NHS performance summary: March–April 2020

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

Latest data

Published: 14/05/2020

Today, NHS England published the latest data on key performance measures for March and April of this year. Here we show some of these statistics and how they compare with previous years.

During this unprecedented time for the health service, QualityWatch will continue to provide independent scrutiny of the health and social care system as far as possible. The most recent data published today reflects dramatic changes in access and service use as a result of the coronavirus (Covid-19) outbreak. In light of these shifts in activity, this month we have changed the presentation of some of our usual charts, to aid interpretation. It is also worth noting that NHS England have suspended data collection from 1 April to 30 June 2020 for some of their performance statistics, including delayed transfers of care.

In March 2019, the Clinically-Led Review of NHS Access Standards Interim Report was released, proposing some significant changes to many of the targets reported on here. A six-month Progress Report from the NHS Medical Director was also published in October 2019. Field testing of the proposed new standards began in 2019, however due to the coronavirus (Covid-19) outbreak, the review has been delayed until later this year.

For urgent and emergency care, the field test sites have not been submitting four-hour performance data since May 2019. The time series presented here excludes the field testing sites and so is comparable across months and years. For elective care, 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.


  • In April 2020, the total number of A&E attendances fell to below one million for the first time since records began. There were 916,581 total A&E attendances – 57% lower than in April 2019.
  • There was an average of 30,553 total A&E attendances per day in April 2020. This is 57% lower than in April 2019.
  • In April 2020, there were 689,720 type 1 A&E attendances – 48% lower than in April 2019.
  • Emergency admissions via A&E have generally been increasing year-on-year, but this month the number of emergency admissions has fallen dramatically. In April 2020, there were 257,928 emergency admissions via A&E – 36% lower than in April 2019.
  • In April 2020, 9.6% of people attending A&E spent more than four hours from arrival to admission, transfer or discharge. After increasing to the worst level on record in December 2019, there has been a slight improvement over the last four consecutive months.
  • 16,629 patients spent more than four hours waiting on a trolley from a decision to admit to admission in April 2020 – 75% lower than in April 2019.

For more information, see our A&E waiting times indicator.

Ambulance response times

  • Following a worsening in ambulance response times in March, the average response time for Category 1 (life-threatening) calls improved slightly to 7 minutes 8 seconds in April 2020. This corresponds with a 21% decrease in Category 1 incidents between March and April.
  • The average response time for Category 2 (emergency) calls was 18 minutes 28 seconds in April 2020. This represents over a 13 minute improvement compared to March 2020, which came alongside a 20% fall in Category 2 incidents.

For more information, see our ambulance response times indicator.

Treatment and diagnostic test waiting times

  • The total number of people waiting to start consultant-led elective treatment fell to 4.4 million in March 2020 (reported waiting list plus the estimate of missing data). Although outpatient and elective inpatient activity dropped in March, there was a larger drop in GP referrals, resulting in an overall reduction in the waiting list.
  • The proportion of people waiting over 18 weeks to start elective treatment reached 20.3% in March 2020. The 18-week target has not been met for four years.
  • In March 2020, 10.2% of patients had been waiting over six weeks for a diagnostic test. This is the worst performance since this waiting time target began. The six-week diagnostic waiting time target has not been met for over six years.

For more information, see our treatment waiting times and diagnostic test waiting times indicators.

Cancer waiting times

  • In March 2020, over one in five patients (21.1%) waited longer than two months to start their first treatment for cancer following an urgent GP referral – the worst performance for any March since records began.
  • The 62-day cancer target has not been met for over four years.

For more information, see our cancer waiting time targets indicator.