NHS performance summary: September-October 2021

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

Latest data

Published: 11/11/2021

Headlines

  • A&E waiting times in October were the worst since records began, with 1 in 4 patients waiting longer than four hours to be admitted, transferred or discharged. Attendances are back to pre-pandemic levels, and trolley waits are at a record high.
  • Ambulance response times worsened in October – the average response time for Category 1 (life-threatening) calls increased to 9 minutes 20 seconds, and the average for Category 2 (emergency) calls increased to 54 minutes – both missing their targets.  
  • The waiting list for planned care continued to grow to over 5.8 million in September, and the number of two year waiters increased to 12,491. 
  • Almost a third of patients with an urgent GP referral for suspected cancer waited longer than two months for their first treatment in September. 

Today, NHS England published the latest data on key activity and performance measures for August and September of this year. Here we show the performance against some key targets, including those set out in the 2021/22 operational planning guidance published in September.

Planned (elective) and diagnostic care

  • The total number of people waiting to start consultant-led elective treatment increased to over 5.8 million in September 2021, the highest level since records began.
    • NHS England’s guidance aims to stabilise waiting lists around this level over the next six months.
  • The number of people waiting over 52 weeks to start elective treatment increased in September 2021 to 300,566. 
  • The number of people waiting over two-years increased to 12,491. The specialities with the highest number of long-waiters were trauma and orthopaedics, general surgery, and ear nose and throat. 
  • Over a third of patients (34%) had been waiting over 18 weeks to start elective treatment in September 2021. 
  • Over one in four patients (26%) had been waiting over six weeks for a diagnostic test in September 2021. 

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

Accident and Emergency

  • In October 2021, 26% of people attending A&E spent more than four hours from arrival to admission, transfer or discharge, the worst performance since records began. 
  • There were over 2.1 million A&E attendances in October 2021 – 0.2% lower than pre-pandemic levels in October 2019. 
  • In October 2021, emergency admissions to hospital via A&E increased on the previous month to 395,587 – 6% lower than pre-pandemic levels in October 2019. 
  • 121,251 patients spent more than four hours waiting on a trolley from a decision to admit to admission in October 2021, the highest for any month since records began. 7,059 people had a trolley wait of over 12 hours. 

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

Cancer waiting times

  • In September 2021, 32% of patients waited longer than two months to start their first treatment for cancer following an urgent GP referral. 
  • 4,757 patients waited longer than two months to start their first treatment following an urgent GP referral, an increase on the previous month and further away from the March 2022 target of 3,316 patients. 

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

Ambulance response times

  • In October 2021, the average response time for Category 1 (life-threatening) ambulance incidents worsened to 9 minutes 20 seconds (mean target of 7 minutes). 
  • The average response time for Category 2 (emergency) incidents increased to 53 minutes 54 seconds in October 2021 (mean target of 18 minutes). The 90th centile reached 1 hour 56 minutes, surpassing the target of 40 minutes. 

For more information, see our ambulance response times indicator.

About this data

During this unprecedented time for the health service, QualityWatch continues to provide independent scrutiny of the health and social care system as far as possible. The most recent data published today reflects changes in access and service use as a result of the coronavirus (Covid-19) pandemic. In light of these shifts in activity, we have added new charts and changed the presentation of some of our usual charts, to aid interpretation. It is also worth noting that NHS England have suspended data collection 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 and NHS England has recently consulted on the recommendations for urgent and emergency care.

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

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