Summary of Key Points

This statistical brief presents information on (i) the number of calls to Phone First and (ii) the number of attendances at urgent and 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 2026/27.1

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

Please note: information sourced from the encompass system is considered to be “official statistics in development”. For more detail on the encompass system and the use of statistics in this report, please use the tabs below.


Use the tabs below to access a summary of key points for September 2026, a graphical flow chart view or a list view are available. Before reading the content of the report please note the information in the encompass and official statistics tabs.

Flow Chart

Flow chart detailing key points

Key Points

  • 72,697 attendances at emergency departments

  • Median waiting time for patients to be triaged was 15 minutes from time of arrival

  • Median waiting time from triage to start of treatment was 1 hour 45 minutes

  • 8.1% of attendances left ED before their treatment was complete

  • Median waiting time for patients admitted to hospital was 14 hours 12 minutes

  • Median waiting time for patients discharged home was 4 hours 13 minutes

  • 12.3% of attendances had been referred by a GP

  • 41.7% treated and discharged or admitted within 4 hours.

  • 13,065 waited more than 12 hours


Encompass

Encompass is a new electronic patient record system with 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 legacy health systems into one administrative system. The programme was first introduced in the South Eastern Health and Social (HSC) Trust on 9th November 2023, the Belfast HSC Trust on 6th June 2024, the Northern HSC Trust on 7th November 2024, and the Southern and Western HSC Trusts on 8th May 2025. Further information about encompass can be found at the link below:

https://dhcni.hscni.net/digital-portfolio/encompass/

Official Statistics / Notes

The performance statistics within this publication has been assessed to the standard of Accredited Official Statistics, however during implementation and stabilisation of the change of data source to the encompass system, they are considered to be ‘official statistics in development’ which are a subset of Official Statistics in line with the Code of Practice for Statistics. While caution must be exercised when using these figures, they are a meaningful representation of what they measure and are of sufficient quality for publication and use.

This also applies to the Clinical Quality Indicators that historically have been published as Official Statistics and not Accredited Official Statistics, these include indicators based on source of referral, method of arrival and destination on discharge from ED. These have been provided to give a more comprehensive overview of activity at EDs across Northern Ireland. These fields are recorded on encompass, and then mapped by DoH to a set of agreed regional codes. A review of the mapping of these codes from the encompass system was undertaken, and a new set of regionally agreed codes was produced. A validation exercise has begun and will be ongoing throughout 2026.

Please note that activity at Urgent Care Centres is now reported as Type 3 EDs.

Unscheduled Care Services

Use the tabs below to find background information on, and defintions of, the unscheduled care services in Northern Ireland 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. As part of the ‘No More Silos’ action plan, two new urgent care services, Phone First and Urgent Care Centres, 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. It is also important to note that urgent and emergency care services in Northern Ireland perform critical roles in responding to patient need.

Phone First

Phone First: Telephone triage service for patients considering travelling to an ED, to access alternative assessments, advice, and information and receive appropriate care promptly.

Urgent Care

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 treatment centre; Emergency Departments (EDs); and, the Northern Ireland Ambulance Service (NIAS). Minor injury units (MIUs) and Urgent Care Centres (UCCs) are classed as Type 3 Emergency Departments.

Emergency Care

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 the Northern Ireland Ambulance Service (NIAS).

Phone First2 3

Table 1: Phone First Calls and Referrals to ED (July 2026 - September 2026)

Activity July 2026 August 2026 September 2026
PhoneFirst 16,047 15,969 18,263
Number Referred to ED 11,189 11,109 12,098
% Referred to ED 70 70 66

The table above shows the number of calls received by the Phone First service, and the number of patients referred to ED from Phone First during July, August and September 2026.

During September 2026, 18,263 calls were received by Phone First. A total of 12,098 resulted in a referral to ED, whilst 6,165 patients did not go on to be referred to an ED.


Figure 1: Phone First Calls and Referrals to ED (October 2020 - September 2026)


The stacked bar chart above shows the number of calls received by the Phone First service and the number of patients referred to an ED from Phone First in each month from October 2020 to September 2026.

The highest number of Phone First calls were received in September 2026 (18,263), with the highest number of referrals to ED from Phone First in September 2026 (12,098).

Attendances at Urgent & Emergency Care Services4

This section includes patients physically attending urgent and emergency care departments. As of 1st April 2025, attendances at Urgent Care Centres are reported with Type 3 emergency departments as they provide an equivalent service.

Please note: Only total attendances figures are available from Craigavon and Daisy Hill UCCs, as these services’ data is held on the GP system and not on encompass.


Table 2: Attendances at Urgent and Emergency Care Services (September 2026 vs September 2025)

Measure September 2025 September 2026 Change (Number) Change (%)
Attendances at EDs 67,633 72,697 5,064 7%

The table above shows the number physically attending urgent and emergency care departments in September 2026, compared with September 2025.

The number of attendances at EDs in September 2026 (72,697) was 5,064 (7.5%) more than September 2025 (67,633).


Figure 2: Heatmap of Monthly Attendances at EDs (April 2008 - September 2026)

The heatmap above presents information on the number of attendances at EDs in Northern Ireland each month from April 2008 to September 2026. 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 3: Monthly Attendances at EDs (April 2008 - September 2026)


The line chart above shows the number of attendances at EDs in Northern Ireland each month from April 2008 to September 2026. The highest number of attendances occurred in May 2026 (73,432) and the lowest number of attendances occurred in April 2020 (35,416).


Table 3: Total Attendances at EDs by Department Type (July - September 2026)

Type July 2026 August 2026 September 2026
Type 1 55,408 55,290 56,049
Type 3 17,349 16,294 16,648
Northern Ireland 72,757 71,584 72,697

The table above shows attendances at EDs by department type in each month from July to September 2026. In September 2026, there were 72,697 attendances at EDs in Northern Ireland with 56,049 (77.1%) at Type 1 EDs and 16,648 (22.9%) 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 4: Monthly Attendances at Type 1 EDs (April 2008 - September 2026)


The line chart above shows the total attendances at Type 1 EDs each month from April 2008 to September 2026. Since April 2008 attendances have increased before dropping during the peak of the Covid-19 pandemic, before once again reaching pre-pandemic levels in September 2026. During September 2026, Antrim (8,218) reported the highest number of attendances at Type 1 EDs, whilst SWA reported the lowest (3,688).


Table

Table 4: Attendances at Type 1 EDs (April 2008 - September 2026)

The table above shows the total attendances at Type 1 EDs each month from April 2008 to September 2026. 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 indicating 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 5: Number of ED attendances per 1,000-population for each SOA in Northern Ireland for September 2026


The interactive map above presents the number of ED attendances per 1,000-population for each SOA in Northern Ireland for September 2026.5 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 Water Works 1 super output area (89.2), whilst the lowest rate was in Aldergrove 1 super output area (2).

Standardised Attendance Rate

Figure 6: Standardised ED attendance rate (SAR) per 1,000 population for each SOA in Northern Ireland by deprivation level

The interactive map above presents the standardised ED attendance rate (SAR) per 1,000 population for SOA in Northern Ireland by deprivation level, and is presented in 3 SAR categories.6 The red dots indicate the location of the EDs in Northern Ireland.

Admissions

Figure 7: Percentage of Attendances at Type 1 EDs Admitted to Hospital (April 2014 - September 2026)


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 September 2026, 16.1% of attendances at EDs were admitted to hospital. Since April 2014, the percentage of ED attendances admitted to hospital ranged from 15.8% in May 2025 to 25.2% in January 2021.

Across Type 1 EDs, the Ulster (29.2%) reported the highest percentage of attendances at ED being admitted to hospital.


Weekday Activity

Figure 8: Arrivals at ED by Hour and Day of Week in September 2026


The heatmap above presents the average number of attendances at EDs for each day of the week and hour during September 2026.

Overall, Monday was the busiest day of the week with an average of 2,782 attendances, whilst the lowest average number of daily attendances was on a Saturday (1,950).

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 September 2026. Figures are based on departure date/time.

Changes in coding of Clinical Quality Indicators in the new encompass system should be taken into account when comparing with previous years. Note: Since the introduction of encompass, GP referral figures have dropped. A validation exercise is currently under way to investigate if this is due to changes in services or changes in data recording.


Figure 9: Percentage of Attendances at Type 1 EDs Referred by a GP (April 2014 - September 2026)


The line chart above shows that during September 2026, 12.3% of attendances at EDs had been referred by a GP. Across Type 1 EDs, Antrim (22.4%) reported the highest percentage of ED attendances referred by a GP, whilst SWA (3.7%) reported the lowest.

Since April 2014, the percentage of ED attendances which had been referred by a GP ranged from 11.0% in August 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.

Changes in coding of Clinical Quality Indicators in the new encompass system should be taken into account when comparing with previous years.


Figure 10: Percentage Leaving Type 1 EDs Before Treatment Complete (April 2014 - September 2026)7


The line chart above shows that during September 2026, 8.1% of attendances left an EDs before their treatment was complete. Across Type 1 EDs, Mater (21.7%) reported the highest percentage of ED attendances leaving before their treatment was complete, whilst SWA (4.0%) reported the lowest.

Since April 2014, the percentage of ED attendances who had left before treatment ranged from 1.4% in April 2020 to 8.6% in August 2026.


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.

Please note: As of 1st April 2025, attendances at Urgent Care Centres are reported with Type 3 emergency departments as they provide an equivalent service.

Only total attendances figures are available from Craigavon and Daisy Hill UCCs, as these services’ data is held on the GP system and not on encompass.


Four Hour Performance

Figure 11: Heatmap of Performance against Four Hour Target at Type 1 EDs (April 2008 - September 2026)


The heatmap above shows the monthly performance against the four hour ED waiting times target at Type 1 EDs, from April 2008 to September 2026. During September 2026, 30.7% of patients attending Type 1 EDs in Northern Ireland were treated and discharged or admitted within four hours compared to 33.8% in September 2025.


Table 5: Performance against Four Hour Target at Type 1 EDs (September 2026 v September 2025)

Attendances
Four Hour
Department Attendances Change Attend % within 4 hrs Change 4 hrs Target Achieved
Altnagelvin 5,003 223 25.3% 0.1
Antrim 8,218 346 31.0% -2.6
Causeway 4,458 185 42.2% -7.2
Craigavon 7,574 1,127 30.3% -2.1
Daisy Hill 5,183 492 39.0% -1.9
Mater 3,770 311 29.4% -6.4
RBHSC 3,995 632 64.8% -6.9
RVH 7,125 14 14.2% -3.1
SWA 3,688 409 39.6% -3.3
Ulster 7,035 74 14.2% -5.7

The table above details the number of attendances and performance against the four hour target at Type 1 EDs during September 2026 compared with September 2025.

During September 2026, the RBHSC (64.8%) reported the highest performance of any Type 1 ED, whilst RVH (14.2%), Ulster (14.2%) reported the lowest.


Figure 12: Performance against Four Hour Target at Type 1 EDs (April 2008 - September 2026)


The line chart above shows the percentage of attendances treated and discharged within four hours at Type 1 EDs from April 2008 to September 2026.

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 13: Time Waited in ED from Arrival to Discharge, by 20 Minute Period in September 2026


The bar chart above shows the time waited in ED from arrival to discharge, by 20 minute period in September 2026.


Twelve Hour Performance

Table 6: Performance against Twelve Hour Target at Type 1 EDs (September 2026 v September 2025)

Attendances
12 Hour
Department Attendances Change Attend Over 12 hrs Change 12 hrs Target Achieved
Altnagelvin 5,003 223 1,288 151
Antrim 8,218 346 1,803 257
Causeway 4,458 185 696 94
Craigavon 7,574 1,127 2,001 265
Daisy Hill 5,183 492 869 208
Mater 3,770 311 763 184
RBHSC 3,995 632 9 4
RVH 7,125 14 2,184 338
SWA 3,688 409 617 93
Ulster 7,035 74 2,585 439


The table above details the number of attendances and performance against the twelve hour target at Type 1 EDs during September 2026 compared with September 2025.

During September 2026, 12,815 patients spent over twelve hours in Type 1 EDs in Northern Ireland, 2,033 more than September 2025 (10,782).

In September 2026, the Ulster (2,585) ED reported the highest number of patients waiting over 12 hours at any Type 1 ED, whilst the RBHSC reported the lowest (9).


Figure 14: Performance against Twelve Hour Target at Type 1 EDs (April 2008 - September 2026)


The line chart above shows the number of patients waiting over 12 hours at Type 1 EDs from April 2008 to date.

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:

  1. the 95th percentile, which is the time below which 95% of patients were triaged each month; and,
  2. the median waiting time, which is the time below which 50% of patients were triaged.

Please note: Figures are based on valid triage instances only. In Southern HSC Trust, data quality issues have been identified in encompass data which mean the number of valid triage instances recorded is lower than usual. This is being investigated as part of a data validation exercise.


Figure 15: Time from Arrival to Triage (April 2014 - September 2026)


The area plot above shows during September 2026, the median waiting time from arrival to triage was 15 minutes, 1 minute longer than the time taken in September 2025 (14 minutes), whilst 95 percent of patients were triaged within 1 hour 7 minutes, less than the time taken in September 2025 (1 hour 12 minutes).

Altnagelvin (27 minutes) reported the longest median waiting time of any Type 1 ED during September 2026, whilst RBHSC (7 minutes) reported the shortest median waiting time.

During September 2026, Altnagelvin (1 hour and 45 minutes) reported the longest time taken to triage 95 percent of attendances, whilst RBHSC (23 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:

  1. the 95th percentile, which is the time below which 95% of patients commenced treatment each month; and,
  2. the median waiting time, which is the time below which 50% of patients commenced treatment.

Please note: Figures are based on valid treatment instances only. In Southern HSC Trust, data quality issues have been identified in encompass data which mean the number of valid treatment instances recorded is lower than usual. This is being investigated as part of a data validation exercise.


Figure 16: Time from Triage to Start of Treatment (April 2014 - September 2026)


During September 2026, the median waiting time from triage to start of treatment was 1 hour 45 minutes, 19 minutes longer than the time taken in September 2025 (1 hour 26 minutes), whilst 95 percent of patients were triaged within 10 hours 38 minutes, longer than the time taken in September 2025 (8 hours 14 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 17: Median Time Spent in an ED for those (i) Admitted and (ii) Discharged Home (April 2014 - September 2026)


The line chart above shows the median time spent in ED by those admitted and those discharged home from April 2014 to September 2026.

Patients admitted to hospital continue to wait longer in an ED than those discharged home.

During September 2026, the median time patients admitted to hospital spent in an ED was 14 hours 12 minutes, 9 hours 59 minutes longer than the median time waited by patients discharged home (4 hours 13 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: calls to Phone First, 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.

Encompass is a new electronic patient record system with 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 legacy health systems into one administrative system. The programme was first introduced in the South Eastern Health and Social (HSC) Trust on 9th November 2023, the Belfast HSC Trust on 6th June 2024, the Northern HSC Trust on 7th November 2024, and the Southern and Western HSC Trusts on 8th May 2025. Further information about encompass can be found at the link below:

https://dhcni.hscni.net/digital-portfolio/encompass/

The statistics within this publication has been assessed to the standard of Accredited Official Statistics, however during implementation and stabilisation of the change of data source to the encompass system, they are considered to be ‘official statistics in development’ which are a subset of Official Statistics in line with the Code of Practice for Statistics. While caution must be exercised when using these figures, they are a meaningful representation of what they measure and are of sufficient quality for publication and use. This also applies to the Clinical Quality Indicators that historically have been published as Official Statistics and not Accredited Official Statistics, these include indicators based on source of referral, method of arrival and destination on discharge from ED. These have been provided to give a more comprehensive overview of activity at EDs across Northern Ireland. These fields are recorded on encompass, and then mapped by DoH to a set of agreed regional codes. A review of the mapping of these codes from the encompass system was undertaken, and a new set of regionally agreed codes was produced. A validation exercise has begun and will be ongoing throughout 2026.

Please note that activity at urgent care centres is now reported as Type 3 EDs.

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

  1. Information on: calls to Phone First, 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.↩︎

  2. Data on Phone First services are not accredited official statistics but have been provided to give a more comprehensive overview of activity at EDs across Northern Ireland.↩︎

  3. Phone First figures from South Eastern HSC Trust do not include Lagan Valley and Downe calls after October 2023, whilst Ulster Phone First calls are included from January 2024.↩︎

  4. Readers should note that those on an ambulatory care pathway delivered outside the ED are not included in these statistics.↩︎

  5. Super Output Areas were developed by the Northern Ireland Statistics & Research Agency (NISRA) to improve the reporting of small area statistics.↩︎

  6. The data presented in the standardised ED attendance map for SOAs by deprivation level in NI refers to the 2024/25 financial year.↩︎

  7. Please note: an encompass workflow issue, which has been resolved, resulted in data quality issues impacting discharge destination figures, including those categorised as having left before treatment was complete, between 1st July 2025 and 21st August 2025.↩︎

 

Hospital Waits Information Branch

Information & Analysis Directorate

Department of Health

Email: statistics@health-ni.gov.uk