Combined Performance Summary: October–November 2018

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

Latest data

Published: 13/12/2018

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

For interactive charts showing the quality of health and social care over time, please refer to our 200+ indicators.


  • In November 2018, 12.4% of people attending A&E spent more than 4 hours from arrival to admission, transfer or discharge. This is 10% higher than November of last year, and 3 times as high as it was five years ago.
  • Attendances in major A&E departments (Type 1) surpassed 1.3 million in November 2018, which is 2% higher than the same month last year.
  • Emergency admissions via A&E have been increasing year-on-year, reaching over 403,000 in November 2018. This is 7% higher than in November last year.
  • 54,373 patients spent more than 4 hours waiting on a trolley from decision to admit to admission in November 2018. 258 patients had a trolley wait of over 12 hours, which is almost 2 ½ times as high as the same month last year, but less than it was two years ago.
  • Only eight out of 134 major A&E departments met the four-hour A&E waiting time target in November 2018.


  • The average ambulance response time for Category 1 (life-threatening) calls decreased slightly to 7 minutes 11 seconds in November 2018. The 90th centile response time was 12 minutes 32 seconds.
  • In Week 49 of 2018 (commencing December 3rd), 10,675 ambulances experienced a handover delay of over 30 minutes. This is 10% lower than in Week 49 of 2017 but over twice as high as in Week 49 of 2013.

Bed occupancy

  • General and acute bed occupancy was 94.2% in Week 49 of 2018. This is slightly lower (<1%) than Week 49 of the last four consecutive years.

Treatment and diagnostic test waiting times

  • The total number of people waiting to start consultant-led elective treatment remained at 4.3 million in October 2018.
  • The proportion of people waiting over 18 weeks to start elective treatment reached 12.9% in October 2018. The referral-to-treatment target has not been met since February 2016.
  • 2,816 people had been waiting over 52 weeks to start elective treatment in October 2018, which is almost twice as high as in October last year.
  • In October 2018, 2.3% of patients had been waiting over 6 weeks for a diagnostic test. This is 34% higher than the same month last year.

Delayed transfers of care

  • The total number of delayed transfer of care days was 146,861 in October 2018, which is 14% lower than in October 2017, but 9% higher than it was four months ago.

Cancer waiting times

  • In October 2018, 21.6% of patients had been waiting longer than two months to start their first treatment for cancer following a GP urgent referral.
  • The 62-day cancer target has only been met in one month over the last 4 ½ years.
  • Alongside this there has been an increase in the number of cancer cases being urgently referred each month, from 8,025 in October 2009 to 14,148 in October 2018.