Encompass
Encompass is a new electronic patient record system that will create a single digital care record for every citizen in Northern Ireland who receives health and social care. It aims to create better experiences for patients, service users and staff by bringing together information from various existing systems that do not currently communicate effectively. The programme was first introduced in the South Eastern Health and Social Care (HSC) Trust on 9th November 2023, the Belfast HSC Trust on 6th June 2024, and the Northern HSC Trust on 7th November 2024, and will be rolled out on a phased basis across the remaining HSC Trusts in Northern Ireland by the end of 2025. Further information about Encompass can be found at the link below:
https://encompassni.hscni.net/digital-portfolio/encompass/
Please Note: Figures in this report for Belfast, Northern and South Eastern HSC Trust sourced from the Encompass system are considered to be ‘official statistics in development’.
Summary of Key Points
Use the tabs below to access a summary of key points for March 2025. A graphical flow chart view or a list view are available.
Flow Chart
This statistical brief presents information on the number of attendances at (i) Urgent Care Services (PhoneFirst / Urgent Care centres (UCC)) and (ii) emergency care departments (EDs) (new and unplanned reviews only), including the length of time spent in EDs and the performance of the Health and Social Care (HSC) Trusts against the emergency care waiting times targets for 2025/26.1
Information is also included on a series of clinical quality indicators detailing the key milestones of a patient’s time in an ED. Further information on data included in this release is available at the link below:
https://www.health-ni.gov.uk/publications/emergency-care-waiting-times-additional-guidance
Key Points
67,871 attendances at emergency departments
Median waiting time for patients to be triaged was 13 minutes from time of arrival
Median waiting time from triage to start of treatment was 83 minutes
6.8% of attendances left ED before their treatment was complete
Median waiting time for patients admitted to hospital was 13 hours 7 minutes
Median waiting time for patients discharged home was 3 hours 51 minutes
11.8% of attendances had been referred by a GP
44.5% treated and discharged or admitted within 4 hours.
10,827 waited more than 12 hours
Unscheduled Care Services
Use the tabs below to find background information on the new unscheduled care services and the work of No More Silos.
Background
Prior to the COVID-19 pandemic, urgent and emergency care services in Northern Ireland were under increased pressure with more patients spending longer periods of time in overcrowded emergency departments (EDs). The impact of the COVID-19 pandemic, and the need to focus on disease prevention and social distancing, increased the need to ensure that we do not allow EDs to reach these levels of overcrowding in the future. To help take this work forward, the Department of Health (DoH) established the ‘No More Silos’ action plan, which sought to improve urgent and emergency care services and build on the improved co-ordination between primary and secondary care, leading to universal patient triage, virtual consultation and new clinical pathways. It is also important to note that urgent and emergency care services in Northern Ireland perform critical roles in responding to patient need:
Urgent Care: An illness or injury that requires urgent attention but is not a life-threatening situation. Urgent care in Northern Ireland includes: General Practice during weekdays; GP Out of Hours (GP OOH) Services at night and weekends; pharmacies; minor injury units; an urgent care centre; Emergency Departments (EDs); and, the Northern Ireland Ambulance Service (NIAS).
Emergency Care: Life threatening illnesses or accidents which require immediate intensive treatment. Emergency Care is currently provided in hospitals with Type 1 and Type 2 Emergency Departments and by NIAS.
No More Silos
As part of the ‘No More Silos’ action plan, two new urgent care services: (i) PhoneFirst and (ii) Urgent Care Centres (UCC), were introduced in late 2020, which aimed to assess patients’ needs before arrival at an ED, and ensure they receive the right care, at the right time, and in the right place, outside ED if appropriate. This section will report the number of patients contacting / attending these urgent care services, who may otherwise have attended an ED.
PhoneFirst / Urgent Care Centres
PhoneFirst:
PhoneFirst is a telephone triage service for patients considering
travelling to an ED, to access alternative assessments, advice, and
information and receive appropriate care promptly.
Urgent Care Centre: Urgent Care Centres assess / treat patients who present with illnesses / injuries that require urgent attention but are not life threatening. Patients are given an urgent care appointment / referral to the appropriate service, with patients requiring immediate medical attention being sent to an ED.
Table 1: PhoneFirst Calls, UCC Attendances
and Referrals to ED (January 2025 - March 2025)
| Activity | January 2025 | February 2025 | March 2025 |
|---|---|---|---|
| PhoneFirst | 12,669 | 12,888 | 14,316 |
| Urgent Care Centres | 3,340 | 3,254 | 3,330 |
| Total Calls / Attendances | 16,009 | 16,142 | 17,646 |
| Number Referred to ED | 7,502 | 7,829 | 8,024 |
| % Referred to ED | 47 | 49 | 45 |
The table above shows the number of calls received by the PhoneFirst service, attendances at UCCs and patients referred to ED from PhoneFirst / UCC during January, February and March 2025.
During March 2025, 17,646 calls / attendances were received by PhoneFirst (14,316) and UCCs (3,330), from patients who may previously have attended an ED. A total of 8,024 resulted in a referral to ED, whilst 9,622 patients did not go on to be referred to an ED.
Select a tab below to view either the chart for calls received at PhoneFirst or attendances at UCCs.
PhoneFirst
Figure 1: PhoneFirst Calls and Referrals to
ED (October 2020 - March 2025)
The stacked bar chart above shows the number of calls received by the PhoneFirst service and the number of patients referred to an ED from PhoneFirst in each month from October 2020 to March 2025.
The highest number of PhoneFirst calls were received in June 2023 (16,144), with the highest number of referrals to ED from PhoneFirst in October 2024 (8,328).
Urgent Care Centres
Figure 2: UCC Attendances and Referrals to
Type 1 EDs (October 2020 - March 2025)
The stacked bar chart above shows the number of attendances at UCCs and the number of patients referred to a Type 1 ED from UCCs in each month from October 2020 to March 2025.
The highest number of attendances at UCCs was in October 2023
(4,336), with the highest number of referrals to Type 1 EDs from Urgent
Care Centres in March 2021 (2,333).
Attendances at Urgent & Emergency Care Services
This section includes physical attendances at UCCs and at EDs.
Table 2: Attendances at Urgent and Emergency
Care Services (March 2025 vs March 2024)2
| Measure | March 2024 | March 2025 | Change (Number) | Change (%) |
|---|---|---|---|---|
| UCC Referred to ED | – | – | 0 | 0.0% |
| UCC Not Referred to ED | 3,469 | 3,330 | -139 | -4.0% |
| Total UCC | 3,469 | 3,330 | -139 | -4.0% |
| Attendances at EDs | 65,298 | 67,871 | 2,573 | 3.9% |
| Attendances at EDs / UCC | 68,767 | 71,201 | 2,434 | 3.5% |
The table above shows the number physically attending urgent and emergency care services (i) attendances at UCCs, and (ii) attendances at EDs in March 2025, compared with March 2024.
During March 2025, 71,201 patients attended urgent and emergency care services, of which 67,871 attended an ED and 3,330 attended UCCs.
The number of attendances at EDs in March 2025 (67,871) was 2,573 (3.9%) more than March 2024 (65,298).
Attendances at EDs
The following sections refer to attendances at EDs where the patient physically attended an ED and does not include urgent care activity (PhoneFirst / UCC) where the patient did not attend an ED.
Figure 3: Heatmap of Monthly Attendances at
EDs (April 2008 - March 2025)
The heatmap above presents information on the number of attendances
at EDs in Northern Ireland each month from April 2008 to March 2025. The
level of attendance, or ‘heat’, is indicated via a colour scale ranging
from green, indicating lower levels of attendance compared to red
indicating higher levels of attendance.
Figure 4: Monthly Attendances at EDs (April
2008 - March 2025)
The line chart above shows the number of attendances at EDs in Northern Ireland each month from April 2008 to March 2025. The highest number of attendances occurred in May 2018 (73,395) and the lowest number of attendances occurred in April 2020 (35,423).
Table 3: Total Attendances at EDs by
Department Type (January - March 2025)
| Type | January 2025 | February 2025 | March 2025 |
|---|---|---|---|
| Type 1 | 47,901 | 47,652 | 55,179 |
| Type 2 | 3,253 | 3,049 | 3,493 |
| Type 3 | 7,380 | 7,647 | 9,199 |
| Northern Ireland | 58,534 | 58,348 | 67,871 |
The table above shows attendances at EDs by department type in each month from January to March 2025. In March 2025, there were 67,871 attendances at EDs in Northern Ireland with 55,179 (81.3%) at Type 1 EDs, 3,493 (5.1%) at Type 2 EDs and 9,199 (13.6%) at Type 3 EDs.
The majority of attendances at EDs are at Type 1 departments, therefore the next section will consider the activity at Type 1 EDs only.
Attendances at Type 1 EDs
Select a tab below to view either the
figure or table presenting total attendances at Type 1
EDs.
Chart
Figure 5: Monthly Attendances at Type 1
EDs (April 2008 - March 2025)
The line chart above shows the total attendances at Type 1 EDs each month from April 2008 to March 2025. Since April 2008 attendances have increased before dropping during the peak of the Covid-19 pandemic, before once again reaching pre-pandemic levels in March 2025. During March 2025, the Antrim (8,349) reported the highest number of attendances at Type 1 EDs, whilst Mater reported the lowest (3,523).
Table
Table 4: Attendances at Type 1 EDs (April
2008 - March 2025)
The table above shows the total attendances at Type 1 EDs each month from April 2008 to March 2025. Use the page buttons below the table to navigate through the data, while the buttons above the table (CSV, Excel, PDF, Print) can be used to download the data.
Attendances by Super Output Area
Super Output Areas (SOAs) were developed by NISRA to improve the reporting of small-area statistics. This section presents two interactive maps, the first indicting ED attendances per 1,000 population by SOA, while the second map shows the standardised ED rate of attendance per 1,000 population by deprivation level. Hover over areas of the map to interact with the content.
Attendances Per 1,000 population
Figure 6: Number of ED attendances per
1,000-population for each SOA in Northern Ireland for March 2025
The interactive map above presents the number of ED attendances per 1,000-population for each SOA in Northern Ireland for March 2025.3 The blue dots indicate the location of the EDs in Northern Ireland.
The highest number of attendances at EDs per 1,000-population was in the Shankill 2 super output area (84.8), whilst the lowest rate was in Stranmillis 3 super output area (10).
Standardised Attendance Rate
Figure 7: Standardised ED attendance rate
(SAR) per 1,000 population for each SOA in Northern Ireland by
deprivation level for March 2025
The interactive map above presents the standardised ED attendance rate (SAR) per 1,000 population for SOA in Northern Ireland by deprivation level for March 2025, and is presented in 3 SAR categories.4 The red dots indicate the location of the EDs in Northern Ireland.
Admissions
Figure 8: Percentage of Attendances at
Type 1 EDs Admitted to Hospital (April 2014 - March
2025)
The chart above presents information on the percentage of attendances at Type 1 EDs which resulted in an emergency admission to hospital, during each month since April 2014.
During March 2025, 16.9% of the 67,871 attendances at EDs were admitted to hospital. Since April 2014, the percentage of ED attendances admitted to hospital ranged from 16.9% in March 2025 to 25.2% in January 2021.
Across Type 1 EDs, the Ulster (27.9%) reported the highest percentage of attendances at ED being admitted to hospital.
Weekday Activity
Figure 9: Arrivals at ED by Hour and Day
of Week in March 2025
The heatmap above presents the number of attendances at EDs for each day of the week and hour during March 2025.
Overall, Monday was the busiest day of the week with an average of 2,536 attendances, whilst the lowest average number of daily attendances was on a Saturday (1,778).
The busiest hour of the week was between 11:00 and 11:59 on Monday.
GP Referrals
Many attendances at EDs are the result of a referral from a GP, the following section reports on the percentage of attendances at Type 1 EDs referred by a GP from April 2014 to March 2025.
Figure 10: Percentage of Attendances at
Type 1 EDs Referred by a GP (April 2014 - March
2025)
The line chart above shows that during March 2025, 11.8% of attendances at EDs had been referred by a GP. Across Type 1 EDs, Craigavon (21.6%) reported the highest percentage of ED attendances referred by a GP, whilst RBHSC (6.2%) reported the lowest.
Since April 2014, the percentage of ED attendances which had been referred by a GP ranged from 11.8% in March 2025 to 22.6% in January 2021.
Left Before Treatment Complete
This section presents information on attendances where patients have chosen to leave the ED before their treatment is complete.
Figure 11: Percentage Leaving Type 1 EDs
Before Treatment Complete (April 2014 - March 2025)
The line chart above shows that during March 2025, 6.8% of attendances left an EDs before their treatment was complete. Across Type 1 EDs, Mater (14.6%) reported the highest percentage of ED attendances leaving before their treatment was complete, whilst SWA (3.9%) reported the lowest.
Since April 2014, the percentage of ED attendances who had left before treatment ranged from 1.4% in April 2020 to 8.0% in July 2022, 8.0% in March 2024.
Waiting Times at ED
The DoH targets on emergency care waiting times in Northern Ireland state that:
‘95% of patients attending any Type 1, 2 or 3 emergency department are either discharged or admitted within four hours of their arrival in the department; and no patient attending any emergency department should wait longer than twelve hours.’
‘[…] at least 80% of patients to have commenced treatment, following triage, within 2 hours.’
The following section presents information on the performance against the four and twelve hour components of the waiting times targets.
Four Hour Performance
Figure 12: Heatmap of Performance against Four Hour Target at Type 1 EDs (April 2008 - March 2025)
The heatmap above shows the monthly performance against the four hour ED waiting times target at Type 1 EDs, from April 2008 to March 2025. During March 2025, 34.2% of patients attending Type 1 EDs in Northern Ireland were treated and discharged or admitted within four hours compared to 35.4% in March 2024.
Table 5: Performance against Four Hour
Target at Type 1 EDs (March 2025 v March 2024)
| Department | Attendances | Change Attend | % within 4 hrs | Change 4 hrs | Target Achieved |
|---|---|---|---|---|---|
| Mater | 3,523 | -156 | 35.6% | -2.5 | |
| RVH | 6,969 | 472 | 17.0% | -3.1 | |
| RBHSC | 4,016 | -264 | 61.1% | 7.8 | |
| Antrim | 8,349 | -379 | 29.7% | -5.4 | |
| Causeway | 4,277 | 177 | 47.9% | -2.1 | |
| Ulster | 7,333 | -12 | 18.9% | 1 | |
| Craigavon | 7,075 | 265 | 38.3% | 1.4 | |
| Daisy Hill | 4,956 | 273 | 44.7% | -2.6 | |
| Altnagelvin | 5,038 | -591 | 28.5% | -1.3 | |
| SWA | 3,643 | 315 | 46.8% | -2.8 |
The table above details the number of attendances and performance against the four hour target at Type 1 EDs during March 2025 compared with March 2024.
During March 2025, the RBHSC (61.1%) reported the highest performance of any Type 1 ED, whilst RVH (17%) reported the lowest.
Figure 13: Performance against Four Hour
Target at Type 1 EDs (April 2008 - March 2025)
The line chart above shows the percentage of attendances treated and discharged within four hours at Type 1 EDs from April 2008 to March 2025. Since April 2008, the percentage of patients treated and discharged or admitted within four hours ranged from 31.9% in December 2024 to 78.3% in July 2014.
The next section presents a further analysis of waiting times at EDs, by presenting the number of patients waiting in each 20 minute time period from zero to 24 hours. The four hour target is marked on the chart in red.
Figure 14: Time Waited in ED from Arrival
to Discharge, by 20 Minute Period in March 2025
The bar chart above shows the time waited in ED from arrival to discharge, by 20 minute period in March 2025.
During March 2025, there is a notable fall in the percentage of patients attending EDs who were discharged / admitted in the 20 minute period immediately before breaching the 4 hour target (3.6%, 2,278) and the 20 minute period immediately after the 4 hour target (3.3%, 2,119).
Twelve Hour Performance
Table 6: Performance against Twelve Hour
Target at Type 1 EDs (March 2025 v March 2024)
| Department | Attendances | Change Attend | Over 12 hrs | Change 12 hrs | Target Achieved |
|---|---|---|---|---|---|
| Mater | 3,523 | -156 | 585 | -105 | |
| RVH | 6,969 | 472 | 1,824 | -495 | |
| RBHSC | 4,016 | -264 | 40 | -33 | |
| Antrim | 8,349 | -379 | 1,785 | 207 | |
| Causeway | 4,277 | 177 | 582 | 31 | |
| Ulster | 7,333 | -12 | 2,042 | -219 | |
| Craigavon | 7,075 | 265 | 1,667 | -104 | |
| Daisy Hill | 4,956 | 273 | 548 | -30 | |
| Altnagelvin | 5,038 | -591 | 1,173 | -199 | |
| SWA | 3,643 | 315 | 543 | 23 |
The table above details the number of attendances and performance against the twelve hour target at Type 1 EDs during March 2025 compared with March 2024.
During March 2025, 10,789 patients spent over twelve hours in Type 1 EDs in Northern Ireland, 924 less than March 2024 (11,713).
In March 2025, the Ulster (2,042) ED reported the highest number of patients waiting over 12 hours at any Type 1 ED, whilst the RBHSC reported the lowest (40).
Figure 15: Performance against Twelve
Hour Target at Type 1 EDs (April 2008 - March 2025)
The line chart above shows the number of patients waiting over 12 hours at Type 1 EDs from April 2008 to date. Since April 2008, the number of 12 hour breaches at Type 1 EDs ranged from 1 in September 2008 to 12,227 in December 2024.
Time to Triage
The length of time patients waited from the time of their arrival at an ED to their triage by a medical practitioner, includes a brief history, pain assessment and early warning scores, for all patients. Two aspects of the time waited are reported, including:
- the 95th percentile, which is the time below which 95% of patients were triaged each month; and,
- the median waiting time, which is the time below which 50% of patients were triaged.
Figure 16: Time from Arrival to Triage
(April 2014 - March 2025)
The area plot above shows during March 2025, the median waiting time from arrival to triage was 13 minutes, 1 minute less than the time taken in March 2024 (14 minutes), whilst 95 percent of patients were triaged within 69 minutes, less than the time taken in March 2024 (83 minutes).
Altnagelvin (23 minutes) reported the longest median waiting time of any Type 1 ED during March 2025, whilst Daisy Hill (9 minutes), RBHSC (9 minutes) reported the shortest median waiting time.
During March 2025, Craigavon (2 hours and 6 minutes) reported the longest time taken to triage 95 percent of attendances, whilst RBHSC (28 minutes) reported the shortest time.
Time to Start of Treatment
The length of time patients waited for their treatment to start following triage (initial assessment) by a medical practitioner is presented below. The start of treatment refers to the begining of a definitive treatment by a decision-making clinician. Two aspects of the time waited are reported, including:
- the 95th percentile, which is the time below which 95% of patients commenced treatment each month; and,
- the median waiting time, which is the time below which 50% of patients commenced treatment.
Figure 17: Time from Triage to Start of
Treatment (April 2014 - March 2025)
During March 2025, the median waiting time from triage to start of treatment was 83 minutes, 9 minutes less than the time taken in March 2024 (92 minutes), whilst 95 percent of patients were triaged within 8 hours 18 minutes, less than the time taken in March 2024 (8 hours 35 minutes).
Do Admitted Patients Wait Longer?
Information detailed below is presented on the total waiting time for patients, (i) admitted to hospital or (ii) discharged home. The time waited refers to the time from arrival in ED until the patient leaves the ED to be discharged home or admitted to hospital.
Figure 18: Median Time Spent in an ED for
those (i) Admitted and (ii) Discharged Home (April 2014 - March
2025)
The line chart above shows the median time spent in ED by those admitted and those discharged home from April 2014 to March 2024.
Patients admitted to hospital continue to wait longer in an ED than those discharged home.
During March 2025, the median time patients admitted to hospital spent in an ED was 13 hours 7 minutes, 9 hours 16 minutes longer than the median time waited by patients discharged home (3 hours 51 minutes).
Guidance
Reader Information
This statistical report presents information on the time waited in emergency care departments (ED) in Northern Ireland. It also includes information on: time to triage, time of day of ED attendances, GP referrals, emergency admissions, patients leaving before treatment complete, time to start of treatment, time waited for patients admitted and not admitted, though this information is not Accredited Official Statistics, it has been included to provide users with a more comprehensive view of emergency care activity and waits. Figures correct at time of publishing.
Authors
- Rebecca Rollins
- Sarah Brown
- Heidi Rodgers
Statistical Quality
Information detailed in this release has been provided by HSC Trusts and was validated by Hospital Waits Information Branch (HWIB) prior to release. Further information on the data included in this statistical release is available at: technical notes and guidance
Target Audience
DoH, Chief Executives of HSC Trusts and Strategic Planning and Performance Group (SPPG) in Northern Ireland, Health Care Professionals, Academics, HSC Stakeholders, Media & General Public.
Technical Notes and Guidance
Please note that statistics in this report relating to attendances at EDs refer to new and unplanned review attendances only. The definition of a new and an unplanned review attendance are given below:
New Attendance: A new attendance refers to the first unplanned attendance by a patient for a new clinical condition at an ED / Minor Injuries Unit (MIU).
Unplanned Review: An unplanned review attendance relates to any patient who returns to an ED / Minor Injuries Unit (MIU) without written instruction, for the same or related clinical condition within 30 days of the first (initial) attendance.
Information detailed in this release has been provided by HSC Trusts and was validated by Hospital Waits Information Branch (HWIB) prior to release. Information on: attendances at urgent care services (PhoneFirst / Urgent Care Centres), time to triage, and time of day for attendances, GP referrals, emergency admissions, left before treatment complete, triage level, time to start of treatment, time to admission or discharge are not Accredited Official Statistics, but have been included to provide users with a comprehensive view of emergency care activity and time spent in ED.
Readers should note technical notes and guidance is available for the information detailed in this statistical brief. This includes information on the:
- Data collection
- General guidance on using the data
- Types and categorisation of EDs
- Data quality and contextual information
- Comparisons with UK and,
- Information on Accredited Official Statistics publications
Footnotes
Information on: attendances at urgent care services (PhoneFirst / Urgent Care Centres), time to triage, and time of day for attendances, GP referrals, emergency admissions, left before treatment complete, triage level, time to start of treatment, time to admission or discharge are not Accredited Official Statistics, but have been included to provide users with a comprehensive view of emergency care activity and time spent in ED.↩︎
UCC referrals to Type 1 EDs is not currently available↩︎
Super Output Areas were developed by the Northern Ireland Statistics & Research Agency (NISRA) to improve the reporting of small area statistics.↩︎
Due to small numbers the data presented in the standardised ED attendance map for SOAs in NI below refers to the 2019/20 financial year.↩︎
Hospital Waits Information Branch
Information & Analysis Directorate
Department of Health
Email: statistics@health-ni.gov.uk