Provisional Accident and Emergency Quality Indicators - England, Experimental statistics by provider for December 2011
In April 2011 a new set of clinical quality indicators was introduced to replace the previous four hour waiting time standard, and measure the quality of care delivered in A&E departments in England. Further details on the background and management of the quality indicators are available from the Department of Health (DH) website. This is the ninth publication of data on the Accident and Emergency (A&E) clinical quality indicators, drawn from A&E data within provisional Hospital Episode Statistics (HES). These data relate to A&E attendances in December 2011 and draw on 1.36 million detailed records of attendances at major A&E departments, single speciality A&E departments (e.g. dental A&Es), minor injury units and walk-in centres in England.
This report sets out data coverage, data quality and performance information for the following five A&E indicators:
Left department before being seen for treatment rate
Time to initial assessment
Time to treatment
Total time in A&E
Publishing these data will help share information on the quality of care of A&E services to stimulate the discussion and debate between patients, clinicians, providers and commissioners, which is needed in a culture of continuous improvement. These A&E HES data are published as experimental statistics to note the shortfalls in the quality and coverage of records submitted via the A&E commissioning data set. The data used in these reports are sourced from Provisional A&E HES data, and as such these data may differ to information extracted directly from Secondary Uses Service (SUS) data, or data extracted directly from local patient administration systems. Provisional HES data may be revised throughout the year (for example, activity data for April 2011 may differ depending on whether they are extracted in August 2011, or later in the year). Indicator data published for earlier months have not been revised using updated HES data extracted in subsequent months.
The data presented here represent the output of the existing A&E Commissioning Dataset (CDS V6 Type 010). It must be recognised that these data will not exactly match the data definitions for the A&E clinical quality indicators set out in the guidance document A&E clinical quality indicators: Implementation guidance and data definitions (external link). The DH is currently working with Information Standards Board to amend the existing CDS Type 10 Accident and Emergency to collect the data required to monitor the A&E indicators.
A&E HES data are collected and published by the NHS Information Centre for Health and Social Care. The data in this report are secondary analyses of HES data produced by the Urgent & Emergency Care team, Department of Health.
A&E HES data are published as experimental statistics to note the known shortfalls in the quality of some A&E HES data elements. The published information sets out where data quality for the indicators may be improved by, for example, reducing the number of unknown values (e.g. unknown times to initial assessment) and default values (e.g. the number of attendances that are automatically given a time to initial assessment of midnight 00:00).
The quality and coverage of A&E HES data have considerably improved over the years, and the Department and the NHS Information Centre are working with NHS Performance and Information directors to further improve the data.
This information is secondary analysis of HES data that have been produced by the Urgent & Emergency Care team in the Department of Health.
Questions should be forward to the mailbox of the Urgent & Emergency Care team at the Department of Health email@example.com .
Revisions Policy: Please note, Provisional HES data may be revised throughout the year (for example data will differ depending on the time at which they were extracted). Indicator data published for earlier months will not be revised using updated HES data extracted in subsequent months.
- A&E HES data contain 1.36 million A&E attendances for December 2011 at all types of A&E. However, A&E HES data are incomplete; over 1.45 million A&E attendances were reported in the Department of Health Situation Report data collection for December, and 158 organizations that report data to Situation Reports did not report data to A&E HES; these organizations are mostly lower acuity services such as minor injury units and walk-in centres.
- Several organizations reported data that did not meet the data quality checks required by the A&E indicators. The 95th percentile and longest single wait information are particularly sensitive to poor data quality, outliers and data definitional issues, which contributes to why some unusually high values may be observed for these measures.
- Nationally, 2.7 per cent of attendances at A&E departments were recorded as having left A&E before being seen for treatment, and 7.2 per cent of attendances at A&E in December 2011 were unplanned re-attendances within 7 days of a previous attendance.
- The median average time to initial assessment for attendances brought to A&E by ambulance was 4 minutes, with 95 per cent of patients being assessed within 47 minutes. For all patients receiving treatment, the median average time to treatment was 50 minutes, with 95 per cent of patients receiving treatment within 3 hours 08 minutes.
- The median average total time in A&E for all patients was 2 hours 10 minutes, with 95 per cent of patients departing A&E within 4 hours 47 minutes of arrival.
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