1. 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

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

3. 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: https://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting- times-and-activity/ This analysis limited to Acute Trusts Only

4. 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, http://www.england.nhs.uk/statistics/statistical-work-areas/ Percentage of Acute Trusts meeting the 95% target

5. Why are hospitals seeing greater pressures? Data from: NHS England statistics, http://www.england.nhs.uk/statistics/statistical-work-areas/ 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

6. Why are hospitals seeing greater pressures? Data from: NHS England statistics, http://www.england.nhs.uk/statistics/statistical-work-areas/ 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

7. How do Trusts across England perform? National data shows variation in Trust performance each week Data from: NHS England statistics, http://www.england.nhs.uk/statistics/statistical-work-areas/ Black line indicates average acute Trust performance

8. How do Trusts across England perform? National data shows variation in Trust performance each week Data from: NHS England statistics, http://www.england.nhs.uk/statistics/statistical-work-areas/ Dark grey area contains 50% of Trusts Light grey area contains 90% of Trusts Area below grey indicates in lowest 5%

9. How do Trusts across England perform? Data from: NHS England statistics, http://www.england.nhs.uk/statistics/statistical-work-areas/ The chart shows the weekly distribution of acute A&E departments in England

10. How do Trusts in Wessex perform? - Poole Data from: NHS England statistics, http://www.england.nhs.uk/statistics/statistical-work-areas/ Most hospitals, such as Poole, show natural variability week on week due to local variation Red line indicates Poole Trust performance

11. How do Trusts in Wessex perform? - Poole Data from: NHS England statistics, http://www.england.nhs.uk/statistics/statistical-work-areas/ 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%)

12. How do Trusts in Wessex perform? –Southampton Data from: NHS England statistics, http://www.england.nhs.uk/statistics/statistical-work-areas/ 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

13. How do Trusts in Wessex perform? –Southampton Data from: NHS England statistics, http://www.england.nhs.uk/statistics/statistical-work-areas/ Area below grey indicates in lowest 5% 4 hour target (95%) Until winter 2013 Southampton had performed well against the 4 hour target

14. How do Trusts in Wessex perform? - Portsmouth Data from: NHS England statistics, http://www.england.nhs.uk/statistics/statistical-work-areas/ 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)

15. How do Trusts in Wessex perform? - Portsmouth Data from: NHS England statistics, http://www.england.nhs.uk/statistics/statistical-work-areas/ 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

16. How do Trusts in Wessex perform? – Bournemouth Data from: NHS England statistics, http://www.england.nhs.uk/statistics/statistical-work-areas/ Other acute Trusts in Wessex are closer to the national average

17. How do Trusts in Wessex perform? - Dorset Data from: NHS England statistics, http://www.england.nhs.uk/statistics/statistical-work-areas/ Other acute Trusts in Wessex are closer to the national average

18. How do Trusts in Wessex perform? - Hampshire Data from: NHS England statistics, http://www.england.nhs.uk/statistics/statistical-work-areas/ Other acute Trusts in Wessex are closer to the national average

19. How do Trusts in Wessex perform? – Isle of Wight Data from: NHS England statistics, http://www.england.nhs.uk/statistics/statistical-work-areas/ Other acute Trusts in Wessex are closer to the national average

20. How do Trusts in Wessex perform? – Salisbury Data from: NHS England statistics, http://www.england.nhs.uk/statistics/statistical-work-areas/ Other acute Trusts in Wessex are closer to the national average

21. How do Trusts in Wessex perform? – Frimley Data from: NHS England statistics, http://www.england.nhs.uk/statistics/statistical-work-areas/ Other acute Trusts in Wessex are closer to the national average

22. Future work Working with: Wessex CLAHRC and CORMSIS groups at University of Southampton http://www.clahrc-wessex.nihr.ac.uk/methodological-hub http://www.southampton.ac.uk/cormsis/index.page Bringing together other national indicators to determine which system parameters affect 4 hour A&E performance

23. Data sources Nationally collected data available from: https://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting- times-and-activity/ https://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting- 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 ….

24. Contact us If you are interested in any of the work please get in touch, visit: http://cisdata.soton.ac.uk/contact_us.html WessexCIS@soton.ac.uk @WessexCIS