NHS activity and performance summary: April and May 2022
Report summarising data on activity and performance in the Welsh NHS for April and May 2022.
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Introduction
Data for each topic area is also available in more detail on our StatsWales website.
This month we have published further data relating to the 111 service webpage visits and completed online symptom checker data on our StatsWales website.
In light of the impact COVID-19 has had on NHS activity and performance levels, the Welsh Government has published its programme for transforming and modernising planned care and reducing waiting lists in Wales. This plan sets out a number of key ambitions to reduce waiting times for people in Wales. We have incorporated these measurements of performance against these ambitions into this statistical release and on StatsWales.
Main points
In May there were 3,558 red (life threatening) calls to the ambulance service, 9.6% of all calls. This is high in historical context. 54.5% of red calls received an emergency response within 8 minutes, lower than the target of 65%.
There was an average of 2,937 daily attendances to emergency departments, an increase in activity compared with the previous month. Performance against the four and twelve hour targets both improved slightly compared with April, though they were the sixth and third lowest on record respectively. The average (median) time spent in emergency departments also improved slightly in May, but was still the fourth longest on record, at three hours and one minute.
The pandemic has caused a large increase in patient pathways waiting to start treatment, and in April lists increased to over 707,000. However, the rate of increase has slowed recently. April saw 65,177 patient pathways closed, lower than the pre-pandemic average but significantly higher than in the early part of the pandemic. Patient pathways differs to the number of patients. More information on this difference is available in the Welsh Government’s chief statistician’s blog.
The proportion of patient pathways waiting less than 26 weeks decreased in April to 53.7%, from 54.2% in March. This has been relatively stable for some time after falling significantly from the levels pre-pandemic. The number of pathways waiting longer than 36 weeks reached the highest number on record in April, at 258,189.
Just over 68,000 pathways were waiting more than two years, a slight reduction in the latest month after a consistent increase over the previous year. The average (median) time patient pathways had been waiting for treatment at the end of April remained high at 22.5 weeks.
For diagnostic services, the number of patient pathways waiting longer than 8 weeks (the target maximum wait) increased to 45,028, the fifth lowest level since April 2021.
For therapies, the number of patient pathways waiting increased slightly to 63,510 in April, the highest level on record. The number waiting longer than fourteen weeks (the target maximum wait) decreased to 13,103, the third highest level on record.
For cancer services, fewer people started their first definitive treatment in April (1,430) and fewer pathways were closed following the patient being informed they did not have cancer (10,539) than in the previous month. Performance decreased against the 62 day target compared with March.
Unscheduled care
New data relating to unscheduled care are provided for the month of May 2022.
Calls to 111 service
As of 16th March 2022, the non-emergency 111 helpline service has been rolled out across the whole of Wales.
In May, 71,120 calls were answered by the 111 service in Wales, an average of 2,294 calls per day. A further 6,215 calls were ended by the caller before being answered. Of these, 2,015 were ended within 60 seconds of the automated messages, suggesting their needs were likely to have been met. 4,236 calls were abandoned after 60 seconds and these are regarded as callers who were more likely to have still required the service after the messages, but were unable to get through or decided not to wait.
Of the calls answered, for 1,084 calls the caller indicated that they wished to conduct the call in Welsh.
There were 329,785 hits on the NHS 111 Wales website and 12,164 completed symptom checks (NHS 111 Wales) in May.
More data is published on StatsWales.
Emergency calls to the ambulance service
A wider range of ambulance quality indicators are published on the Emergency Ambulance Services Committee (EASC) website and on StatsWales.
Activity
Emergency ambulance calls and responses to red calls, by local health board and month on StatsWales
Note: An update to call handling in May 2019 resulted in a change to red incident volume. It is not possible to directly compare before and after this date. Further details are available in the quality information.
In May, almost 38,000 emergency calls were made to the ambulance service. This is an average of 1,207 calls per day, a decrease of 55 (4.3%) calls on average per day than the previous month and 130 (9.7%) fewer calls on average per day than the same month last year.
Calls to the ambulance service are categorised as red (immediately life-threatening), amber (serious but not life-threatening) or green (non-urgent). An average of 116 red calls were made per day in May. This is the twelfth month in a row where on average there were more than 100 immediately life-threatening calls made each day.
In May, the proportion of all calls that were immediately life-threatening was 9.6%, similar to 9.5% in April.
Performance
Target
- 65% of red calls (immediately life-threatening – someone is in imminent danger of death, such as a cardiac arrest) to have a response within 8 minutes.
Note: An update to call handling in May 2019 resulted in a change to red incident volume. It is not possible to directly compare before and after this date. Further details are available in the quality information.
In May, 54.5% of emergency responses to immediately life threatening (red) calls arrived within 8 minutes. This is 3.4 percentage points higher than the previous month, but 6.1 percentage points lower than in May 2021.
The median response time in the four years prior to the pandemic ranged between 4 minutes 30 seconds and 6 minutes for red calls. In May, the average (median) response time to immediately life-threatening ‘red’ calls was 7 minutes and 22 seconds. This was 27 second faster than April but 36 seconds slower than May 2021.
The majority of calls to the ambulance service are categorised as ‘amber’ calls, for which there is no performance target for call response times. In May, the median response time for amber calls was just under 1 hour and 18 minutes. This is almost 30 minutes quicker than in April, and 30 minutes slower than in May 2021.
Emergency department attendances and admissions to hospital
A wider range of emergency department performance statistics are published on the National Collaborative Commissioning Unit (NCCU) website, as management information.
Activity
Number of attendances in NHS Wales emergency departments by age band, sex and site on StatsWales
Note: Chart shows number of attendances at both major emergency departments and minor injuries units, and the number of admissions resulting from attending major emergency departments only.
In May there were more than 91,000 attendances to all NHS Wales emergency departments. This is an average of 2,937 emergency department attendances per day; 162 more attendances per day on average than in the previous month, and 123 more than in the same month last year.
In May, almost 14,000 patients were admitted to the same or a different hospital following attendance at a major emergency department. This was 6.7% higher than the previous month, but 15.3% lower than the same month in 2021.
Performance
Targets
- 95% of new patients should spend less than 4 hours in emergency departments from arrival until admission, transfer or discharge.
- No patient waiting more than 12 hours in emergency departments from arrival until admission, transfer or discharge.
Performance against 4 hour target by hospital on StatsWales
In April, 66.6% of patients in all NHS emergency departments spent less than 4 hours in the department from arrival until admission, transfer or discharge, which was the third lowest level on record. This was 0.8 percentage points higher than the previous month, but 5.6 percentage points lower than the same month a year ago. In 2019, the median time patients spent in emergency departments was around 2 hours and 30 minutes. During the early part of the pandemic, as attendances decreased the median time spent in the department decreased, to a low of 1 hours 47 minutes in April 2020. Since then, median times have increased and reached a record high of 3 hours and 8 minutes in March 2022. In the latest data for May, the median waiting time was 3 hours and 1 minute. This was one minute faster than the previous month, but the third longest average (median) waiting time on record.
The median time spent in emergency department varies by age. Prior to the pandemic, children (aged 0 to 4) spent between 1 hour and 30 minutes and 2 hours in emergency departments, while older patients (aged 85 or greater) spent between 3 hours and 30 minutes and 5 hours.
In May, children (aged 0 to 4) spent an average of 2 hours and 24 minutes. Adults aged 85 and over spent an average of 7 hours and 17 minutes in emergency departments, the lowest it has been September last year.
Performance against the 12 hour target by hospital on StatsWales
In May there were over 10,200 patients waiting 12 hours or more. This was 235 fewer than in the previous month and the second consecutive decrease since the highest on record.
Scheduled care activity
New data relating to unscheduled care are provided for the month of April 2022.
Outpatient referrals
Activity
Outpatient referrals on StatsWales
An average of 3,248 referrals for first outpatient appointments were made per day in April. This is a decrease of 13.4% (503 fewer referrals per day on average) compared to March, and is 5.8% lower than in April 2021.
Performance
Targets
No one waiting for longer than a year for their first outpatient appointment by the end of 2022 (new target established in the planned care recovery plan).
In April, the number of pathways waiting longer than one year for their first outpatient appointment increased to 93,077. This has increased dramatically over the course of the pandemic, though it has fallen since the peak of over 101,000 in October 2021.
Diagnostic and therapy waiting times
Activity
Diagnostic and Therapy Services Waiting Times by week on StatsWales
Note: The low point in April 2020 for therapies is in part due to Betsi Cadwaladr not submitting data for this month, please see the quality information.
In April there were over 109,000 patient pathways waiting for diagnostics, an increase of 0.3% compared with the previous month and there were over 63,000 patient pathways waiting for therapies, an increase of 0.3% compared to the previous month to the highest level on record.
Performance
Targets
- The maximum wait for access to specified diagnostic tests is 8 weeks.
- The maximum wait for access to specified therapy services is 14 weeks.
- The planned care recovery plan established a target date of Spring 2024 to reach these targets.
Diagnostic and Therapy Services Waiting Times by week on StatsWales
Note: Betsi Cadwaladr did not submit data for April 2020, so are not included in the Wales figures for this month.
At the end of April, over 45,000 patient pathways were waiting longer than the target time for diagnostics. This was an increase of 8.1% compared to the previous month and 10.0% higher than April 2021.
At the end of April there were slightly over 13,000 patient pathways waiting longer than the target time for therapies. This is a decrease of 10.5% compared to March 2022 and is the first monthly decrease since May 2021.Median waiting times had been relatively stable for diagnostic tests since 2017 and for therapy services since 2018. Median waiting times for both services peaked in June 2020 (14.3 weeks for diagnostics and 14.9 weeks for therapies).
In April, the median waiting time for diagnostic tests was 6.2 weeks. This is an increase from 5.4 weeks in the previous month. The median waiting time for therapy services was 6.4 weeks. This is an increase from 5.8 weeks in the previous month.
Referral to treatment time
Referral to treatment time statistics show monthly data on waiting times for both open and closed pathways following a referral by a GP or other medical practitioner to hospital for treatment in the NHS. Open pathways are those that remain on the waiting list for treatment, whereas closed pathways are those taken off the waiting list.
Activity is measured by patient pathways, which differs to the number of patients. More information on this difference is available in the Welsh Government’s chief statisticians blog.
Performance
Targets
- No patients waiting longer than two years in most specialities by March 2023, and no patients waiting longer than one year in most specialities by Spring 2025 (new targets established in the planned care recovery plan).
- 95% of patients waiting less than 26 weeks from referral.
-
No patients waiting more than 36 weeks for treatment from referral.
In April there were over 707,000 patient pathways waiting to start treatment, the highest since comparable data was first collected in 2011. This was 0.8% higher than in the previous month and was 60.1% higher than April 2020.
Over 171,000 pathways were waiting more than one year in April, broadly stable over the last 12 months, and just over 68,000 pathways were waiting more than two years, a slight reduction in the latest month after a consistent increase over the previous year.
Of the 707,000 patient pathways waiting to start treatment by the end of April, 53.7% had been waiting less than 26 weeks. This is 0.5 percentage points lower than in the previous month and 20.5 percentage points lower than April 2020.
In April over 258,000 patient pathways had been waiting more than 36 weeks. This represented 36.5% of all patient pathways waiting to start treatment. This is 5,012 (or 2.0%) more pathways waiting than in the previous month and over five times more than April 2020.
The median waiting time to start treatment had generally been around 10 weeks pre pandemic between late 2013 and February 2020. This increased during the pandemic and peaked at a record high of 29 weeks in October 2020. In April, the median waiting time was 23 weeks. This is an increase from 22.5 weeks in the previous month.
Closed patient pathways by month, local health board and weeks waiting on StatsWales
Note: Cwm Taf Morgannwg health board have been unable to provide closed pathway data since September 2018. Data for this health board is excluded from the Wales total in the chart to allow for trend analysis. More details are available in the quality information.
The number of patient pathways closed in March was over 65,000. This is an average of 3,104 patient pathways closed per working day, a decrease of 12.6% from February.
Cancer services (experimental statistics)
Experimental statistics (ONS) are official statistics that are in the testing phase and not yet fully developed.
A number of wider measures from the suspected cancer pathway are produced by Digital Health and Care Wales are published alongside this statistical release.
Activity
Suspected cancer pathway (closed pathways) on StatsWales
In April, 1,430 pathways where the patient was newly diagnosed with cancer started their first definitive treatment in the month. This is a decrease of 16.9% compared to the previous month and a decrease of 6.7% from April 2021.
10,539 pathways were closed following the patient being informed they did not have cancer. This is a decrease of 16.6% compared to the previous month.
In April, 12,814 patient pathways were opened in the month following a new suspicion of cancer. This was a decrease of 2,486 (16.2%) on the previous month.
Performance
Target
- At least 75% of patients should start treatment within 62 days (without suspensions) of first being suspected of cancer. Data published for time periods before December 2020 are not subject to the target.
- The planned care recovery plan established a new target of 80%, to be reached by 2026.
Suspected cancer pathway (closed pathways) on StatsWales
In April, 56.4% (807 out of 1,430) of pathways started their first definitive treatment within 62 days of first being suspected of cancer. This was 2.2 percentage points lower than the previous month and 10.4 percentage points lower than April 2021.
Quality and methodology information
All quality and methodology information in relation to this statistical release can be found in the NHS activity and performance summary: quality report
Well-being of Future Generations Act (WFG)
The Well-being of Future Generations Act 2015 is about improving the social, economic, environmental and cultural wellbeing of Wales. The Act puts in place seven wellbeing goals for Wales. These are for a more equal, prosperous, resilient, healthier and globally responsible Wales, with cohesive communities and a vibrant culture and thriving Welsh language. Under section (10)(1) of the Act, the Welsh Ministers must (a) publish indicators (“national indicators”) that must be applied for the purpose of measuring progress towards the achievement of the wellbeing goals, and (b) lay a copy of the national indicators before Senedd Cymru. Under section 10(8) of the Well-being of Future Generations Act, where the Welsh Ministers revise the national indicators, they must as soon as reasonably practicable (a) publish the indicators as revised and (b) lay a copy of them before the Senedd. These national indicators were laid before the Senedd in 2021. The indicators laid on 14 December 2021 replace the set laid on 16 March 2016.
Information on the indicators, along with narratives for each of the wellbeing goals and associated technical information is available in the Wellbeing of Wales report.
Further information on the Well-being of Future Generations (Wales) Act 2015.
The statistics included in this release could also provide supporting narrative to the national indicators and be used by public services boards in relation to their local wellbeing assessments and local wellbeing plans.
We want your feedback
We welcome any feedback on any aspect of these statistics which can be provided by email to stats.healthinfo@gov.wales.
Next update
21 July 2022
Contact details
Statistician: Rhys Strafford
Telephone: 0300 025 0058
Email: stats.healthinfo@gov.wales
Media: 0300 025 8099
SFR 141/2022