Urgent and Emergency Care Statistics Developments and Plans

This page brings together information around developments to urgent and emergency care statistics, including user engagement, in response to a review by Office for Statistics Regulation. It will be updated periodically, as and when further developments are planned.

We produce several sets of statistics on Urgent and Emergency Care to provide information around performance against monthly targets listed below, further contextual information and a comprehensive set of data made available annually here.

We are using the Emergency Care Services Dataset to underpin more published outputs. This dataset is at record level which has many advantages in enabling the production of summaries for specific care areas and patient characteristics:

• We have produced monthly summary information on 12 hour waits using this dataset – published below. We have linked this closely with our existing publication on 4 hour waits, which is currently sourced from aggregate data, but are maintained as separate documents to reflect the distinctions between them.
• We have released detailed information around data quality and provenance of the different sources
• We have expanded the scope of our monthly use of ECDS to include type 2 providers and Urgent Treatment Centres
• We have started to use the greater detail available in ECDS by including breakdowns by these characteristics (age, gender, ethnicity and chief complaint) in our monthly reports published below)
• We will also be publishing monthly data specific to frailty in December 2024.

We would welcome user feedback on other areas of interest from ECDS data.

We are exploring and considering whether publication of site level data would be beneficial to users and in particular whether it would be in the best interest of patients and their outcomes. We would need to consider carefully how these data would be presented given the complexities of understanding the interaction between services.

These items above show our general approach to use record level data, including ECDS more, and in time replace some of our aggregate collections with this. The aim of many of our publications is to measure government and NHS targets so many of our outputs are driven by government decisions around the target so we will add further details when there are specific decisions around individual targets.

A major development area is to improve the timeliness, completeness and quality of the Emergency Care Dataset (ECDS) both to improve existing outputs and so it can be used to underpin more outputs. Quality is closely monitored by the ECDS data quality dashboard, available here.

We are working with local areas, including via the ECDS user group to drive up this timeliness completeness and quality. A particular focus of this work is supporting providers to move from ECDS v3 to v4.

V4 includes very important information around Virtual Care and the recording of Same Day Emergency Care Activity, as well as Injury Sharing to Tackle Violence (ISTV), so our focus on providers moving to v4 will enrich the data available in these areas.

We will review our plans for development following engagement with some users over the Spring/Summer 2025.

OSR compliance assessment

In January 2024, the Office for Statistics Regulation undertook an exercise to assess the Code of Practice for Statistics compliance of the Accident and Emergency Statistics published by NHS England. The report can be found here.

Data Quality

The published monthly A&E statistics are based on returns from all providers meeting the thresholds set out in the official guidance (Guidance) there are no issues to report on the completeness of the data set, although there could be issues with the accuracy of the data reported – these are addressed by revisions twice a year. Any missing trust submissions in a month are highlighted in the Statistical Commentary for the month. Since this is a well established data collection we do not anticipate that these are significant.

The flow of data from trusts to the publication, is explained in this document
MSITAE data flowchart V1.

There is detailed information available on ECDS completeness and data quality within the publication, on the final page of the published Supplementary ECDS Analysis. The data quality checks for each measure are explained in the publication.

Engagement with users of A&E statistics

We welcome feedback from users and have a number of mechanisms to gather this, drawing both on existing approaches to gather feedback from users across statistical areas, and approaches tailored to urgent and emergency care.

We welcome feedback on our emergency care outputs, including the option of giving their contact details enabling us to reach out for further discussions

You can contact us by emailing AEdata@england.nhs.net

Internal engagement

We will continue regular engagement with a range of NHS England Programme and Improvement colleagues who use our A&E statistics for programme development and delivery, performance monitoring and quality improvement work.

We engage with key individuals across the organisation. This includes regular outputs and meetings, as well as responses to ad hoc requests for analysis and information.

We will maintain engagement with other data and analytical teams across NHS England including in the regions to ensure consistent and coherent use of our A&E statistics in a variety of outputs and tools. One forum in which we do this is through a monthly internal A&E matrix group.

Other engagement

We routinely engage with a range of organisations that regularly use the A&E statistics that we produce including the Department for Health and Social Care.

We also work with groups concerned with the consistency of A&E statistics across the United Kingdom. This includes regular email correspondence and meetings with the Office for National Statistics, the Government Statistical Service, and teams responsible for producing and reporting A&E statistics in each of the devolved nations.

We have structured engagement with users and data providers to drive up the quality of the Emergency Services Dataset (ECDS) via the ECDS user group and ECDS user forum and we will continue to use these to set priorities for improving quality. The user group is largely attended by providers which enables them to advise on current challenges that we can then work together to address. Users can find out more on our ECDS home page and join our mailing list to receive ECDS updates, news and alerts.

Improvement

There have been and will be opportunities to feed in specific views through broader engagement channels:

The UK statistics assembly: Formed in response to a recommendation in the Independent Review of the UK Statistics Authority, the Assembly was a unique opportunity for a diverse range of voices and views, including from central, local and devolved governments, business and industry, academia, civil society and charities to come together to discuss and advise us on statistical priorities, user needs and gaps for the country. Feedback from the event is being synthesised and relevant aspects will feed into NHS England statistical development plans.

The cross-organisation Health and Social Care statistics consultation provided an opportunity for users to provide feedback on all statistics consultations and is summarised here.
We welcome user feedback specific to our Emergency Care publications and are developing feedback forms to accompany our statistics publications.

In addition to all of the above activities, we plan to more proactively seek feedback from the following organisations, to learn more about how our statistics are used and how we can improve our outputs:

• professional groups, such as the Royal College of Emergency Medicine
• health think tanks and research organisations such as, the Health Foundation, the Nuffield Institute
• the House of Commons library
• media outlets and journalists

We plan to approach these types of users, from Spring 2025 onwards.

This will start with questions sent by email and the offer of a follow-up discussion, and then will evolve to best meet these users’ needs, sharing the outcome of this work following user engagement in the Spring and further considerations in Autumn.