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In response to the coronavirus (COVID-19) pandemic, daily information on health care has been produced to support transparency and understanding of the NHS activity and capacity. The release includes figures on invasive ventilated beds by use, admissions and hospitalisations of COVID-19 related patients, and attendances to Accident and Emergency (A&E) departments.

We are considering changing the content of this release and welcome your feedback on how you use the data published here, and our proposed changes. Please see the quality and methodology information section for more detail on these proposals.

Please note that Cardiff and Vale were unable to supply hospital data for the 25 May 2021 due to a failed systems upgrade. Hospital data from Cardiff and Vale for 24 May 2021 has been used as a proxy for 25 May 2021 and will be revised on 26 May 2021. This revision will be published on our StatsWales website on 27 May 2021.

Main points

  • The number of new daily admissions with suspected or confirmed COVID-19 fluctuates, taking that into account, the 7 day rolling average has generally decreased since early January 2021 but has plateaued since early April 2021. The number of new daily admissions is currently similar to the lowest levels since reporting began on 1 April 2020.
  • In the last 7 days, an average of 17 people a day were admitted to hospital as confirmed or suspected with COVID-19. This compares to an average of 13 for the week to 18 May 2021.
  • The total number of beds occupied with COVID-19 related patients (confirmed, suspected and recovering) increased from the end of September 2020 and reached its highest level on 12 January 2021, at 2,879 patients. Since then, despite fluctuations, the number of beds occupied with COVID-19 related patients has generally decreased.
  • As at 25 May 2021, 178 beds were occupied with COVID-19 related patients (confirmed, suspected and recovering), representing 2.2% of all hospitalisations. This is a slight increase from 163 on 18 May 2021 (2.0% of all hospitalisations) and is currently similar to the lowest levels since reporting began on 1 April 2020.
  • As at 25 May 2021, there have been reductions in the number of beds occupied with confirmed and recovering COVID-19 patients. The number of beds occupied with suspected patients has increased slightly from the week ending 18 May 2021. This increase in suspected COVID-19 patients has contributed to the overall increase in the number of COVID-19 related patients.
  • As at 25 May 2021, 4 invasive ventilated beds were occupied with COVID-19 related patients (confirmed and suspected), and are now at similar levels to September 2020. This compares to 3 on 18 May 2021 and to 164 at the peak in April 2020.

Accompanying tables for this release are available, including all the data shown below and also data concerning general and acute beds.

Statistics on 111 and NHS Direct calls, NHS staff absence and emergency ambulance calls are available on StatsWales as well as all other statistics in this release.

Additionally, information on beds, hospitalisations and admissions is published on weekdays at 12pm, on StatsWales containing data up to the previous day. After 12pm on Thursdays, the data shown in this release will not contain the most up to date published data. However, this weekly release provides additional commentary on trends in the data.

The data are taken from management information and are subject to change. They have not been subject to the same validation processes undertaken for official statistics releases. Where available, the official statistics should continue to be considered the authoritative source of data. Please see the Chief Statistician’s blog for more information on reporting management information, data quality and transparency.

Hospital activity and capacity

This section covers the number of admissions and hospitalisations of COVID-19 related patients and invasive ventilated beds occupied with COVID-19 related patients, to support transparency and provide an understanding of NHS activity and capacity during the COVID-19 pandemic.

Hospital coverage has changed over time, please see the quality and methodology information section for more information.

Hospital admissions

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Chart 1 shows that after the peak in April, admissions of patients with suspected or confirmed COVID-19 reached a high point on 30 December 2020 before decreasing again.

Patients admitted to hospital as suspected or confirmed with COVID-19, from 1 April 2020 (MS Excel)

Notes

Admissions are the number of patients admitted to hospital between 9am on the update date and 9am the day before. COVID-19 related admissions include COVID-19 suspected or confirmed patients.

Please note that Cardiff and Vale were unable to supply hospital data for the 25 May 2021 due to a failed systems upgrade. Hospital data from Cardiff and Vale for 24 May 2021 has been used as a proxy for 25 May 2021 and will be revised on 26 May 2021. This revision will be published on our StatsWales website on 27 May 2021.

Please see the quality and methodology information section for the complete set of notes and historical changes relating to admission figures.

Main points

  • The number of new daily admissions with suspected or confirmed COVID-19 fluctuates, taking that into account, the 7 day rolling average has generally decreased since early January 2021 but has plateaued since early April 2021. The number of new daily admissions is currently similar to the lowest levels since reporting began on 1 April 2020.
  • In the last 7 days, an average of 17 people a day were admitted to hospital with confirmed or suspected COVID-19. This compares to an average of 13 for the week to 18 May 2021.

Hospitalisations

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Chart 2 shows the number of people in hospital with COVID-19 reached its highest level on 12 January 2021 before decreasing again.

Number of people in hospital as suspected, confirmed or recovering with COVID-19, from 1 April 2020 (MS Excel)

Notes

Recovering patients was a category introduced on 26 May 2020 to capture patients who were COVID-19 positive in hospital and who showed no symptoms for 14+ days but remained in hospital on a COVID-19 treatment pathway, often for rehabilitation. There have been some differences in reporting by health boards in the time series which are outlined in more detail in the quality and methodology information section.

Please see the Chief Statistician’s blog for more information on reporting on recovering patients.

Please note that Cardiff and Vale were unable to supply hospital data for the 25 May 2021 due to a failed systems upgrade. Hospital data from Cardiff and Vale for 24 May 2021 has been used as a proxy for 25 May 2021 and will be revised on 26 May 2021. This revision will be published on our StatsWales website on 27 May 2021.

To ensure accurate and consistent reporting of Covid-19 recovering patients in the hospitalisations data, all health boards were reminded to follow the national guidance for SITREP reporting, and asked to ensure any necessary changes to their daily reporting were implemented by 12 April 2021. Contrary to the guidance, some health boards were counting long stay patients who had fully recovered from COVID-19 in the COVID-19 recovering category, rather than the non-COVID-19 category, which inflated the number of COVID-19 recovering patients. This change resulted in a step-change decrease in the number of recovering patients (a decrease of around 123 patients at the point of implementation). Whilst the impact was seen across most health boards, it mainly impacted the Swansea Bay University Health Board.

Please see the quality and methodology information section for the complete set of notes and historical changes relating to hospitalisation figures.

Main points

  • The number of beds occupied with COVID-19 related patients is currently similar to the lowest levels since reporting began on 1 April 2020.
  • The total number of beds occupied with COVID-19 related patients (confirmed, suspected and recovering) increased from the end of September 2020 and reached its highest level on 12 January 2021 (2,879 patients). Since then, despite some fluctuations, the total number has been generally falling.
  • The number of confirmed COVID-19 patients and the number of recovering COVID-19 patients peaked at different times; with highest numbers of confirmed patients occurring early in January 2021 (1,643 on 4 January 2021) and highest numbers of recovering patients seen a few weeks later (1,192 on 31 January 2021).

As at 25 May 2021

  • There have been reductions in the number of beds occupied with confirmed and recovering COVID-19. The number of beds occupied with suspected patients has increased slightly in the latest week. This slight increase in suspected COVID-19 patients has contributed to the overall increase in the number of COVID-19 related patients.
  • 178 beds were occupied with COVID-19 related patients (confirmed, suspected and recovering), representing 2.2% of all hospitalisations. Of these, 11 were occupied with confirmed COVID-19 patients, 85 with recovering patients and 82 with suspected COVID-19 patients.

Invasive ventilated beds

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Chart 3 shows that after the peak in April 2020, the number of invasive ventilated beds occupied with COVID-19 patients reached a high point on 12 January before decreasing again.

Number of invasive ventilated beds by use, from 1 April 2020 (MS Excel)

Notes

Baseline relates to the number of beds that were available prior to the COVID-19 pandemic. There are usually 152 critical care beds available. Invasive ventilated beds include beds in and outside a critical care setting, and include surge capacity. COVID-19 patients in this chart include suspected, confirmed, and recovering COVID-19 patients. Recovering patients were only included from 26 May 2020 to the 18 January 2021.

Please note that Cardiff and Vale were unable to supply hospital data for the 25 May 2021 due to a failed systems upgrade. Hospital data from Cardiff and Vale for 24 May 2021 has been used as a proxy for 25 May 2021 and will be revised on 26 May 2021. This revision will be published on our StatsWales website on 27 May 2021.

Please see the quality and methodology information section for the complete set of notes and historical changes relating to the invasive ventilated beds figures.

Main points

  • The number of occupied invasive ventilated beds generally increased from September 2020, reaching a high of 150 on 12 January 2021, but has decreased since to levels seen in September 2020.

As at 25 May 2021

  • 4 invasive ventilated beds were occupied with COVID-19 related patients. This compares to 3 on 18 May 2021 and to 164 (160 fewer occupied beds) at the peak in April 2020.
  • 145 invasive ventilated beds were occupied with non-COVID-19 related patients. This compares to 154 (9 fewer occupied beds) on 18 May 2021.
  • There were 67 vacant invasive ventilated beds that could be staffed. This compares to 68 (1 fewer bed) on 18 May 2021.

Information on healthcare presented in the UK Government COVID-19 dashboard and in the Public Health Wales (PHW) dashboard differ from this publication. Please see the quality and methodology information section and the comparability with other publications section for more information.

A&E attendances

Digital Health and Care Wales have been unable to provide the ‘Attendances in NHS Wales accident and emergency departments’ dataset to Welsh Government due to a data processing issue. The publication of this dataset has been postponed and we will publish this information as soon as possible. Therefore, the A&E figures and chart have not been updated since the last publication.

This section covers daily information on attendances to Accident and Emergency (A&E) departments in Wales, to further support transparency and provide an understanding of NHS activity and capacity during the COVID-19 pandemic.

The data are taken from management information and are subject to change. The latest data have not been subject to the same validation processes undertaken for official statistics releases. The official statistics should continue to be considered the authoritative source of data.

Please see the Chief Statistician’s blog for more information on reporting management information, data quality and transparency.

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Chart 4 shows that A&E attendances fell sharply from mid-March 2020 and increased gradually from April 2020 to the 2015 to 2019 average, but they have now reached similar levels to the 2015 to 2019 average.

Number of daily A&E attendances to major and minor hospitals, from 1 January 2015 (MS Excel)

Notes

A&E attendances to major and minor hospitals, from all mode of transports across Wales. Some small minor A&E units are not able to submit daily data, therefore there is probably a small undercount in total attendance. The five-year average uses data from the years 2015 to 2019. For data on the 29 February, only data from the year 2016 and 2020 is included. There tends to be a lower number of attendances recorded on a Sunday compared to other days of the week and a higher recorded number of attendances in the summer compared to the winter.

Please see the quality and methodology information section for the complete set of notes and historical changes relating to A&E figures.

Main points

  • During March 2020, A&E attendances fell sharply to below half of the usual level. Attendances gradually increased from early April 2020, but generally remained below the 2015 to 2019 average.
  • Since mid-January 2021, A&E attendances have been increasing, reaching similar levels to the 2015 to 2019 average.

Quality and methodology information

The data are taken from management information and are subject to change. They have not been subject to the same validation processes undertaken for official statistics releases. However, they are provided to support transparency and understanding of NHS activity at this time. The official statistics should continue to be considered the authoritative source of data.

Historic data are subject to revisions and therefore may differ slightly to previously published information.

Proposed content changes for future releases

With the number of coronavirus cases decreasing over the last few months, we are considering changing the content of this release, as outlined below. We welcome your feedback on how you use the data published in this release, and any changes we are proposing.

NHS staff absence and self-isolation rate

This information is currently published each Thursday on StatsWales. Our proposal is to move this collection from weekly to fortnightly initially.

This data collection was introduced early in the pandemic to help understand and manage capacity within the NHS to rapidly respond to the changing needs and priorities. This data collection is resource intensive for NHS organisations and, as staff absence due to COVID is no longer a major factor in delivering critical NHS services, we want to reduce the burden on organisations who collect and supply this data.

Attendances in NHS Wales’ accident and emergency departments

This information is currently published within this statistical release and also on StatsWales each Thursday. Our proposal is to remove this section from the statistical release and no longer update this data.

At the start of the pandemic, official statistic on attendances at A&E departments were paused, and we introduced daily data taken from management information. However, official statistics on A&E attendances are once again published every month as part of the NHS activity and performance statistical release. Also, in recent months the data shows that attendances are now similar levels to the 2015-19 average.

Calls made to 111 and NHS direct

This is currently published each Thursday on StatsWales. Our proposal is to no longer update this data.

Calls to 111 and NHS direct are published by Public Health Wales on their Rapid COVID-19 surveillance dashboard. Information is available for all calls and the proportion of calls that are for any COVID-19 like symptoms. The information is available at health board level.

Emergency ambulance calls, by date

This is currently published each Thursday on StatsWales. Our proposal is to no longer update this data.

At the start of the pandemic, official statistic on emergency calls to the ambulance service were paused, and we introduced daily data taken from management information. However, official statistics on calls to the ambulance service are once again published every month as part of the NHS activity and performance statistical release.

Hospital activity and capacity

Please note that Cardiff and Vale were unable to supply hospital data for the 25 May 2021 due to a failed systems upgrade. Hospital data from Cardiff and Vale for 24 May 2021 has been used as a proxy for 25 May 2021 and will be revised on 26 May 2021. This revision will be published on our StatsWales website on 27 May 2021.

The health minister announced on 13 March 2020 that all non-urgent activity should stop to prepare for the pandemic.

Following further validation, admissions and hospitalisation data prior to 1 April 2020 were decided to not be suitable for publication. Therefore, the time series begins on 1 April 2020.

Figures on hospitalisations and activity include data from acute hospitals from 1 April 2020, field hospitals from 20 April 2020, community hospitals from 23 April 2020, mental health units from 10 July 2020, and exclude data from private hospitals.

Hospital admissions

Admissions are the number of patients admitted to hospital between 9am on the update date and 9am the day before. COVID-19 related admissions include COVID-19 suspected or confirmed patients.

From 3 July 2020, guidance was updated to only include emergency admissions in the COVID-19 related admissions figures.

From 29 June 2020, the guidance changed to explicitly ask health boards to exclude transfers between acute and community hospitals from admissions figures. Prior to this, some transfers may have been captured as new admissions.

From 29 June 2020, patients admitted for elective procedures were only included in COVID-19 related admissions if they received a positive COVID-19 test result on arrival at the hospital.

Following the re-introduction of elective procedures from June 2020, patients admitted for elective procedures suspected of having COVID-19 were initially captured in COVID-19 related admissions, even if they received a negative test later. This inflated the numbers of suspected cases in hospital at the time of reporting.

Hospitalisations

To ensure accurate and consistent reporting of COVID-19 recovering patients in the hospitalisations data, all health boards were reminded to follow the national guidance for SITREP reporting, and asked to ensure any necessary changes to their daily reporting were implemented by 12 April 2021. Contrary to the guidance, some health boards were counting long stay patients who had fully recovered from COVID-19 in the COVID-19 recovering category, rather than the non-COVID-19 category, which inflated the number of COVID-19 recovering patients. This change resulted in a step-change decrease in the number of recovering patients (a decrease of around 123 patients at the point of implementation). Whilst the impact was seen across most health boards, it mainly impacted the Swansea Bay University Health Board.

From 8 March 2021, Cardiff and Vale University health board aligned their data more closely to the national guidance for SITREP reporting. This change had a small impact on the hospitalisation figures, which resulted in a small increase in the number of confirmed COVID-19 patients and a small decrease in the number of recovering COVID-19 patients.

From 1 February 2021, guidance was reiterated to health boards that patients who were already in hospital and contracted COVID-19, but have now recovered and are back on their original setting, should be reported as non-COVID-19. This may have affected a small number of patients who were in acute hospitals or mental health settings and may have resulted in a decrease in recovering patients and an increase in non-COVID-19 patients.

From 16 November 2020, data is included from the Grange University Hospital in Aneurin Bevan University Health board. This increased the total number of beds available by around 450 beds.

Data from mental health units were included retroactively from 10 July 2020 for the first time in the release on 20 August 2020. The inclusion of mental health beds had a small impact on beds occupied with COVID-19 patients’ figures but a large impact on all beds occupied with non-COVID19 patients and vacant beds, as the majority of mental health beds are not occupied by COVID-19 patients. Mental health units’ data are submitted each Friday, and the Friday position is used as proxy for the following week, unless there is a major change in circumstances.

Recovering patients was a category introduced on 26 May 2020 to capture patients who were COVID-19 positive in hospital and who showed no symptoms for 14+ days but remained in hospital on a COVID-19 treatment pathway, often for rehabilitation. There have been some differences in reporting by health boards in the time series which are outlined in more detail in the quality and methodology information section.

Please see the Chief Statistician’s blog for more information on reporting on recovering patients.

On reporting recovering patients, Aneurin Bevan started reporting recovering patients from 7 June 2020, but these were captured in the confirmed COVID-19 category before. Cardiff and Vale classified recovering patients as non-COVID-19 patients between 1 May 2020 and 22 May 2020. Following the change in guidance, Cardiff and Vale re-categorised these patients as COVID-19 patients, capturing them in the confirmed COVID-19 category until the recovering category was introduced on 26 May 2020.

From June 2020, hospitals began closing some of the additional surge capacity that was previously put in place for the COVID-19 pandemic.

Invasive ventilated beds

From 18 January 2021, no patients occupying an invasive ventilated bed (critical care bed) should be counted as ‘recovering’ COVID-19 patients as they are still requiring a high level of care. Any patient previously reported as ‘recovering’ are now counted under ‘confirmed’. This resulted in an increase in the number of invasive ventilated beds occupied by ‘confirmed’ COVID-19 patients (an increase of around 14 patients at the point of implementation) and no invasive ventilated beds showing as occupied by ‘recovering’ patients. This change had no impact on the total number of COVID-19 related patients.

From 13 November 2020, only critical care beds that could be staffed were included as available. Previously all critical care beds had been included regardless of whether they could be staffed. Staffed beds are those that can be staffed at the time of the census. General and acute beds only include beds that can be staffed. However, not all health boards implemented this change on that date. Following and update to guidance, more local health boards implemented this change from 4 December 2020.

From 19 October 2020, data for specialist critical care beds (such as those in Burns and Plastic in Morriston) and other specialist acute beds (such as maternity) across other acute sites have been included. These beds have been included in the data as they are part of the available bed stock, and may be used for COVID-19 patients in exceptional circumstances. The majority of these beds are not occupied with COVID-19 patients. Therefore the inclusion of these had very little impact on the number of beds occupied with COVID-19 patients but a larger impact on vacant beds and those occupied with non-COVID19 patients.

A&E attendances

A&E attendances to major and minor hospitals, from all mode of transports across Wales. Some small minor A&E units are not able to submit daily data, therefore there is probably a small undercount in total attendance. The five-year average uses data from the years 2015 to 2019. For data on the 29 February, only data from the year 2016 and 2020 is included. There tends to be a lower number of attendances recorded on a Sunday compared to other days of the week and a higher recorded number of attendances in the summer compared to the winter.

Comparability

Please see the UK Government COVID-19 dashboard for information on healthcare at a UK level. Note: the healthcare data presented in the UK dashboard differs from this publication. Data for Wales on the UK dashboard includes data for acute hospitals only which was initially provided to enable better comparability with other countries. Whereas this publication includes data from acute, community, field hospitals and mental health units to provide a more comprehensive view of the system in Wales. From 11 December 2020, data for England presented on the UK dashboard was updated to align with NHS England publications and as a result the full time series for this item was revised. Data for England on the UK dashboard now includes data from acute, community, field hospitals and mental health units. Due to this reporting change, we are reviewing the suitability of data currently provided for Wales. Estimates of the number of people who had coronavirus in England and Wales is also published by the Office for National Statistics in their Coronavirus (COVID-19) Infection Survey.

Please note that health care surveillance data presented in the Public Health Wales (PHW) dashboard differ from this publication. The PHW dashboard uses data systematically collected through ICNET, the hospital infection control data system used across Wales. It includes hospital in-patients with a laboratory confirmed result and does not count any patients who were admitted and discharged on the same day.

The Welsh Government publication uses data sourced from daily management information provided by health boards. Guidance was issued to local health boards for completion and submission of the data return. However, data collection methods may vary between health boards. It includes COVID-19 related patients as suspected, confirmed and recovering, as well as non-COVID-19 patients.

The narrower definition used by PHW will likely result in smaller numbers of reported COVID-related admissions compared to the Welsh Government publication, but provides a systematic way of carrying out surveillance of patients requiring hospital stays with confirmed COVID-19.

National Statistics status

These statistics are not National Statistics. However, as far as has been practicable, they have been collected and validated in accordance with the pillars and principles within the Code of Practice for Statistics. We continue to develop the data collection and quality assurance process to improve the data.

These statistics have been produced quickly in response to developing world events.

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. The 46 national indicators were laid in 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.

Next update

The next release will be at 9.30am Friday 4 June 2021.

Contact details

Statistician: Alex Fitzpatrick
Telephone: 0300 025 9016
Email: kas.covid19@gov.wales

Media: 0300 025 8099

SFR 163/2021