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Emergency Department Activity

Data Collection

NHS National Services Scotland ISD Scotland & NHS National Services Scotland

Data Collection

ISD collect information on A&E services via two processes - the A&E datamart and a weekly aggregate collection of summary statistics.

When a patient attends an Accident and Emergency (A&E) Service, information about their attendance is collected on a patient administration system (PAS). The information recorded relates to the patient and their attendance and may include information that is not sent to ISD.

The A&E Datamart

The Accident and Emergency (A&E) datamart contains data from June 2007 to the present day on patient attendances at Emergency Department (EDs), Minor Injuries Units (MIUs) and community hospital A&Es across NHS Scotland. An extraction process pulls the data into an A&E attendance record. The A&E attendance record is a by-product of information that is already recorded by hospital staff for the management of the care of the patient during their hospital attendance.

A&E attendance records are validated by NHS Board staff and submitted to ISD soon after the end of each month. When the record is submitted to ISD there are additional derived items added. In addition to local data quality checks, the data submitted to the A&E datamart is subject to a validation procedure. For a list of the validation rules refer to Appendix A of the A&E User Guide. As well as ensuring that data for the correct site and time period is submitted, the validation ensures that the data is in the correct format and only contains accepted codes; refer to A&E: Data Recording Manual.

If the submission file does not meet all of the validation rules then the whole file is rejected. The resulting errors are reported back to the submitting site where they must be amended and the file resubmitted. Once the file passes validation it is loaded into the datamart where it is then available for analysis and reporting. ISD 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.

The A&E datamart contains information on all sites delivering A&E services in Scotland; this includes Emergency Departments (EDs) - larger A&E services that typically provide a 24 hour consultant led service - as well as other sites including Minor Injuries Units (MIU), small hospitals and health centres in rural areas. These smaller sites still carry out emergency department related activity but are GP or Nurse led which may or may not be open 24 hours. The larger hospitals with ED's generally submit episode level data containing a detailed record for each attendance and smaller sites usually only submit aggregate level data. The smaller sites only submit total monthly attendance figures as they do not have the information systems and support to enable collection of detailed patient based information. Consequently, detailed analysis can only be conducted on sites providing episode level data. For a list of all sites providing A&E services along with the type of site indicating which hospitals have an ED, please see the hospital site list.

Recording completeness of data items

Episode level information is submitted for 94% of attendances at A&E Services in Scotland, providing useful information on the type of attendance, arrival mode, and other parameters (e.g. age, sex, time of arrival, discharged to). The A&E datamart has the facility to record additional information relating to a patient's attendance (e.g. Triaged Category), however these items are optional for submission and the level of recording varies by NHS Board. The Recording Completeness of 'Optional' Data Items in the A&E Datamart details the recording completion for each of these data items, the breakdown of attendances by ED and MIU/Other sites, and the percentage of records that are from episode and aggregate submissions. For more information on the data items included in the A&E datamart please refer to the A&E: Data Recording Manual Download PDF file.

Weekly aggregate ED data

All Emergency Departments submit summary data on the number of attendances and 4, 8, and 12 hour waits. 24 hour consultant led service; other sites that provide A&E services such as minor injury units, small hospitals and health centres in rural areas are not included. This data is intended to provide timely information and the aggregate summary data are subject to only basic quality assurance checks.

NHS Boards are required to confirm to ISD that the statistics are accurate.

Historical Data (A&E Waiting Times Surveys, 1994 - 2006)

Until April 2006 A&E data was collected through an annual survey covering either a three or seven day period. This included an estimate of the hospital's performance against the 4-hour wait target. The survey covered only a set of core hospitals until 2006 when it was extended to cover all A&E departments including minor injury units.

The A&E Waiting Times Survey, 2006 contains tables showing the results of the final survey with selected trend information. This data can also be found on the ISD archived website; A&E Waiting Times Survey, this page also contains a link to the previous surveys 1994 - 2005.

Alternative Source (Acute Hospital Activity, 2001 - March 2012)

A&E attendances were collected as part of the ISD(S)1, a quarterly aggregate data submission for monitoring activity in hospitals. This data provides aggregate numbers of attendances going back to 2001. Data on Annual Inpatient, Day Case and Outpatient Activity Summary for Scotland and NHS Boards of treatment for financial years 2003/04 to 2012/13 can be found on the Outpatient Activity pages of the ISD website. Note: there are slight differences in the figures between the A&E data mart and the Acute Hospital Activity data due to the different sources of the two data sets.

Since August 2012, figures on A&E attendances were no longer be published under the Hospital Care Topic. Historic annual figures up to 2010/11 and quarterly figures March 2012 can be found respectively within the March 2012 and June 2012 publications. The data contained on the Emergency Department Activity web pages is now considered the primary source of emergency department activity.

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