Croydon Health Services NHS Trust

Within England 95% of patients who attend A&E or make an emergency admission should be admitted, transferred or discharged within 4 hours of arrival. This means that depending on the severity of their condition, patients need to be admitted into the hospital for further treatment or observations, transferred into another NHS organisation or separate care (such as social services) or discharged home.

This data includes those who make an unplanned attendance at either a 24-hour A&E department, a single speciality A&E department or a walk-in/urgent care centre. An A&E department must see, on average, more than 200 separate patients each month before it is obliged to provide this data.

A&E attendances and emergency admission data is published monthly and can be found on the NHS England website at: https://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting-times-and-activity/. This data is public sector information licensed to Blackwater Law under the Open Government Licence v3.0: http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/.

The NHS report on bed occupancy rates as an indicator as to what capacity each individual trust is running at.

The figures presented here relate to the overall percentage of beds that are occupied overnight during the reporting period.

It is thought by some commentators that bed occupancy levels greater than 85% can lead to compromised patient safety and higher hospital acquired infection rates (Bagust A et al , British Medical Journal, Vol 319).

Bed occupancy data is available quarterly and can be found on the NHS England website at: https://www.england.nhs.uk/statistics/statistical-work-areas/bed-availability-and-occupancy/. This data is public sector information licensed to Blackwater Law under the Open Government Licence v3.0: http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/.

If a Trust cancels a patient’s urgent operation, for a non-medical reason, they must report this. The definition of an urgent operation is determined by the Trust but should include any operation on a patient that is life-saving or limb saving, or where life or limb is threatened. In addition, any operation that requires early intervention but is not yet a threat to survival should also be included according to the Monthly SitReps Definitions v1.07 – Critical Care Capacity document, available on the NHS England website. The Trust should record any cancelled urgent operation, not just those that are cancelled at the last-minute.

Urgent operations cancelled data is available monthly and can be found on the NHS England website at: https://www.england.nhs.uk/statistics/statistical-work-areas/critical-care-capacity/. This data is public sector information licensed to Blackwater Law under the Open Government Licence v3.0: http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/.

All NHS Trusts must report when an elective operation has been cancelled at the lastminute for non-clinical reasons. For the purposes of reporting, a last-minute cancellation is deemed to have occurred after the patient has arrived at the hospital, or on the day of the operation or surgery. The operation must have been cancelled for non-clinical reasons for it to be reported.

Examples of a non-clinical reason for cancelling an operation include: ward beds being unavailable, equipment failures, administrative errors and emergency cases needing the theatre. This includes all planned and elective operations, including day cases. However, in accordance with the Cancelled Operations Guidance available on the NHS England website, any operation that is rescheduled to a time that is within 24 hours of the original operation time and date is classed as a postponement rather than a cancellation, as long as this only occurs once (any further postponements are then classed as a cancellation).

Cancelled elective operations data is available quarterly and can be found on the NHS England website at: https://www.england.nhs.uk/statistics/statistical-work-areas/cancelled-elective-operations/. This data is public sector information licensed to Blackwater Law under the Open Government Licence v3.0: http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/.

In order to provide a medical diagnosis, it is often necessary to perform a diagnostic test or procedure to identify a disease or condition. As a result, the NHS report on a number of items relating to diagnostics. The figures presented here relate to the percentage of patients who had to wait 6 weeks or more from the moment the request for the diagnostic test or procedure is made, through to when the test or procedure has been completed.

“Early diagnosis is important to patients and central to improving outcomes. For example early diagnosis of cancer improves survival rates. Bottlenecks in diagnostic services can significantly lengthen patient waiting times to start treatment.” (NHS England)

Diagnostics waiting time data is available monthly and can be found on the NHS England website at: https://www.england.nhs.uk/statistics/statistical-work-areas/diagnostics-waiting-times-and-activity/monthly-diagnostics-waiting-times-and-activity/. This data is public sector information licensed to Blackwater Law under the Open Government Licence v3.0: http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/.

All NHS Trusts have been expected to eliminate all instances of mixed-sex accommodation, unless it is in the best interest of the patient, for instance where there is a need for urgent or critical care. In such cases, mixing may be justified and therefore will not be a breach and will not be counted in these statistics.

Any reported occurrence of shared mixed sex accommodation shown here is classed as an unjustifiable breach and therefore should not be occurring under the NHS guidelines. The Department for Health states:
“There is no justification for placing a patient in mixed-sex accommodation where this is not in the best interests of the patient and better management, better facilities or the removal of organisational constraints could have averted the situation.” Department for Health (2010) Eliminating Mixed Sex Accommodation.

Data is gathered and published monthly to report on any unjustified breaches of NHS sleeping accommodation guidelines. This includes any areas where patients are admitted and cared for on beds or trolleys, even if they do not stay overnight and includes day surgery units as well as clinical decision units; but excludes any areas where patients have not yet been admitted – such as accident and emergency cubicles.

Mixed sex accommodation breach source data can be found on the NHS Improvement website at: https://www.england.nhs.uk/statistics/statistical-work-areas/mixed-sex-accommodation/msa-data/. This data is public sector information licensed to Blackwater Law under the Open Government Licence v3.0: http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/.