Dear Mark and Chris

I am writing to you about the availability of statistics on the numbers of patients waiting more than 12 hours in Accident and Emergency Departments in England.

As you will be aware, the figures published in the monthly A&E Attendances and Emergency Admissions release refer to those patients who endure a wait of more than 12 hours from decision to admit to admission. However, concerns have been raised that this figure is misleading as it does not highlight the full extent of the problem of the number of patients who endure a wait of more than 12 hours from the point of arrival in A&E to the time they are discharged, admitted or transferred. We are aware that NHS Digital publishes statistics on the 12 hour wait from arrival to discharge, admittance or transfer in its Annual A&E report. However, this is only released annually, and users have expressed an interest for it to be available on a more frequent basis.

We have previously written to you and about this topic. At the time we concluded that while the statistics were not misleading, the fact that there were two 12-hour measures led to the potential to confuse users. We asked you to strengthen your explanations of the two measures and which measure each of your respective publications contained. Given the new concerns raised, we have re-examined the statistical releases and are encouraged to see that the clarity has improved in both releases. We do feel, however, that the monthly A&E Attendances and Emergency Admissions release would benefit from further explanation of the two measures, why the metric covering decision to admit in particular is included and what users can and cannot infer from this measure.

In addition to this, there appears to be a clear user need for more frequent figures on the number of patients whose total time in A&E exceeds 12 hours. This would additionally allow greater comparison of figures for England with those for Wales, Scotland and Northern Ireland, where statistics are published on either a monthly or a quarterly basis. We would like to ask you jointly to take steps to make these figures available on a monthly

basis, in a way which is easily accessible and clear to users, and to keep us updated of progress in this area.

Yours sincerely

Ed Humpherson
Director General for Regulation