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Date: 23 May 2012
Time: 17:46
Time to initial assessment in A&E
What does this indicator mean?
Time to initial assessment is the time from arrival at A&E to the time when a patient is assessed by an emergency care medical or nursing professional to determine priority for treatment. The initial assessment should include a brief history, pain and early warning scores (including vital signs) to determine how unwell the patient is and whether emergency treatment is required.
As there is no commonly accepted and consistent definition of major cases at present, the indicator applies only to patients who arrive by ambulance.
What is good performance?
The time to initial assessment should be minimised. Good practice would be for all patients arriving by ambulance to be assessed within 15 minutes of arrival. The NHS Operating Framework for 2011/12 expects trusts to meet a performance threshold of 95% of patients waiting 15 minutes or less.
How is UHB performing?
In March 2012 95% of patients waited 26 minutes or less from arrival at A&E to initial assessment. The average (median) wait was 1 minute. The latest available national performance data shows that 95% of patients waited 47 minutes or less in December 2011.
The Emergency Department at UHB also sees a higher proportion of patients who arrive by ambulance (36%) compared to the national average of 25.2% (2009/10). This is because UHB is a regional centre for trauma, burns and plastics, neurosurgery and maxillo-facial surgery.
What is UHB doing to improve performance?
Work continues to improve data quality for this indicator by improving the timeliness of data entry by nursing staff of initial assessment times for all patients who arrive by ambulance. In addition, the Trust has implemented a new electronic system within the Emergency Department which will enable better and more timely data capture.
UHB data quality
Trusts are expected to have less than 5% of patients with a missing assessment time. In March 2012 all UHB patients included in this indicator had an assessment time recorded.
