Accident & Emergency Waiting Times Survey
Survey Results
A summary of the main points from the 7-day April 2006 A&E Waiting Times Survey
- There were 29,961 attendances.
- Half of the patients had a first clinical assessment within 22 minutes.
- Half of the patients had their treatment completed within 87 minutes.
- Half of the patients were discharged, admitted or transferred within 97 minutes.
- 9 out of 10 patients were discharged, admitted or transferred within 265 minutes.
- Waiting times vary considerably between departments (see notes in the Data Interpretation section).
- 88% of patients spent 4 hours or less in the department.
- 3,663 patients spent more than 4 hours in the department. The main reasons for delay for these patients were waiting for a bed (31% of all reasons recorded) and waiting for first assessment (20%). Reasons for delay varied from hospital to hospital, and by patient type. For "major" patients, waiting for a bed rose to 44% of all reasons recorded.
More detailed information on Accident and Emergency Waiting Times is available via the Excel downloads below. The times to treatment stages are presented as medians and 90th percentiles. The median signifies that 50% of patients waited up to the time shown; 50% took longer. The 90th percentile signifies that 90% of the patients waited up to the time shown; 10% took longer.
A_and_E_waiting_times_survey_2006.xls 
1,620 KB
A_and_E_waiting_times_survey_selected_trend_information.xls 76 KB
A&E attendances data are also captured on the ISD(S)1 database and details of the numbers of new and total A&E attendances, along with outpatient specialties, may be viewed here for NHSScotland.
Limitations
The surveys have their limitations not least of which is the focus on a few days out of a whole year and the difficulties of extrapolating information for the whole year, encompassing issues such as seasonality. The survey approach has been necessary because there has been no routine systematic collection of data on A&E waiting times and the survey duration is short to minimise the workload on busy A&E departments, many of which complete the survey forms manually. Variation in reported waiting times between departments may be due, in part, to different hospitals recording data in slightly different ways.
Input from the Centre for Change & Innovation Unscheduled Care Collaborative (UCC) Programme guided the revision of the survey content in 2005 to capture data consistent with the 4-hour commitment and to start to identify major causes of waits and delays. Therefore, there are inconsistencies in definition in the information captured by the 2005 and 2006 surveys, and that captured by earlier surveys, meaning that caution should be exercised when comparing data across these years. In order to collect data relating to the 4-hour target, the final time recorded was altered from 'Time left A&E department' in surveys prior to 2005 to 'Time of discharge, admission or transfer' in the 2005 and 2006 surveys. For further information on the changes in the surveys, and to view copies of the survey forms, see the Data Source section.
Another factor contributing to the difficulty in comparing data across years is that the duration of the survey has varied since the first survey in 1994. Originally, its duration was 7 days. In 2003 and 2004 the survey duration was reduced to 3 days, then in 2005 there was a mandatory 3-day survey, with departments having the option to extend over 7 days. In 2006, the survey was of 7 days duration for all departments survey.
The Data quality page contains important information on data quality including the results of a Data Quality Assurance exercise carried out on the 2005 survey.
Data Interpretation
Waiting times vary considerably between departments and this observed variation is affected by a number of factors.
Different hospitals may record data in slightly different ways and this has an impact on the calculated waiting times.
The severity of a patient's condition also affects the time they spend in A&E and departments with specialist services may have longer reported times for aspects of patient care.
Patients can spend a long time in A&E for clinical reasons.
In some of the tables, medians and percentiles are based on small numbers of attendances and this should be considered in their interpretation because these few cases may be unrepresentative.
ISD routinely applies the following convention to the publication of median waiting times based on small numbers:
- fewer than 15 cases: median waiting times are not shown
- 15-49 cases: medians are shown in italics and attention is drawn to their basis on small numbers of cases
This convention has been extended, in this publication, to the 90th percentile.
The coverage of the A&E waiting times survey has varied since the first survey in 1994. Originally, it was focussed on larger A&E departments, capturing data from 33 hospitals (the 'core departments'). In 2005, other A&E departments, minor injuries units and medical assessment units that had not previously participated were invited to take part in the survey and as a result, data were captured from 72 departments in total, including smaller community hospitals and minor injuries units as well as health centres running unscheduled care services. In 2006, all of Scotland's 93 hospitals with A&E departments, minor injuries units or medical assessment units participated. The trend data available above includes information only on the 'core departments' for which historical data are available.
The survey content changed in 2005, meaning earlier years' results are not strictly comparable with results from the 2005 and 2006 surveys. Where comparisons can be made, caution should be exercised in doing so because of inconsistencies in definition in the information captured by these surveys.
Due to the change in the content of the 2005 Accident & Emergency Waiting Times Survey, the 2005 and 2006 survey results have not been released under the terms of National Statistics. This reflects the developmental nature of the survey as a step in providing information to support the Unscheduled Care Collaborative Programme.
Data Source
The Accident and Emergency Waiting Times Survey is carried out using form SMR30C. Copies of the forms used are available via the links below:
The changes made to the 2005 survey, and maintained in the 2006 survey, are summarised below:
Patient type - For 2005 and 2006, patient category was revised from its original values of: resuscitation, triage and walking wounded to a new grouping of: majors and minors. This reflects the categorization adopted by the NHS in England and allows a degree of cross-border comparisons to be made.
Major (patient type) - Patients who require a longer assessment and observation in addition to diagnostics and treatment. Patients in this category may go on to medical/surgical admission.
Minor (patient type) - Patients who can be treated and discharged relatively quickly, often following a simple diagnostic assessment. "Minor" has no relation to age within the A&E survey.
Time of discharge, admission or transfer - Replaces 'Time left A&E department'. This field was altered in order to capture the information required to monitor the prospective 4-hour target.
Destination of patient - Previously 'Means of leaving'. The outcome of the patient's attendance at A&E indicating whether they were discharged (inc. deaths), transferred or admitted. A separate field indicates when a patient left the department before their treatment was completed.
First full clinical assessment - Replaces 'Time of triage'. Recognises that at this stage of treatment, active, positive intervention may occur (e.g. issuing pain relief or request of diagnostic test) to advance the progress of the patient through the A&E department or minor injuries unit or trolleyed area of an acute receiving and assessment unit.
Definitions
Unscheduled Care Core data standards were developed by the National Clinical Dataset Development Programme (NCDDP) and are available in the Clinical Datasets Section of the Data Dictionary - http://www.datadictionary.scot.nhs.uk/
Waiting Times Programme
Printer friendly version
