Understanding pressure on A&E services in Wessex - what can the data show us? Brad Keogh Richard Guerrero Caroline Powell - Centre for Implementation Science, University of Southampton

Contents What is the 4 hour target? Why are hospitals seeing greater pressures? How do Trusts in Wessex perform? Future work Data sources

What is the 4 hour target? National guidelines say that 95% of patients arriving in A&E should be seen within 4 hours of arriving Each Trust is monitored weekly to see if the target is being met Results are published online: times-and-activity/ This analysis limited to Acute Trusts Only

Why are hospitals seeing greater pressures? Less than 20% of acute Trusts met the 4hr target for 5 weeks last winter The number of acute Trusts regularly meeting the 4 hour A&E target has reduced over the last 4 years Data from: NHS England statistics, Percentage of Acute Trusts meeting the 95% target

Why are hospitals seeing greater pressures? Data from: NHS England statistics, Growing numbers of A&E attendances are putting services under pressure Blue line indicates number of attendances at all acute Trusts Percentage of Acute Trusts meeting the 95% target & number of admissions from A&E

Why are hospitals seeing greater pressures? Data from: NHS England statistics, Growing numbers of admissions from A&E are putting services under pressure Red line indicates number of admissions at all acute Trusts Percentage of Acute Trusts meeting the 95% target & number of admissions from A&E

How do Trusts across England perform? National data shows variation in Trust performance each week Data from: NHS England statistics, Black line indicates average acute Trust performance

How do Trusts across England perform? National data shows variation in Trust performance each week Data from: NHS England statistics, Dark grey area contains 50% of Trusts Light grey area contains 90% of Trusts Area below grey indicates in lowest 5%

How do Trusts across England perform? Data from: NHS England statistics, The chart shows the weekly distribution of acute A&E departments in England

How do Trusts in Wessex perform? - Poole Data from: NHS England statistics, Most hospitals, such as Poole, show natural variability week on week due to local variation Red line indicates Poole Trust performance

How do Trusts in Wessex perform? - Poole Data from: NHS England statistics, Most hospitals, such as Poole, show natural variability week on week due to local variation Poole has generally performed similarly to the England average, the Trust has regularly met the 4 hr target 4 hour target (95%)

How do Trusts in Wessex perform? –Southampton Data from: NHS England statistics, Area below grey indicates in lowest 5% Red line indicates Southampton Trust performance Southampton shows greater variation in 4 hour performance week to week than Poole

How do Trusts in Wessex perform? –Southampton Data from: NHS England statistics, Area below grey indicates in lowest 5% 4 hour target (95%) Until winter 2013 Southampton had performed well against the 4 hour target

How do Trusts in Wessex perform? - Portsmouth Data from: NHS England statistics, Area below grey indicates in lowest 5% Portsmouth has often been in the lowest 5% of acute Trust performance in the country for extended periods (45/52 weeks in 2014)

How do Trusts in Wessex perform? - Portsmouth Data from: NHS England statistics, Area below grey indicates in lowest 5% Portsmouth has often been in the lowest 5% of acute Trust performance in the country for extended periods (45/52 weeks in 2014) It has only met the 95% target for a few weeks in the 2 years

How do Trusts in Wessex perform? – Bournemouth Data from: NHS England statistics, Other acute Trusts in Wessex are closer to the national average

How do Trusts in Wessex perform? - Dorset Data from: NHS England statistics, Other acute Trusts in Wessex are closer to the national average

How do Trusts in Wessex perform? - Hampshire Data from: NHS England statistics, Other acute Trusts in Wessex are closer to the national average

How do Trusts in Wessex perform? – Isle of Wight Data from: NHS England statistics, Other acute Trusts in Wessex are closer to the national average

How do Trusts in Wessex perform? – Salisbury Data from: NHS England statistics, Other acute Trusts in Wessex are closer to the national average

How do Trusts in Wessex perform? – Frimley Data from: NHS England statistics, Other acute Trusts in Wessex are closer to the national average

Future work Working with: Wessex CLAHRC and CORMSIS groups at University of Southampton Bringing together other national indicators to determine which system parameters affect 4 hour A&E performance

Data sources Nationally collected data available from: times-and-activity/ times-and-activity/ Many other data sets available: Measures on: Cancer wait times Bed avail Staffing Immunisation Dementia assessment and referral Diagnostics waiting times & activity PROMs ….

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