The Northern Ireland Emergency Departments with the longest waiting times and how Health Minister Robin Swann believes they can be improved

The North Antrim MLA, who returned to the Ministerial role earlier this month following the restoration of the Assembly, was commenting after figures released by the Department of Health showed more people attended the province’s Emergency Departments between October and the end of December 2023 compared to the same period in 2022, while the number of people waiting over 12 hours also rose between December 2022 and December 2023.

Which ED did people attend?

• Mater 3,048 (December 2022) compared to 3,428 (December 2023)
• RVH 6,246 (December 2022) compared to 8,108 (December 2023)
• Royal Belfast Hospital for Sick Children 4,958 (December 2022) compared to 3,680 (December 2023)
• Antrim 8,121 (December 2022) compared to 7,733 (December 2023)
• Causeway 3,914 (December 2022) compared to 3,787 (December 2023)
• Ulster 8,805 (December 2022). No data available for December 2023
• Craigavon 7,064 (December 2022) compared to 6,553 (December 2023)
• Daisy Hill 4,869 (December 2022) compared to 4,377 (December 2023)
• Altnagelvin 5,472 (December 2022) compared to 5,266 (December 2023)
• South West Acute 3,274 (December 2022) compared to 3,207 (December 2023)

The statistics detailed how there were 157,178 attendances at Emergency Departments during the quarter ending December 31 2023 (October, November, December), 3,162 more than during the same quarter in 2022.

The most familiar mechanisms for monitoring ED performance are the ‘four and twelve hour’ measures, which report the percentage of patients treated and discharged or admitted from ED within 4 hours of their arrival and the number treated and discharged or admitted from ED within 12 hours of arrival.

How long do patients spend in an ED?

• Mater four hour performance: 49.8 per cent (December 2022) compared to 41.9 per cent (December 2023). Mater 12 hour performance: 427 (December 2022) compared to 557 (December 2023)
• RVH four hour performance: 24.6 per cent (December 2022) compared to 31.6 per cent (December 2023). RVH 12 hour performance: 1,858 (December 2022) compared to 1,949 (December 2023)
• Royal Belfast Hospital for Sick Children four hour performance: 49.0 per cent (December 2022) compared to 57.7 per cent (December 2023). Royal Belfast Hospital for Sick Children 12 hour performance: 76 (December 2022) compared to 43 (December 2023)
• Antrim four hour performance: 45.6 per cent (December 2022) compared to 35.2 per cent (December 2023). Antrim 12 hour performance: 1,209 (December 2022) compared to 1,464 (December 2023)
• Causeway four hour performance: 51.3 per cent (December 2022) compared to 47.0 per cent (December 2023). Causeway 12 hour performance: 575 (December 2022) compared to 558 (December 2023)
• Ulster: four hour performance: 39.6 per cent (December 2022). Ulster 12 hour performance: 1,570 (December 2022). No data available for 2023
• Craigavon four hour performance: 34.9 per cent (December 2022) compared to 36.8 per cent (December 2023). Craigavon 12 hour performance: 1,814 (December 2022) compared to 1,570 (December 2023)
• Daisy Hill four hour performance: 48.7 per cent (December 2022) compared to 43.2 per cent (December 2023). Daisy Hill 12 hour performance: 592 (December 2022) compared to 655 (December 2023)
• Altnagelvin four hour performance: 28.1 per cent (December 2022) compared to 26.3 per cent (December 2023). Altnagelvin 12 hour performance: 1,174 (December 2022) compared to 1,274 (December 2023)
• South West Acute four hour performance: 46.6 per cent (December 2022) compared to 44.2 per cent (December 2023). South West Acute 12 hour performance: 518 (December 2022) compared to 543 (December 2023)

The data illustrated how between December 2022 and December 2023, the number of patients waiting over 12 hours increased from 8,243 to 8,613, accounting for 17.3 per cent of attendances in December 2023.

The time up to the start of a patient being treated was also higher in December 2023, compared to December 2022, with 57.1 per cent of patients attending Emergency Departments in December 2023 commencing their treatment within two hours of being triaged, less than in December 2022 (58.3 per cent).

Detailing the “total time” spent in an accident and emergency department, the Departmental report states: “The median time patients who were discharged home (not admitted) spent in a Type 1 ED was four hours 23 minutes in December 2023, 12 minutes more than the time taken during the same month last year (four hours 11 minutes).

“The median time patients who were admitted to hospital spent in a Type 1 ED was 14 hours 22 minutes in December 2023, 24 minutes more than the same month last year (13 hours 58 minutes).

“During December 2023, Altnagelvin reported the longest median time spent in ED from arrival to admission (21 hours 52 minutes), whilst the RBHSC reported the shortest time (five hours 55 minutes).”

Health Minister Robin Swann MLA has highlighted the challenges facing the sector, but stressed “a way forward is achievable through investment”.

Responding to NI World, the Minister said: “I’m acutely aware of the pressures within EDs and very conscious of the toll on both staff and patients. The situation is reflective of the pressures across the entire health and social care system, with demand for care outweighing existing capacity.

"The pressures in EDs are related not just to the numbers of patients attending, but also the acuity of patient conditions. A central factor is capacity in social care, which impacts on hospital discharge rates and consequently on patient flow from EDs.

"These pressures across the system have built up over many years and cannot be quickly or simply fixed. However, I’m convinced a way forward is achievable through investment in both new pathways for urgent care and supporting discharge, maximising our existing capacity, productivity and efficiency and changing how we organise some services.”

The latest figures released by the Department stipulate emergency care data for clinical care episodes completed on, or after November 2023 in South Eastern Trust was not available due to the trust’s transition to completely digitised health records following the launch of the ‘encompass’ programme.

As such, all Northern Ireland level figures presented throughout the report only include those for Belfast, Northern, Southern and Western Health and Social Care Trusts.