monthly data, NHS EnglandTrolley waits: Patients spending >4 hours from decision to admit to admission, NHS EnglandTrolley waits: Patients spending >12 hours from decision to admit to admission, NHS England117 out of 119* major A&E departments (Type 1) missed the 4 hour target in June 2019

Treatment and diagnostic test waiting times

  • The total number of people waiting to start consultant-led elective treatment exceeded 4.5 million in August 2019 (reported waiting list plus the estimate of missing data).
  • The proportion of people waiting over 18 weeks to start elective treatment reached 15% in August 2019 – the highest level since September 2008.
  • In August 2019, 4.3% of patients had been waiting over 6 weeks for a diagnostic test. The diagnostic waiting time target has not been met since November 2013.

Patients waiting to start consultant-led elective treatment, NHS England

Delayed transfers of care

  • The average number of people delayed per day increased slightly to 4,800 in August 2019. This is 28% lower than it was in February 2017, but 22% higher than it was in August 2013.

Cancer waiting times

  • In August 2019, over one in five patients (21.5%) waited longer than two months to start their first treatment for cancer following an urgent GP referral.
  • The 62-day cancer target has only been met once in the last five years.

Per cent waiting >62 days from urgent GP referral to first treatment for cancer, NHS England

© Nuffield Trust & The Health Foundation

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