NHS data shows 99% of NHS Trusts are falling short of the A&E waiting times target

How Are NHS A&E Departments Performing Across the Country?

With reports that up to a fifth of patients are leaving accident and emergency departments before completing treatment – sometimes before being assessed at all – we’ve analysed the newest available figures across NHS England Trusts to find out which areas of the country are being hardest hit.

And it turns out the vast majority of NHS A&E departments are struggling to meet their target.

The operational standard for A&E waiting times is that 95% of patients should be admitted, transferred, or discharged within four hours of their arrival, but our analysis has shown that 99% of NHS Trusts are currently falling short.

We’ve previously looked at the wait times across NHS Trusts for routine surgeries, finding that the Covid-19 pandemic had exacerbated the pressure on these services.

While non-urgent surgeries are often booked in in advance, A&E services are more ad-hoc, and patients requiring treatment may be seriously injured or at risk of complications if they aren’t treated quickly – which means these departments have to be able to act rapidly.

We found that, concerningly, just 1% of NHS Trusts are meeting the operational standard for waiting times, with just one A&E department – at Moorfields Eye Hospital in London – performing at the expected level in April and May 2022.

When looking at the data for April, just 72.3% of A&E patients across England were seen within four hours, while the figure dropped to 59% for Type 1 (Major A&E) attendances. The most recent data for May 2022 has shown a small improvement across England, with 73% of patients seen within the four-hour mark, while figures for Major A&E admissions rose slightly to 60.2%.

Type 1 departments are the ones people most traditionally think of as an A&E service, defined by the NHS as consultant-led 24-hour services with full resuscitation facilities and designated accommodation for the reception of accident and emergency patients, as opposed to specialty emergency services (e.g. ophthalmology, dental) generally defined as Type 2.

April already saw a small improvement in performance compared to March, as 72.3% of patients were seen inside four hours, compared to 71.6% the previous month. However, this was still majorly off target, and the gap doesn’t seem to be closing in at a fast enough rate, when considering May 2022 figures too.

Overall, on a yearly basis the situation does look the be worsening. In April 2021, 85.4% of A&E patients were attended to within four hours – a year later, this fell to 72.3%.

When looking at year-on-year figures for May, overall performance data showed 83.7% of patients were seen within the four-hour mark in 2021, while this was the case for 76.3% of those in Major A&E, meaning performance figures in 2022 saw a -12% decrease year-on-year for overall statistics, and a -21% decrease for Type 1 performance.

It is worth noting, that A&E attendances have grown by 8.6% in April and 5% in May 2022, which could explain the decline in performance compared to April 2021 and May 2021.

The best performing A&E departments

When it comes to the NHS Trusts performing the best against the 95% target, just one is at or above this level.

But some Trusts do come close to the target. Northumbria Healthcare (93.4%) and Sheffield Children’s NHS Foundation Trust (93%) were the second and third best performers in April. In May, Sheffield Children’s NHS Foundation Trust maintained its standard, becoming the second-best performing Trust with figures increasing to 93.1%, while Liverpool Women’s NHS Foundation Trust (92.9%) followed in third position.

For overall A&E visits, the top 10 NHS Trusts (with the highest percentage of patients being seen to within the four-hour target) were:

April 2022

1. Moorfields Eye Hospital – London (99.9%) 
2. Northumbria Healthcare – North East (93.4%) 
3. Sheffield Children’s NHS Foundation Trust – Yorkshire (93%) 
4. Liverpool Women’s NHS Foundation Trust – North West (91%) 
5. Birmingham Women’s and Children NHS Foundation Trust – Midlands (89.8%) 
6. Alder Hey Children’s NHS Foundation Trust – North West (84.5%) 
7. Chesterfield Royal Hospital – Midlands and Milton Keynes University Hospital – East (84.1%) 
8. Homerton University Hospital – London (84%) 
9. Southport and Ormskirk – North West (82.6%) 
10. The Dudley Group – Midlands (82%) 

May 2022

1. Moorfields Eye Hospital – London (99.8%)
2. Sheffield Children’s NHS Foundation Trust (93.1%)
3. Liverpool Women’s NHS Foundation Trust (92.9%)
4. Birmingham Women’s and Children’s NHS Foundation Trust (92.1%)
5. Northumbria Healthcare NHS Foundation Trust (91.8%)
6. Chesterfield Royal Hospital NHS Foundation Trust (86.6%)
7. Maidstone And Tunbridge Wells NHS Trust (84.6%)
8. Yeovil District Hospital NHS Foundation Trust (84.5%)
9. Surrey And Sussex Healthcare NHS Trust (83.7%)
10. Alder Hey Children’s NHS Foundation Trust (83.3%)

So, while some Trusts are undoubtedly performing better than others, just one is currently meeting the target while only four NHS Trusts across England were within 10% shy of the desired operational standard in April 2022, with just one more reaching this goal in May 2022.

When it comes to Type 1 attendances specifically, no Trust is seeing 95% of patients within four hours – the best performing Trust for Type 1 is Sheffield Children’s NHS Foundation Trust, which saw 92.9% of patients within four hours in both April and May 2022.

The worst performing A&E departments

On the other side of the spectrum, all of the Trusts finding it the hardest to meet the 95% target are still managing to see more than half of patients within four hours. However, they are undoubtedly a long way behind the aspired wait time.

For overall A&E visits, the 10 NHS Trusts with the lowest percentage of patients seen within the four-hour target are:

April 2022

• East Cheshire NHS Trust – North West (55.8%) 
• Countess Of Chester Hospital NHS Foundation Trust – North West (57.4%) 
• North West Anglia NHS Foundation Trust – East (57.9%) 
• Torbay And South Devon NHS Foundation Trust – South West (58%) 
• Bolton NHS Foundation Trust – North West (58.4%) 
• Stockport NHS Foundation Trust – North West (60%) 
• Wye Valley NHS Trust – Midlands (60.1%) 
• Barking, Havering and Redbridge University Hospitals NHS Trust – London (60.4%) 
• The Queen Elizabeth Hospital, King’s Lynn, NHS Foundation Trust – East (61%) 
• North Bristol NHS Trust – South West (61.7%)

May 2022

1. North West Anglia – East (54.7%)
2. East Cheshire NHS Trust – North West (54.8%)
3. Torbay and South Devon NHS Foundation Trust – South West (57.6%)
4. West Hertfordshire NHS Trust – East (58.2%)
5. Countess of Chester – North West (59.1%)
6. Mid Cheshire Hospitals NHS Foundation Trust – North West (59.9%)
7. Barking, Havering and Redbridge University Hospitals NHS Trust – London (60.5%)
8. Bolton NHS Foundation Trust – North West (61.5%)
9. The Queen Elizabeth Hospital, King’s Lynn, NHS Foundation Trust – East (62.2%)
10. University Hospitals of North Midlands NHS Trust – Midlands (62.5%)

When looking at Type 1 or Major A&E departments specifically, the figures are even lower.

In April, Barking, Havering and Redbridge University Hospitals in London was the lowest-performing Trust, seeing just 32.6% of patients wait less than four hours in emergency rooms.
According to May figures, it was West Hertfordshire Hospitals NHS Trust which saw the lowest performance, seeing just 31.5% of patients within four hours. Out of the lowest-performing trusts, four out of five have seen a performance decline between April 2022 and May 2022.

Analysis of the data shows that the North West continues to be the worst affected area, with four of the 10 lowest-performing Trusts situated in the region according to both April and May figures.

Changes in A&E performance

Comparing figures with those of the previous month, we can see which Trusts are improving towards the operational standard, or falling further from it.

The Trust that saw the biggest decline in performance in April was Kingston Hospital NHS Foundation Trust, dropping from 89.5% of patients seen within four hours in March 2022 ,to 78.6% in April 2022.

Following closely were County Durham and Darlington NHS Foundation Trust, which saw a month-on-month decrease from 76.2% to 68.7% of patients seen within four hours, and Royal Surrey County Hospital NHS Foundation Trust, where performance figures dropped from 71% in March to 63.8% in April 2022.

In May, the Trust seeing the biggest decline was The Dudley Group NHS Trust, one of the best performing Trusts the previous month, dropping from 82% of patients seen in April 2022, to 77.1% in May, followed by West Hertfordshire Hospitals NHS Trust (62.1% vs 58.2%) and Barts Health NHS Trust (73.5% vs 69.6%)

When looking at the biggest improvements in April, North West Anglia NHS Foundation Trust saw the largest increase in number patients seen within the four-hour target, from 49.7% in March to 57.9%, but despite this it remained one of the lowest-performing Trusts.
Another notable performance improvement in hospital was seen at James Paget University Hospitals NHS Foundation Trust, in which the percentage of patients seen within target rose from 63.7% to 69.9%.

The Dudley Group NHS Foundation Trust saw one of the biggest improvements in April, where figures from 76.7% to 82%, but the data has shown the month of May represented a decline for this Trust.

When looking at May 2022 data, the biggest improvement was made at North Bristol NHS Trust, going from 61.7% in April to 77.7% in May, Yeovil District Hospital NHS Foundation Trust (78% in April vs 84.5% in May) and Barnsley Hospital NHS Foundation Trust (63.2% in April vs 69.1% in May)

Our conclusion

While slight improvements have been made across NHS England more broadly, the national picture is that A&E waiting times are still too long, and almost all Trusts are falling short of the target.

Not only can this lead to overcrowded and uncomfortable A&E departments, but long wait times can put patients’ health at further risk, despite the best efforts of NHS staff.

And while not necessarily an issue of negligence, longer wait times and more crowded A&E departments can lead to patients unfortunately not receiving the quality of care or necessary treatment in a timely manner.

When patients haven’t received adequate care, bringing cases of medical negligence to light is pivotal in raising the standards across medical services and facilities.

Here are just a few of the incidents that can result in a claim against medical staff:

• A diagnosis being incorrect or unduly delayed
• Treatment not being adequate or suitable
• Symptoms ignored
• A medical device or item not functioning as it should
• An operation or procedure being carried out incorrectly

How Been Let Down could help you

If you think you have been the victim of medical negligence and want to talk about the possibility of making a claim, you can make an enquiry online or get in touch with our expert team of clinical negligence solicitors.

Further information can also be found on our medical negligence webpage.

You can make an online enquiry, request a callback at a time that suits you, or call us on 0800 234 3234.