Accident and emergency

Monthly Accident and Emergency (A&E) Activity and Waiting Times Statistics

Weekly Emergency Department Statistics

These pages report key statistics on unplanned attendances at A&E services across Scotland.

This includes information on:

• emergency departments
• minor injury units
• smaller community casualty and A&E departments
• patients in trolleyed areas of acute assessment units
• virtual contacts

Health and social care

Emergency care

Webpage with embedded RShiny dashboard content, CSV files and Excel Tables, machine readable open data.

Weekly and monthly, reflecting the timeliness of data available.

Weekly

New data for Emergency Departments only released each Tuesday covering the week ending on the Sunday 9 days before publication.

Monthly

New data for all types of A&E site released on the first Tuesday of the month, covering the month two months prior to publication (e.g. March publication contains the data for January).

Previously, monthly and weekly figures were released as separate publications.

The monthly data release was designated as National Statistics in 2013 based on assessment by the UK Statistics Authority.

The weekly release was originally based on aggregate data returns and was designated as Official Statistics.  

Weekly submissions have improved over time and PHS now receive episode level data for all emergency departments. These official statistics were independently reviewed by the Office for Statistics Regulation in October 2023. They comply with the standards of trustworthiness, quality and value in the Code of Practice for Statistics and should be labelled 'accredited official statistics'.

Statistics on A&E activity are important to patients and are a measure of how the NHS is responding to demand for urgent and emergency care services.

Measuring and regular reporting of waiting times and attendances highlight where there are delays in the system and enable monitoring of the effectiveness of NHS performance throughout the country.

Statistics are presented in summaries that highlight the main headline points from the latest releases, in interactive charts where users can select data of interest using drop down menus, and as downloadable tables or machine readable open data files.

In order to help users understand and interpret our statistics, further information is contained within this metadata section.

We have also provided a glossary and tried to minimise use of abbreviations and acronyms.

Trend data available from 3 March 2015 for weekly data (emergency department only) and from 1 July 2007 for monthly data (all types of A&E site).

Under terms of the “Pre-Release Access to Official Statistics (Scotland) Order 2008”, PHS is obliged to publish information on those receiving pre-release access ('pre-release access' refers to statistics in their final form prior to publication).

The standard maximum pre-release access is five working days. Shown below are details of those receiving standard pre-release access.

Standard pre-release access

• Scottish Government Health and Social Care Directorate
• Territorial NHS Board Chief Executives
• Territorial NHS Board Communication leads

Early access for quality assurance

The monthly statistics are made available, around two weeks prior to publication, to key individuals within the Scottish Government and NHS boards to help quality assure the publication. The contacts within NHS Boards are a mixture of information staff (data suppliers), operational staff (general managers) and clinicians. This varies by NHS Board. The contacts at the Scottish Government are analysts and policy leads for Unscheduled Care.

It is the policy of PHS to make its websites and products accessible according to our accessibility statement. Graphs and tables have been assessed against PHS accessibility standards.

NHS boards use a variety of local IT systems to collect A&E data.

NHS boards provide weekly episode-level submissions to PHS. For a small number of sites, weekly data is submitted as an aggregate return.

NHS boards provide the majority of the monthly data (covering all types of A&E site) at episode level. Monthly aggregate returns for some sites are provided by NHS Grampian and NHS Highland.  These monthly aggregate returns account for around 3% of overall activity in Scotland.

Episode level data provides details about each individual attendance, enabling further analysis including breakdowns by patient characteristics (such as age or sex). 

The statistics presented in the following sections exclude the small proportion of attendances for which episode-level data is not available. These are for the sections:

• who attends
• when do people attend
• routes into A&E departments
• what happens following A&E attendance

A list of the A&E sites with information about their location, the type of site and whether PHS receives aggregate or episode-level data for that site can be found in our list of all hospital sites.

All of the data submitted weekly and monthly are collated centrally in the national A&E datamart.

NHS board submissions completed and processed by Thursday each week for weekly data and by around 10th of each month for monthly data.

Please note that from 2 May 2023 the data included in the weekly ED publication is based on date/time of arrival instead of date/time of discharge, admission or transfer. This brings the weekly publication in line with the monthly publication. This change caused some very small changes in attendance and performance in the historical data. A note of revisions can be in the revisions section of the metadata.

View details of data items collected and validation process in our A&E User Guide.

View data item codes, descriptions and definitions in our A&E: Data Recording Manual

In addition to any local data quality checks, the data submitted to PHS is subject to automated validation procedures. Anomalies identified by PHS as part of these validation procedures are raised with NHS Boards, who are then required to provide more information and, if necessary, resubmit data. Revisions to previously published figures are noted as per the revisions section. For more information about this, see Appendix A of the A&E user guide, the  A&E data recording manual and the data quality section of the PHS website.

The data quality and completeness is variable. Information on the date and time of arrival and discharge is of consistently high quality. Information on reasons why people attend and clinical diagnosis is less complete and less robust in terms of nationally consistent data quality.

PHS works closely with colleagues in the NHS boards to improve the validation and accuracy of the data and to ensure that the appropriate data standards are understood and applied by all sites. This takes place on a continuous basis, as queries or potential issues arise.

Annual review meetings are held between PHS and each NHS Board to take stock and discuss any outstanding or emerging issues. The meetings focus on data quality issues identified for that particular NHS Board. PHS are currently reviewing the frequency of these meetings.

In addition to these formal annual meetings, data quality is monitored and issues or queries flagged with suppliers on an ongoing basis, through the range of regular monitoring and analysis that PHS produces for NHS Boards and the Scottish Government.

The small number of aggregate returns included in the monthly report are subject to only basic quality assurance checks by PHS. NHS Boards are required to confirm to PHS that the statistics are accurate.

The statistics in the monthly release cover all A&E sites. 

The weekly release covers a subset, only emergency departments (EDs, larger A&E services that typically provide a 24-hour consultant led service).

The weekly statistics for EDs cover the majority (over 80%) of total A&E activity, but they do not reflect the full range of A&E services and activity.

Data completeness varies by data item and further information can be found in the completeness tables.

The type of services provided by A&E departments in Scotland can vary, depending on current demand and what other urgent and emergency care services are available nearby.

Sites are categorised as either emergency departments, minor injuries units or other smaller community casualty departments, but within these categories there can be variation in service delivery which can impact comparability.

Various urgent and emergency care services run alongside A&E departments across Scotland, including assessment units. A&E data submitted to PHS should include activity in trolleyed areas of assessment units, but it is not possible to separately identify this in the data. This means that A&E statistics reported for an emergency department or minor injuries unit (MIU) at a hospital can also include activity from trolleyed areas of assessment units at the same hospital.

How different urgent and emergency care services operate and the way space such as trolleyed areas are used can vary both by hospital (depending on the facilities available and how services have been set up to meet local demand) and also over time (depending on how many people need urgent or emergency care at different times).

These differences could impact on the consistency and comparability of A&E statistics and it is important to bear this in mind when comparing statistics for different areas or hospitals, or looking at trend data over time.

Direct comparison of A&E statistics across the United Kingdom is limited by differences in service delivery and categorisation of different types of A&E department, and by differences in definitions in the four nations. Definitions for A&E waiting times statistics are driven by devolved policies in each nation. This means that there are differences around coding of attendance types, and around exactly when the 'clock starts' (for example, for those who arrive at A&E by ambulance).

The UK wide comparison looks only at Emergency Departments in Scotland and Type 1 departments in the other nations. This is not necessarily comparing like for like. It does not take into account the differing case mix of patients attending, which will be influenced by the differing provision and accessibility of alternative emergency care services across the UK nations.

NHS Digital work with producers of A&E statistics across the UK to produce an annual comparison, with notes about the differences between statistics for each nation.

PHS provide links to the above publication rather than links to the individual reports for each nation. This is to ensure that those who are interested in comparing across the UK have access to what are deemed to be ‘best fit’ comparisons, accompanied by additional narrative and caveats, which are clearly highlighted on the notes page that accompanies the data.

Public Health Scotland works with the UK Health Statistics Steering Group (UKHSSG) to maintain information about the comparability of health care waiting times statistics.

The UKHSSG is currently responsible for improving the coherence and accessibility of health and social care statistics across the UK. Within the UKHSSG, theme groups have been established.  One of these groups is focussed on improving comparability of cross-UK performance statistics, including for A&E.

Trend data showing number of attendances and length of time people spend in A&E departments is robust at a national level.

At site level, some hospitals which previously submitted aggregate data have moved to submitting episode level data. Those affected are flagged in the list of sites. Please bear this in mind when looking at trends in tables that are based on episode level data only (for example, the breakdowns by age, sex and deprivation); an increase in the number of attendances or population rate may be the result of additional sites submitting episode level information rather than a true increase.

The Redesign of Urgent Care (RUC) programme was implemented in December 2020. One of the main aims of the programme was to change the way people access A&E and convert some unscheduled activity into planned activity to help people get the right care in the right place. This planned activity primarily follows contacts with Flow Navigation Centres that were set up as part of the RUC programme. In order to help measure the impact of the RUC programme PHS introduced a new planned code for attendances at A&E scheduled following contact with Flow Navigation Centres. 

PHS also introduced a new referral source code for Flow Navigation Centres and Virtual clinics. PHS is aware that currently not all areas are using this new code and some are recording NHS 24 as source of referral rather than Flow Navigation Centre. This may be due to how patients report this on arrival at reception.

PHS is aware that some NHS Boards are not recording planned A&E activity as expected. The planned attendances are currently excluded from both the weekly and monthly publication, and they are excluded from the 4 hour standard. PHS intend to publish information on planned attendances when the completeness and data quality have been improved.

Due to the timeliness of submissions and reporting and the dynamic nature of the A&E dataset, figures contained within each update may be subject to change in future releases.

If NHS boards discover that data submitted to PHS is incorrect, or that data are missing, further re-submissions can be made.

Any revised figures will then be reflected within the latest update.

Figures contained within each update may also be subject to change in future releases as historic data may be re-submitted. Revisions generally contribute to around 0.1% of all weekly attendances across Scotland; this rate varies by NHS Board.

These amendments are usually minor, affecting a small number of records for individual sites or areas. Any major or significant changes are handled as formal revisions as outlined in PHS Statistical Revisions Policy.

Minor amendments to historic data in the latest weekly and monthly release are noted in a monthly revisions log and weekly revisions log.

Count of total attendances. Number and proportion of attendances in department for 4, 8 and 12 hours. Guidance on when the clock should start and stop at in relation to the four hour A&E access standard can be found in the A&E data recording manual. Currently, the date and time of arrival is used for calculations published in the monthly release, and date and time of discharge in the weekly publication. The difference in approaches was retained to be consistent with legacy weekly publications. The impact on the statistics of using the different date and time values for those waiting over 4, 8 and 12 hours is very minimal. PHS is planning to align both publications to use date and time of arrival as soon as possible.

Average counts for day of the week. Count of attendances by time of day. Time of day and day of week are based on date/time of arrival at A&E.

Population rates for age groups, sex and SIMD categories. The population rates are based on the number of attendances attributed to a group or region divided by the number of residents in that group (the population). This can potentially inflate the rates for those population groups with higher repeat attenders- (that is, individuals with multiple attendances), for example those living in more deprived areas.  

The PHS Statistical Disclosure Protocol is followed for both the weekly and monthly publication to protect patient confidentiality.