Combined Performance Summary: October-November 2019

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

Latest data

Published: 13/12/2019

Today, NHS England published its Combined Performance Summary, which provides data on key performance measures for September and October 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, proposing some significant changes to many of the targets reported on here. A six-month Progress Report from the NHS Medical Director was also recently published.

For urgent and emergency care, field testing of the proposed new standards began in 14 hospital trusts on 22 May. The first stage of testing 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 November 2019, 18.6% of people attending A&E spent more than 4 hours from arrival to admission, transfer or discharge – the worst performance for any month since records began.
  • Zero out of 118 major A&E departments (type 1) that submitted performance data met the four-hour A&E waiting time target in November 2019.
  • The total number of A&E attendances exceeded 2.1 million in November 2019, which is 5% higher than November of last year. There was an average of 71,444 A&E attendances per day.
  • There were over 1.3 million type 1 A&E attendances in November 2019 – the highest for any November since records began. This equates to an average of over 45,500 type 1 A&E attendances per day – an increase of 5% compared to November 2018.
  • Emergency admissions via A&E have been increasing year-on-year, reaching over 416,000 in November 2019. There were on average 13,882 emergency admissions via A&E per day, which is 3% higher than November 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.
  • 88,923 patients spent more than 4 hours waiting on a trolley from a decision to admit to admission in November 2019; this is the highest since records began. 1,112 patients had a trolley wait of over 12 hours, which is more than four times higher than November of last year.

Per cent spending >4 hours in A&E, Monthly data,NHS EnglandPer cent spending >4hoiurs in A&E, Monthly Data, NHS EnglandTotal A&E attendances, Mothly 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 EnglandAll 118* major A&E departments (Type 1) missed the 4 hour target in October 2019

Ambulance handover delays

  • In Week 49 of 2019 (commencing on 2 December), 14,599 ambulances experienced a handover delay of over 30 minutes. This is 37% higher than Week 49 of 2018 and over twice as high as it was five years ago.

Bed occupancy

  • General and acute bed occupancy was 94.9% in Week 49 of 2019. This is slightly higher (<1%) than Week 49 of the last seven consecutive years.

Treatment and diagnostic test waiting times

  • The total number of people waiting to start consultant-led elective treatment almost reached 4.6 million in October 2019 (reported waiting list plus the estimate of missing data).
  • The proportion of people waiting over 18 weeks to start elective treatment reached 15.3% in October 2019 – the highest level since September 2008.
  • In October 2019, 3.1% 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

  • There was an average of 4,920 people delayed per day in October 2019. This is 24% lower than it was in October 2016, but 23% higher than it was in October 2013.

Cancer waiting times

  • In October 2019, over one in five patients (22.9%) 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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