NHS performance dashboard

1. Urgent care

Ambulance services

  • Since June 2012 ambulance trusts have been given eight minutes to respond to the most urgent cases and nationally no more than 25 per cent of these calls should be responded to outside of this time.

  • This standard was met until 2013/14 but for all subsequent years has been missed. The most recent data shows performance remains poor; in six of the past seven months more than 30 per cent of calls were responded to after eight minutes (Figure 26). This is the worst run in performance since this target was introduced.

Figure 26: Monthly performance of ambulance trusts in England for Red 1 calls

Data source: Ambulance quality indicators www.england.nhs.uk

Accident and emergency

  • In quarter 3 2016/17 the proportion of patients waiting more than four hours from arrival to discharge, admission or transfer in all A&E departments was 12.1 per cent (more than 709,600 patients in total). This is the highest proportion in the third quarter of the year since 2003/4 (Figure 27).
Figure 27: Percentage spending more than four hours in A&E from arrival to admission, transfer or discharge; quarterly data

Data source: A&E attendances and emergency admissions www.england.nhs.uk

  • Pressures to admit more patients continued to impact performance against the four-hour standard in the third quarter of the year (Figure 27). Compared to the same quarter last year, A&E attendances are 3 per cent higher this year (Figure 28) and emergency hospital admissions from A&E have also increased by 3 per cent (Figure 29).

  • These small percentages represent large numbers. The increase equates to more than 186,300 additional attendances and 36,180 additional admissions to hospital in the third quarter of 2016/17 compared to 2015/16.

  • Over the year, for each month so far in 2016/17 this is the equivalent of an additional 71,300 attendances at A&E departments and 13,161 admissions from A&E compared to the previous year.

Figure 28: Total attendances at accident and emergency departments, monthly data

Data source: A&E attendances and emergency admissions www.england.nhs.uk

Figure 29: Emergency admissions from accident and emergency departments, monthly data

Data source: A&E attendances and emergency admissions www.england.nhs.uk

  • There has been an increase in the number of patients waiting more than four hours from decision to admit from A&E to admission to a hospital bed on a ward (‘trolley waits’) to 163,311 in quarter 3 2016/17, which is 64,620 patients (65 per cent) more than in the same quarter in 2015/16 (Figure 30).
Figure 30: Patients waiting more than four hours in A&E from decision to admit to admission, monthly data

Data source: A&E attendances and emergency admissions www.england.nhs.uk

2. Waiting times

  • The proportion of patients waiting more than 18 weeks to begin their treatment increased to more than 10 per cent in December 2016 (Figure 31). This is the worst performance, and the first time that performance has breached 10 per cent, since this definition of the standard was introduced in April 2012. It is also the tenth month in a row that the standard (8 per cent) has been breached. In total, there were 376,877 patients still waiting to begin their treatment after 18 weeks at the end of December 2016, and 1,228 of these patients have been waiting for more than a year.

  • For the standards that were dropped last year, latest figures show that the proportion of admitted patients treated after having waited more than 18 weeks has remained above 20 per cent for the past seven months. The proportion of non-admitted patients waiting more than 18 weeks has remained above 9 per cent for the past four months in a row.

Figure 31: Per cent still waiting 18 weeks to begin treatment / having waited more than six weeks for diagnostics

Data source: Referral-to-treatment waiting times statistics www.england.nhs.uk

Diagnostic waiting times statistics www.england.nhs.uk

  • The total elective waiting list grew to 3.75 million in October 2016, but fell to 3.66 million in December. Though falling, this is still 367,387 more patients than in January 2016.

  • Furthermore, this total does not include several trusts that have not been reporting their waiting lists. Including these trusts, NHS England estimates that the true waiting list in December 2016 was more than 3.8 million patients (Figure 32).

Figure 32: Referral-to-treatment total waiting list size in millions, England

Data source: Referral-to-treatment waiting times statistics www.england.nhs.uk

  • The proportion of patients waiting more than six weeks for a diagnostic test has now missed its target (1 per cent) for the past 37 months in a row.

  • The overall waiting time standard for cancer treatment is that no more than 15 per cent of patients should wait more than 62 days from an urgent referral from their GP to receiving treatment for their cancer. This standard was met from quarter 4 2008/9 until quarter 4 2013/14, when it was missed (15.6 per cent). In quarter 3 2016/17 (October to December 2016) performance was again below the standard. The trend over the previous two years shows increasing numbers of total patients treated, while the proportion of patients waiting more than 62 days to treatment remains around 17.5 per cent (Figure 33).

Figure 33: Maximum 62-day wait for first treatment: all cancers (urgent GP referral to treatment)

Data source: Provider-based cancer waiting times www.england.nhs.uk

3. Delayed transfers of care

  • At the end of December 2016, 6,191 patients were delayed in hospitals. This is the highest number for this time of year since the data began and is an increase of 24 per cent since December 2015 (Figure 34).

  • The number of total days delayed increased to more than 195,000 in December 2016, the highest ever recorded for this month (Figure 35) and 27 per cent higher than December 2015.

Figure 34: Delayed transfers of care: number of patients delayed on last day of month

Data source: Acute and non-acute delayed transfers of care, patient snapshot, 2016/17 www.england.nhs.uk

Figure 35: Delayed transfers of care: total number of days delayed each month

Data source: Acute and non-acute delayed transfers of care, total days delayed, 2016/17 www.england.nhs.uk

4. Workforce

  • In November 2016 the total number of full-time equivalent (FTE) staff working in hospital and community health services (excluding, for example, general practitioners) was more than 1.044 million (Figure 36).

  • Compared to November 2015, there has been an increase in all staff of 21,346 FTE posts (2.1 per cent). This has been across all staff groups: consultant numbers have increased by 3.3 per cent; managers by 2.5 per cent; scientific, therapeutic and technical staff by 2.7 per cent; nurses, midwives and health visitors by 0.6 per cent.

Figure 36: Index change in NHS full-time equivalent staff: September 2009 – November 2016

Data source: Monthly NHS Hospital and Community Health Service (HCHS) Workforce Statistics in England – November 2016, Provisional statistics www.digital.nhs.uk

5. Health care-acquired infections

  • C difficile infections increased to more than 400 cases a month between August and November 2016 but reduced to 370 in December 2016. The number of methicillin-resistant Staphylococcus aureus (MRSA) infections remains low – a total of 27 in December across England (Figure 37).

  • The number of reported methicillin-susceptible Staphylococcus aureus (MSSA) infections in December 2016 has decreased to 229. Similarly, numbers of E coli infections decreased.

Figure 37: Monthly counts of selected health care-acquired infections

Data source: Clostridium difficile infection: monthly data by NHS acute trust www.gov.uk

Monthly counts of methicillin resistant Staphylococcus aureus (MRSA) bacteraemia by post infection review (PIR) assignment www.gov.uk

Monthly counts of trust apportioned methicillin susceptible Staphylococcus aureus (MSSA) bacteraemia by NHS acute trust www.gov.uk

Monthly counts of Escherichia coli (E coli) bacteraemia by NHS acute trust www.gov.uk