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Introduction

Data for each topic area is also available in more detail on our StatsWales website.

This month we have published further data relating to the 111 service webpage visits and completed online symptom checker data on our StatsWales website.

In light of the impact COVID-19 has had on NHS activity and performance levels, the Welsh Government has published its programme for transforming and modernising planned care and reducing waiting lists in Wales. This plan sets out a number of key ambitions to reduce waiting times for people in Wales. We have incorporated these measurements of performance against these ambitions into this statistical release and on StatsWales.

Main points

In June, 88,000 calls were answered by the 111 service in Wales, an average of 2,924 calls per day. There were also almost 336,000 hits on the NHS 111 Wales website and over 12,000 completed symptom checks (NHS 111 Wales).

In June there were 3,728 red (life threatening) calls to the ambulance service, 10.0% of all calls. This is high in historical context. 50.8% of red calls received an emergency response within 8 minutes, which is low in historical context and below the target of 65%. This was the second longest on record. Data is only comparable from May 2019 onwards.

There was an average of 2,953 daily attendances to emergency departments, a slight increase in activity compared with the previous month. Performance against the both the four and twelve hour decreased marginally against when compared with May, they were the sixth and third lowest on record respectively. The average (median) time spent in emergency departments also lengthened slightly in June, and was the joint-third longest on record, at three hours and two minutes.

The pandemic has caused a large increase in patient pathways waiting to start treatment, and in May lists continued to increase, to over 722,000. The number of patient pathways is not the same as the number of individual patients, because some people have multiple open pathways. More information is available in the Welsh Government’s chief statistician’s blog.

New management information suggests that in March 2022, when there were over 701,000 open patient pathways, there were around 544,000 individual patients on treatment waiting lists in Wales.

May saw just over 73,000 patient pathways closed, lower than the pre-pandemic average but significantly higher than in the early part of the pandemic.

The proportion of patient pathways waiting less than 26 weeks increased slightly in May to 53.9%, from 53.7% in April. This has been relatively stable for some time after falling significantly from the levels pre-pandemic. The number of pathways waiting longer than 36 weeks continued to increase in May and reached the highest level on record at just under 261,000.

Just over 65,000 pathways were waiting more than two years, the second month on month reduction in a row following a consistent increase over the previous year. The average (median) time patient pathways had been waiting for treatment at the end of May decreased on the previous month but remained high at 22.6 weeks.

For diagnostic services, the number of patient pathways waiting longer than 8 weeks (the target maximum wait) increased to more than 45,000, in May, an increase over the previous month.

For therapies, the number of patient pathways waiting increased slightly to just over 65,000 in May, the highest level on record. The number waiting longer than fourteen weeks (the target maximum wait) decreased to just over 13,000.

For cancer services, more people started their first definitive treatment in May (1,646) and more pathways were closed following the patient being informed they did not have cancer (11,883) than in the previous month. However, performance decreased against the 62 day target to the lowest since current data collections began.

Unscheduled care

New data relating to unscheduled care are provided for the month of June 2022.

Calls to 111 service

As of 16 March 2022, the non-emergency 111 helpline service has been rolled out across the whole of Wales.

In June, 88,000 calls were answered by the 111 service in Wales, an average of 2,924 calls per day. Almost a further 18,000 calls were ended by the caller before being answered. Of these, 5,000 were ended within 60 seconds of the automated messages, suggesting their needs were likely to have been met. 13,000 calls were abandoned after 60 seconds and these are regarded as callers who were more likely to have still required the service after the messages, but were unable to get through or decided not to wait.

Of the calls answered, for 1,176 calls the caller indicated that they wished to conduct the call in Welsh.

There were almost 336,000 hits on the NHS 111 Wales website and over 12,000 completed symptom checks (NHS 111 Wales) in June.

More data is published on StatsWales.

Emergency calls to the ambulance service

A wider range of ambulance quality indicators are published on the Emergency Ambulance Services Committee (EASC) website and on StatsWales.

Activity

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The number of emergency calls received by the Welsh Ambulance Services NHS Trust (WAST) had been rising steadily over the long term but following a decrease due to the COVID-19 pandemic figures have returned to a pre covid level.

Emergency ambulance calls and responses to red calls, by local health board and month on StatsWales

Note: An update to call handling in May 2019 resulted in a change to red incident volume. It is not possible to directly compare before and after this date. Further details are available in the quality information

In June, just over 37,000 emergency calls were made to the ambulance service. This was an average of 1,249 calls per day, an increase of 42 (3.4%) calls on average per day than the previous month but 133 (9.6%) fewer calls on average per day than the same month last year.

Calls to the ambulance service are categorised as red (immediately life-threatening), amber (serious but not life-threatening) or green (non-urgent). An average of 124 red calls were made per day in June. This was the thirteenth month in a row where on average there were more than 100 immediately life-threatening calls made each day.

In June, the proportion of all calls that were immediately life-threatening was 10.0%, an increase on the previous month (9.6%).

Performance
Target
  • 65% of red calls (immediately life-threatening, someone is in imminent danger of death, such as a cardiac arrest) to have a response within 8 minutes.
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Performance for emergency response calls improved during the initial coronavirus period but since July 2020 has declined.

Emergency responses: minute-by-minute performance for red calls by local health board and month on StatsWales

Note: An update to call handling in May 2019 resulted in a change to red incident volume. It is not possible to directly compare before and after this date. Further details are available in the quality information

In June, 50.8% of emergency responses to immediately life threatening (red) calls arrived within 8 minutes. This was 3.7 percentage points lower than the previous month, and 9.8 percentage points lower than in June 2021.

The median response time in the four years prior to the pandemic ranged between 4 minutes 30 seconds and 6 minutes for red calls. In June, the average (median) response time to immediately life-threatening ‘red’ calls was 7 minutes and 55 seconds. This was 33 second slower than the previous month.

This was the second longest on record, only exceeded in October 2021. Data is only comparable from May 2019 onwards.

The majority of calls to the ambulance service are categorised as ‘amber’ calls, for which there is no performance target for call response times. In June, the median response time for amber calls was just under 1 hour and 35 minutes. This was almost 17 minutes slower than in May, and 35 minutes slower than in June 2021.

Emergency department attendances and admissions to hospital

A wider range of emergency department performance statistics are published on the National Collaborative Commissioning Unit (NCCU) website, as management information.

Activity

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A&E attendances are generally higher in the summer months than the winter. The decrease in attendances due to the COVID-19 pandemic can also be seen.

Number of attendances in NHS Wales emergency departments by age band, sex and site on StatsWales

Note: Chart shows number of attendances at both major emergency departments and minor injuries units, and the number of admissions resulting from attending major emergency departments only.

In June there were almost 89,000 attendances to all NHS Wales emergency departments. This was an average of 2,953 emergency department attendances per day; 16 more attendances per day on average than in the previous month but 184 fewer than in the same month last year.

In June, almost 14,000 patients were admitted to the same or a different hospital following attendance at a major emergency department. This was 1.1% lower than the previous month, but 15.5% lower than the same month in 2021.

Performance

Targets
  • 95% of new patients should spend less than 4 hours in emergency departments from arrival until admission, transfer or discharge.
  • No patient waiting more than 12 hours in emergency departments from arrival until admission, transfer or discharge.
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From October 2015 the 95% target has not been met but performance has increased over the initial few months of the covid-19 pandemic.

Performance against 4 hour target by hospital on StatsWales

In June, 66.4% of patients in all NHS emergency departments spent less than 4 hours in the department from arrival until admission, transfer or discharge. This was 0.2 percentage points lower than the previous month and 5.2 percentage points lower than the same month a year ago.

In 2019, the median time patients spent in emergency departments was around 2 hours and 30 minutes. During the early part of the pandemic, as attendances decreased the median time spent in the department decreased, to a low of 1 hours 47 minutes in April 2020. Since then, median times have increased and reached a record high of 3 hours and 8 minutes in March 2022. In the latest data for June, the median waiting time was 3 hours and 2 minutes. This was the joint-third longest average (median) waiting time on record and one minute slower than the previous month.

The median time spent in emergency department varies by age. Prior to the pandemic, children (aged 0 to 4) spent between 1 hour and 30 minutes and 2 hours in emergency departments, while older patients (aged 85 or greater) spent between 3 hours and 30 minutes and 5 hours.

In June, children (aged 0 to 4) spent an average of 2 hours and 27 minutes. Adults aged 85 and over spent an average of 7 hours and 8 minutes in emergency departments, the lowest it has been since September last year.

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Since October 2015 the target of no patients waiting longer than 12 hours has not been met. The decrease in patients waiting over 12 hours in March 2020 is due to the decrease in the number of emergency department attendances during the coronavirus pandemic.

Performance against the 12 hour target by hospital on StatsWales

In June there were almost 10,300 patients waiting 12 hours or more. This was 26 more than in the previous month.

Scheduled care activity

New data relating to unscheduled care are provided for the month of May 2022.

Outpatient referrals

Activity

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The decrease in outpatient referrals from February 2020 onwards is due to the coronavirus pandemic.

Outpatient referrals on StatsWales

An average of 3,907 referrals for first outpatient appointments were made per day in May. This is an increase of 13.0% (449 more referrals per day on average) compared to April, and the highest since October 2019.

Performance

Targets

No one waiting for longer than a year for their first outpatient appointment by the end of 2022 (new target established in the planned care recovery plan).

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The chart illustrates the number of Pathways Waiting More than a Year for their First Appointment, by Month. It shows that since the start of the coronavirus pandemic the number of patient pathways have increased.

Diagnostic and Therapy Services Waiting Times by week, November 2019 onwards on StatsWales

In May, the number of pathways waiting longer than one year for their first outpatient appointment increased to just under 96,000. This has increased dramatically over the course of the pandemic, though it has fallen since the peak of over 101,000 in October 2021.

Diagnostic and therapy waiting times

Activity

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The increase in patients waiting from March 2020 for diagnostic services is due to the coronavirus pandemic. The decrease in the number of people waiting for therapy services in March 2020 is mainly due to fewer patients accessing these services.

Diagnostic and Therapy Services Waiting Times by week on StatsWales

Note: The low point in April 2020 for therapies is in part due to Betsi Cadwaladr not submitting data for this month, please see the quality information.

In May there were almost 110,000 patient pathways waiting for diagnostics, an increase of 0.4% compared with the previous month. There were also just over 65,000 patient pathways waiting for therapies, an increase of 2.4% compared to the previous month, this was the highest level on record.

Performance

Targets
  • The maximum wait for access to specified diagnostic tests is 8 weeks.
  • The maximum wait for access to specified therapy services is 14 weeks.
  • The planned care recovery plan established a target date of Spring 2024 to reach these targets.
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The increase in the number of patients waiting over the target time from March 2020 is due to the coronavirus pandemic.

Diagnostic and Therapy Services Waiting Times by week on StatsWales

Note: Betsi Cadwaladr did not submit data for April 2020, so are not included in the Wales figures for this month.

At the end of May, over 45,000 patient pathways were waiting longer than the target time for diagnostics. This was an increase of 0.6% compared to the previous month and 8.7% higher than May 2021.

At the end of May there were slightly over 13,000 patient pathways waiting longer than the target time for therapies. This was a decrease of 0.3% compared to the previous month.

Median waiting times had been relatively stable for diagnostic tests since 2017 (2.8 weeks on average) and for therapy services since 2018 (3.6 weeks on average). Median waiting times for both services peaked in June 2020 (14.3 weeks for diagnostics and 14.9 weeks for therapies).

In May, the median waiting time for diagnostic tests was 5.7 weeks. This was a decrease from 6.2 weeks in the previous month. The median waiting time for therapy services was 5.5 weeks. This was a decrease from 6.4 weeks in the previous month.

Referral to treatment time

Referral to treatment time statistics show monthly data on waiting times for both open and closed pathways following a referral by a GP or other medical practitioner to hospital for treatment in the NHS. Open pathways are those that remain on the waiting list for treatment, whereas closed pathways are those taken off the waiting list.

Activity is measured by patient pathways, which differs to the number of patients. More information on this difference is available in the Welsh Government’s chief statisticians blog.

Also published for the first time is newly collected management information for the number of individual patients on treatment waiting lists in Wales.

Performance

Targets
  • No patients waiting longer than two years in most specialities by March 2023, and no patients waiting longer than one year in most specialities by Spring 2025 (new targets established in the planned care recovery plan).
  • 95% of patients waiting less than 26 weeks from referral.
  • No patients waiting more than 36 weeks for treatment from referral.

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The chart illustrates the patient pathway data. It shows that since the coronavirus pandemic the number of patient pathways have increased.

Patient pathways waiting to start treatment by month, grouped weeks and stage of pathway on StatsWales

In May there were more than 722,000 patient pathways waiting to start treatment, the highest since comparable data was first collected in 2011. This was 2.1% higher than in the previous month and 56.4% higher than February 2020.

Over 176,000 pathways were waiting more than one year in May, broadly stable over the last 12 months. Just over 65,000 pathways were waiting more than two years, which was the second month on month reduction following a consistent increase over the previous year.

The number of patient pathways is not the same as the number of individual patients, because some people have multiple open pathways.

We do not have official statistics on the number of individual patients waiting to start treatment. However, newly collected management information presented for the first time this month suggests that in March, when the National Statistics reported there were over 701,000 open patient pathways, there were 543,773 individual patients on treatment waiting lists in Wales.

Unlike the National Statistics elsewhere in this release, which have been independently assessed against the Code of Practice for statistics, this estimate is based on newly collected management information. Whilst the principles of the Code of Practice have been applied, quality assurance is not to the level of the National Statistics. Work is ongoing to further understand the strengths and limitations of this data and this will be communicated as we learn more. For these reasons there is greater uncertainty around this estimate than with the other figures in this release. However, the level of public interest in understanding the number of patients in addition to the number of patient pathways adds sufficient value to warrant making this available now.

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The chart illustrates the month on month fluctuations of the data and shows that since the coronavirus pandemic the percentage of patients waiting less than 26 weeks has decreased.

Percentage of patient pathways waiting to start treatment within target time by month and grouped weeks on StatsWales

Of the 722,000 patient pathways waiting to start treatment, by the end of May, 53.9% had been waiting less than 26 weeks. This was 0.2 percentage points higher than in the previous month, 1.2 percentage points higher than the same month last year but 30.5 percentage points lower than February 2020.

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The chart illustrates the month on month fluctuations of the data and shows that since the Coronavirus (Covid-19) pandemic the number of patients waiting more than 36 weeks has increased.

Percentage of patient pathways waiting to start treatment within target time by month and grouped weeks on StatsWales

In May just under 261,000 patient pathways had been waiting more than 36 weeks. This represented 36.1% of all patient pathways waiting to start treatment. This was 2,670 (or 1.0%) more pathways waiting than in the previous month and 14.2% higher than the same month last year.

The median time waiting to start treatment had generally been around 10 weeks pre pandemic between late 2013 and February 2020. This increased during the pandemic and peaked at a record high of 29 weeks in October 2020. In May, the median waiting time was 22.6 weeks, which was a decrease from 23.0 weeks in the previous month.

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The decrease in the number of closed pathways in the months following March is due to the coronavirus pandemic.

Closed patient pathways by month, local health board and weeks waiting on StatsWales

Note: Cwm Taf Morgannwg health board have been unable to provide closed pathway data since September 2018. Data for this health board is excluded from the Wales total in the chart to allow for trend analysis. More details are available in the quality information.

The number of patient pathways closed in May was over 73,000. This was an average of 3,477 patient pathways closed per working day, an increase of 1.4% from the previous month and 15.1% higher than the same month last year.

Cancer services (experimental statistics)

Experimental statistics (ONS) are official statistics that are in the testing phase and not yet fully developed.

A number of wider measures from the suspected cancer pathway are produced by Digital Health and Care Wales are published alongside this statistical release.

Activity

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A chart showing the number of patients informed they do not have cancer and the number of patients starting their first definitive treatment in the month.

Suspected cancer pathway (closed pathways) on StatsWales

In May, 1,646 pathways where the patient was newly diagnosed with cancer started their first definitive treatment in the month. This was an increase of 15.1% compared to the previous month and an increase of 2.4% from May 2021.

11,883 pathways were closed following the patient being informed they did not have cancer. This is an increase of 12.8% compared to the previous month.

In May, 14,776 patient pathways were opened in the month following a new suspicion of cancer. This was an increase of 1,962 (15.3%) on the previous month.

Performance

Target
  • At least 75% of patients should start treatment within 62 days (without suspensions) of first being suspected of cancer. Data published for time periods before December 2020 are not subject to the target.
  • The planned care recovery plan established a new target of 80%, to be reached by 2026.
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A chart showing the percentage of patients that started their first definitive treatment within 62 days of first being suspected of cancer in the month, by month.

Suspected cancer pathway (closed pathways) on StatsWales

In May, 53.0% (872 out of 1,646) of pathways started their first definitive treatment within 62 days of first being suspected of cancer, the lowest proportion on record. This was 3.5 percentage points lower than the previous month and 15.7 percentage points lower than May 2021.

Quality and methodology information

All quality and methodology information in relation to this statistical release can be found in the NHS activity and performance summary: quality report

Well-being of Future Generations Act (WFG)

The Well-being of Future Generations Act 2015 is about improving the social, economic, environmental and cultural wellbeing of Wales. The Act puts in place seven wellbeing goals for Wales. These are for a more equal, prosperous, resilient, healthier and globally responsible Wales, with cohesive communities and a vibrant culture and thriving Welsh language. Under section (10)(1) of the Act, the Welsh Ministers must (a) publish indicators (“national indicators”) that must be applied for the purpose of measuring progress towards the achievement of the wellbeing goals, and (b) lay a copy of the national indicators before Senedd Cymru. Under section 10(8) of the Well-being of Future Generations Act, where the Welsh Ministers revise the national indicators, they must as soon as reasonably practicable (a) publish the indicators as revised and (b) lay a copy of them before the Senedd. These national indicators were laid before the Senedd in 2021. The indicators laid on 14 December 2021 replace the set laid on 16 March 2016.

Information on the indicators, along with narratives for each of the wellbeing goals and associated technical information is available in the Wellbeing of Wales report.

Further information on the Well-being of Future Generations (Wales) Act 2015.

The statistics included in this release could also provide supporting narrative to the national indicators and be used by public services boards in relation to their local wellbeing assessments and local wellbeing plans.

We want your feedback

We welcome any feedback on any aspect of these statistics which can be provided by email to stats.healthinfo@gov.wales.

Next update

19 August 2022

Contact details

Statistician: Rhys Strafford
Email: stats.healthinfo@gov.wales

Media: 0300 025 8099

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Ystadegau Gwladol

SFR 172/2022