A&E Attendance Report

Author

Craig R Shenton

Published

19 January 2023

A&E (Type 1) 4-Hour Performance

The four-hour A&E waiting time target is a pledge set out in the Handbook to the NHS Constitution. The operational standard is that at least 95% of patients attending A&E should be admitted, transferred or discharged within four hours.

This report uses the ae_attendances dataset from the {NHSRdatasets} package, developed by the NHS-R Community. The dataset contains all reported A&E attendances for the period April 2016 through March 2019.

Column Description
period The month that this activity relates to, stored as a date (1st of each month)
org_code The ODS code for the organisation that this activity relates to
type The Department Type for this activity, either 1, 2, or other
attendances The number of attendances for this department type at this organisation for this month
breaches The number of attendances that breached the 4 hour target
admissions The number of attendances that resulted in an admission to the hospital

Department Types

According to the NHS Data Dictonary the type of Accident and Emergency Department is determined according to the activity performed as follows:

Type Definition
01 Emergency departments are a Consulatant led 24 hour service with full resuscitation facilities and designated accommodation for the reception of accident and emergency Patients
02 Consultant led mono specialty accident and emergency service (e.g. ophthalmology, dental) with designated accommodation for the reception of Patients 
03 Other type of A&E/minor injury activity with designated accommodation for the reception of accident and emergency Patients. The department may be doctor led or NURSE led and treats at least minor injuries and illnesses and can be routinely accessed without appointment. A service mainly or entirely appointment based (for example a GP Practice or Out-Patient Clinic) is excluded even though it may treat a number of Patients with minor illness or injury. Excludes NHS walk-in centres
04 NHS walk in centres

The length of time patients spend in A&E before admission, transfer or discharge depends on the type of A&E unit they visit. In the past, minor A&Es (types 2 and 3, such as single specialty departments or minor injury units) nearly always admit, transfer, or discharge in less than four hours, whereas major A&Es (type 1) deal with a higher number of attendees and more serious cases, and consistently perform worse at the four-hour target1.