{ "meta": { "title": "A&E waiting times in England", "standfirst": "Every major emergency department in England has now missed the four hour standard for years. In August 2026, 75.0% of all attendances were seen within four hours across all department types, against the 95% NHS Constitution standard.", "basis": "These are NHS England's published monthly A&E Attendances and Emergency Admissions statistics, collected via the WSitAE data return. The headline is the share of all A&E attendances admitted, transferred or discharged within four hours of arrival, against the 95% NHS Constitution standard. Type 1 figures cover major emergency departments only; Type 2 and Type 3 cover single specialty units and minor injury units respectively. The 12 hour wait figure is the decision to admit measure: patients who waited more than 12 hours from a clinical decision to admit them to the point of leaving the department. This is the measure used in the NHS Constitution.", "sourceNote": "National figures are from the Monthly A&E Time Series covering August 2010 to August 2026, published 10 September 2026. Trust level figures are from the August 2026 provider file, same publication. Annual percentages are attendance weighted; see caveats.", "latestPct": 75.0, "latestPctType1": 61.1, "latestMonth": "08/2026", "target": 95, "latestAttendances": 2342959, "latestType1Att": 1436125, "latestOver12h": 44951, "latestOver4hDTA": 118550, "latestEmergAdmissions": 517868, "rolling12mAttendances": 28324863, "rolling12m12hWaits": 613176, "trusts121MeetingStandard": 0, "trustsReporting": 120, "trustsShown": 15, "latestMonthLabel": "August 2026", "attendancesYoYPct": 3.4, "attendancesYoYLabel": "August 2025", "seriesFrom": "August 2010", "firstMonth": { "label": "November 2010", "pctAll": 97.2, "pctType1": 95.9 }, "lastFullYearMet": 2013, "lastMonthMet": "July 2015", "rollingMonths": 12, "basisComparison": { "tolerancePct": 0.1, "fullYears": 15, "agreeingYears": 13, "divergentYears": [ 2020, 2021 ], "example": { "year": 2020, "weightedPct": 86.4, "averagedPct": 86.9 }, "rows": [ { "year": 2011, "weightedPct": 96.8, "averagedPct": 96.8 }, { "year": 2012, "weightedPct": 96.3, "averagedPct": 96.2 }, { "year": 2013, "weightedPct": 95.4, "averagedPct": 95.4 }, { "year": 2014, "weightedPct": 94.4, "averagedPct": 94.4 }, { "year": 2015, "weightedPct": 93.0, "averagedPct": 93.0 }, { "year": 2016, "weightedPct": 89.2, "averagedPct": 89.2 }, { "year": 2017, "weightedPct": 89.0, "averagedPct": 89.0 }, { "year": 2018, "weightedPct": 88.0, "averagedPct": 88.0 }, { "year": 2019, "weightedPct": 84.7, "averagedPct": 84.7 }, { "year": 2020, "weightedPct": 86.4, "averagedPct": 86.9 }, { "year": 2021, "weightedPct": 78.9, "averagedPct": 79.2 }, { "year": 2022, "weightedPct": 71.1, "averagedPct": 71.2 }, { "year": 2023, "weightedPct": 72.1, "averagedPct": 72.2 }, { "year": 2024, "weightedPct": 73.4, "averagedPct": 73.4 }, { "year": 2025, "weightedPct": 74.8, "averagedPct": 74.7 } ] } }, "decline": { "eyebrow": "The four hour standard", "heading": "From 95% to 61% in Type 1 departments, 2011 to 2025", "intro": "In November 2010, the first full month on record, England's emergency departments saw 97.2% of patients across all department types within four hours, comfortably above the 95% NHS Constitution standard. For Type 1 major departments the figure was 95.9%. The decline since then has been almost unbroken. By 2016 the all types figure had fallen below 90%. By 2022, after the pressure of the pandemic and its aftermath, it was 71.1%. Not one trust with a major emergency department met the standard in August 2026.", "series": [ { "year": 2010, "pct_all": 96.0, "pct_type1": 94.1, "partial": true }, { "year": 2011, "pct_all": 96.8, "pct_type1": 95.2, "partial": false }, { "year": 2012, "pct_all": 96.3, "pct_type1": 94.4, "partial": false }, { "year": 2013, "pct_all": 95.4, "pct_type1": 93.1, "partial": false }, { "year": 2014, "pct_all": 94.4, "pct_type1": 91.6, "partial": false }, { "year": 2015, "pct_all": 93.0, "pct_type1": 89.5, "partial": false }, { "year": 2016, "pct_all": 89.2, "pct_type1": 83.8, "partial": false }, { "year": 2017, "pct_all": 89.0, "pct_type1": 83.5, "partial": false }, { "year": 2018, "pct_all": 88.0, "pct_type1": 81.5, "partial": false }, { "year": 2019, "pct_all": 84.7, "pct_type1": 76.3, "partial": false }, { "year": 2020, "pct_all": 86.4, "pct_type1": 80.3, "partial": false }, { "year": 2021, "pct_all": 78.9, "pct_type1": 69.5, "partial": false }, { "year": 2022, "pct_all": 71.1, "pct_type1": 57.5, "partial": false }, { "year": 2023, "pct_all": 72.1, "pct_type1": 58.0, "partial": false }, { "year": 2024, "pct_all": 73.4, "pct_type1": 58.9, "partial": false }, { "year": 2025, "pct_all": 74.8, "pct_type1": 60.6, "partial": false }, { "year": 2026, "pct_all": 75.2, "pct_type1": 61.4, "partial": true } ], "target": 95, "note": "Annual figures are attendance weighted: a year is total attendances seen within four hours over total attendances. 2010 covers November to December only; 2026 covers January to August only. The standard has not been met nationally in any full calendar year since 2013." }, "longWaits": { "eyebrow": "Trolley waits", "heading": "12 hour waits: from 129 a year to 554,044", "intro": "The starkest measure of pressure is the number of people who waited more than 12 hours from a clinical decision to admit them to the point they were moved to a bed. This is sometimes called a trolley wait. In 2011, the first full year on record, it happened 129 times across all of England. In 2025 it happened 554,044 times, about 1,518 a day on average. In a single month, August 2026, there were 44,951 such waits.", "series": [ { "year": 2010, "count": 18, "partial": true }, { "year": 2011, "count": 129, "partial": false }, { "year": 2012, "count": 37, "partial": false }, { "year": 2013, "count": 261, "partial": false }, { "year": 2014, "count": 489, "partial": false }, { "year": 2015, "count": 1206, "partial": false }, { "year": 2016, "count": 2600, "partial": false }, { "year": 2017, "count": 2792, "partial": false }, { "year": 2018, "count": 4059, "partial": false }, { "year": 2019, "count": 8272, "partial": false }, { "year": 2020, "count": 14258, "partial": false }, { "year": 2021, "count": 48626, "partial": false }, { "year": 2022, "count": 348135, "partial": false }, { "year": 2023, "count": 415136, "partial": false }, { "year": 2024, "count": 518237, "partial": false }, { "year": 2025, "count": 554044, "partial": false }, { "year": 2026, "count": 412648, "partial": true } ], "note": "The decision to admit 12 hour wait is the NHS Constitution measure. 2010 and 2026 are part years: 2010 covers August to December and 2026 covers January to August. The jump from 2021 to 2022 is not an artefact: the monthly figures show a step change from 12,859 in December 2021 to 16,564 in January 2022, reaching 54,573 in December 2022. The 2012 figure (37) is lower than both 2011 and 2013; the published monthly series carries zero returns for April, May and October 2012, so it should be treated as a lower bound. The series also shows a zero return for May 2013.", "perDay": 1518, "perDayBasis": "554,044 waits in 2025 over 365 days", "stepChange": { "from": { "label": "December 2021", "count": 12859 }, "to": { "label": "January 2022", "count": 16564 }, "peak": { "label": "December 2022", "count": 54573 } }, "zeroReturnMonths": [ "April 2012", "May 2012", "October 2012", "May 2013" ] }, "attendances": { "eyebrow": "Demand", "heading": "More than 28 million attendances in the latest 12 months", "intro": "Total A&E attendances in August 2026 were 2,342,959, up 3.4% on August 2025. Across the 12 months to August 2026, there were 28,324,863 attendances. By comparison, in 2011 there were 21,420,766 across the full year. Between 2011 and 2025, both full calendar years, demand rose by 30% while performance fell by 22.0 percentage points on the all types measure, from 96.8% to 74.8%, and by 34.6 percentage points in Type 1 departments, from 95.2% to 60.6%.", "series": [ { "year": 2011, "total_attendances": 21420766, "partial": false }, { "year": 2012, "total_attendances": 21930329, "partial": false }, { "year": 2013, "total_attendances": 21731202, "partial": false }, { "year": 2014, "total_attendances": 22444954, "partial": false }, { "year": 2015, "total_attendances": 22394734, "partial": false }, { "year": 2016, "total_attendances": 23580825, "partial": false }, { "year": 2017, "total_attendances": 23606962, "partial": false }, { "year": 2018, "total_attendances": 24460954, "partial": false }, { "year": 2019, "total_attendances": 25636826, "partial": false }, { "year": 2020, "total_attendances": 18765581, "partial": false }, { "year": 2021, "total_attendances": 22779783, "partial": false }, { "year": 2022, "total_attendances": 25175637, "partial": false }, { "year": 2023, "total_attendances": 25610769, "partial": false }, { "year": 2024, "total_attendances": 27431201, "partial": false }, { "year": 2025, "total_attendances": 27802272, "partial": false }, { "year": 2026, "total_attendances": 18940190, "partial": true } ], "note": "The 2020 drop reflects the sharp fall in attendances during the COVID-19 pandemic. Annual figures cover the calendar year January to December." }, "trusts": { "eyebrow": "By trust, August 2026", "heading": "The trusts under most pressure", "intro": "No trust with a major Type 1 emergency department met the 95% standard in August 2026. Of the 120 trusts reporting Type 1 attendances, the league table below shows the 15 under most pressure. Children's hospitals are included in the data but tend to serve a different population; all departments shown are Type 1. The worst performing trust saw 33.6% of patients within four hours.", "note": "Children's hospitals serve a substantially different population and are not directly comparable to adult major emergency departments. Smaller trusts with fewer attendances can see larger month to month swings. Figures are for August 2026 only.", "rows": [ { "name": "University Hospitals Plymouth NHS Trust", "pct_4h_type1": 33.6, "type1_attendances": 8842, "over4h_type1": 5871, "region": "NHS England South West" }, { "name": "Nottingham University Hospitals NHS Trust", "pct_4h_type1": 42.6, "type1_attendances": 12682, "over4h_type1": 7285, "region": "NHS England Midlands" }, { "name": "The Shrewsbury And Telford Hospital NHS Trust", "pct_4h_type1": 43.3, "type1_attendances": 11181, "over4h_type1": 6338, "region": "NHS England Midlands" }, { "name": "Wirral University Teaching Hospital NHS Foundation Trust", "pct_4h_type1": 43.6, "type1_attendances": 7611, "over4h_type1": 4296, "region": "NHS England North West" }, { "name": "East Kent Hospitals University NHS Foundation Trust", "pct_4h_type1": 45.3, "type1_attendances": 13068, "over4h_type1": 7142, "region": "NHS England South East" }, { "name": "Lewisham And Greenwich NHS Trust", "pct_4h_type1": 46.2, "type1_attendances": 15343, "over4h_type1": 8254, "region": "NHS England London" }, { "name": "Royal Cornwall Hospitals NHS Trust", "pct_4h_type1": 46.3, "type1_attendances": 8238, "over4h_type1": 4422, "region": "NHS England South West" }, { "name": "North Tees And Hartlepool NHS Foundation Trust", "pct_4h_type1": 46.5, "type1_attendances": 5028, "over4h_type1": 2690, "region": "NHS England North East And Yorkshire" }, { "name": "Sheffield Teaching Hospitals NHS Foundation Trust", "pct_4h_type1": 46.7, "type1_attendances": 9312, "over4h_type1": 4961, "region": "NHS England North East And Yorkshire" }, { "name": "Kingston And Richmond NHS Foundation Trust", "pct_4h_type1": 46.9, "type1_attendances": 6977, "over4h_type1": 3705, "region": "NHS England London" }, { "name": "Milton Keynes University Hospital NHS Foundation Trust", "pct_4h_type1": 47.2, "type1_attendances": 8818, "over4h_type1": 4660, "region": "NHS England East Of England" }, { "name": "Hampshire Hospitals NHS Foundation Trust", "pct_4h_type1": 47.9, "type1_attendances": 9903, "over4h_type1": 5160, "region": "NHS England South East" }, { "name": "University Hospitals Of North Midlands NHS Trust", "pct_4h_type1": 48.2, "type1_attendances": 15857, "over4h_type1": 8215, "region": "NHS England Midlands" }, { "name": "Hull University Teaching Hospitals NHS Trust", "pct_4h_type1": 48.6, "type1_attendances": 10084, "over4h_type1": 5186, "region": "NHS England North East And Yorkshire" }, { "name": "Torbay And South Devon NHS Foundation Trust", "pct_4h_type1": 48.6, "type1_attendances": 7404, "over4h_type1": 3802, "region": "NHS England South West" } ], "topPerformers": [ { "name": "Sheffield Children's NHS Foundation Trust", "pct_4h_type1": 92.3, "type1_attendances": 3874, "over4h_type1": 298, "region": "NHS England North East And Yorkshire" }, { "name": "Birmingham Women's And Children's NHS Foundation Trust", "pct_4h_type1": 92.3, "type1_attendances": 3730, "over4h_type1": 286, "region": "NHS England Midlands" }, { "name": "Alder Hey Children's NHS Foundation Trust", "pct_4h_type1": 89.4, "type1_attendances": 4626, "over4h_type1": 492, "region": "NHS England North West" }, { "name": "Calderdale And Huddersfield NHS Foundation Trust", "pct_4h_type1": 85.9, "type1_attendances": 15380, "over4h_type1": 2166, "region": "NHS England North East And Yorkshire" } ] }, "standard": { "eyebrow": "The standard", "heading": "A target set in 2004, not met in any full calendar year since 2013", "intro": "The NHS Constitution standard is that 95% of patients attending A&E should be admitted, transferred or discharged within four hours of arrival. It was introduced in 2004. England last met it in a full calendar year in 2013, measured across all department types with each year weighted by its attendances; the last single month at or above 95% was July 2015. Since 2022 the national figure has sat between 71% and 75% for all department types, and between 57% and 61% for Type 1 major departments alone. In August 2026, zero out of 120 reporting trusts with a Type 1 department met the standard.", "timeline": [ { "label": "2004", "event": "95% four hour standard introduced." }, { "label": "2013", "event": "Last full calendar year England met the 95% standard on all types performance, at 95.4% across the year. The last single month at or above 95% was July 2015." }, { "label": "2019", "event": "All types performance had fallen to 84.7%. Type 1 at 76.3%." }, { "label": "2022", "event": "Step change. All types falls to 71.1%; 12 hour trolley waits reach 348,135 for the year, from 8,272 in 2019." }, { "label": "August 2026", "event": "All types 75.0%; Type 1 61.1%. Zero trusts with a Type 1 department met the 95% standard." } ], "note": "The NHS Constitution 95% standard is the legal and constitutional measure. NHS England has at various points set lower operational recovery targets as stepping stones; these are internal planning figures and do not replace the constitutional standard. The figures on this page are measured against the 95% standard." }, "questions": { "eyebrow": "Questions this raises", "heading": "For trusts, NHS England and government", "items": [ { "q": "The 95% standard has not been met nationally in any full calendar year since 2013. Is it still the right target, and what would it take to return to it?", "a": "The data cannot settle whether the target is right; it shows how far away it is. The page records 2013 as the last full calendar year England met the standard, at 95.4 per cent across the year on the all types measure; the last single month at or above 95 per cent was July 2015. In August 2026 the all types figure was 75.0 per cent and the Type 1 figure 61.1 per cent, and in every full year since 2022 the all types figure has sat between 71 and 75 per cent. NHS England has set lower operational recovery targets as stepping stones, but this page measures against the constitutional 95 per cent." }, { "q": "Twelve hour trolley waits have grown from 129 in 2011 to 554,044 in 2025. How much of this is emergency department capacity, how much is bed availability upstream, and how much is social care discharge downstream?", "a": "The published series does not split the causes, so the page cannot apportion them. What it shows is the scale and the timing: 129 waits of more than 12 hours from decision to admit in 2011, 554,044 in 2025, and 44,951 in August 2026 alone. The step change came between 2021 and 2022, when the annual count went from 48,626 to 348,135, and the monthly figures confirm it was not an artefact. Because the measure runs from a clinical decision to admit to the point the patient leaves the department, it records the wait for a bed once the department has decided one is needed, which is where the three causes in the question meet; the data itself cannot separate them." }, { "q": "Performance varies from 33.6% to 92.3% across Type 1 trusts in a single month. What are the best performing non specialist trusts doing that others could adopt?", "a": "The data shows the spread but not the practice behind it. In August 2026, University Hospitals Plymouth NHS Trust saw 33.6 per cent of Type 1 patients within four hours and Sheffield Children's NHS Foundation Trust saw 92.3 per cent. The non specialist trusts at the top of the table were Calderdale And Huddersfield NHS Foundation Trust at 85.9 per cent. A single month at trust level can swing more than the national figure, so these positions are a snapshot rather than a ranking, and the series records outcomes, not how each trust achieved them." }, { "q": "Total attendances have risen by around 30% since 2011. How much is demand driven and how much reflects patients attending A&E because they cannot access primary care or urgent treatment centres?", "a": "The attendance count does not record why people came, so the split cannot be read from it. It shows 21,420,766 attendances in 2011 and 28,324,863 in the 12 months to August 2026, with August 2026 itself at 2,342,959, up 3.4 per cent on August 2025. The rise is not smooth: 2020 fell to 18,765,581 during the pandemic before demand recovered and, by 2025, passed its 2019 level of 25,636,826. Whether the growth reflects need, access elsewhere or both would need data on why patients attended, which this series does not carry." }, { "q": "Children's hospital trusts consistently outperform adult departments. Is their patient mix, staffing model, or flow management doing something that adult departments cannot replicate?", "a": "The figures show the gap but not its cause. In August 2026 Sheffield Children's NHS Foundation Trust saw 92.3 per cent, Birmingham Women's And Children's NHS Foundation Trust 92.3 per cent and Alder Hey Children's NHS Foundation Trust 89.4 per cent of Type 1 patients within four hours, against 61.1 per cent for Type 1 departments nationally. The page's own caveat is that children's hospitals serve a substantially different patient mix and are not directly comparable with adult major emergency departments, so the data cannot say how much of the difference is the population they see and how much is how they run. The non specialist trusts beside them at the top of the table, Calderdale And Huddersfield NHS Foundation Trust at 85.9 per cent, show that adult departments can post figures in the same range in a given month." } ] }, "sources": [ { "name": "NHS England, A&E Attendances and Emergency Admissions Monthly Statistics, August 2026", "licence": "Open Government Licence v3.0", "url": "https://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting-times-and-activity/ae-attendances-and-emergency-admissions-2026-27/" }, { "name": "NHS England, Monthly A&E Time Series August 2026 (XLS)", "licence": "Open Government Licence v3.0", "url": "https://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2026/09/Monthly-AE-Time-Series-August-2026-YG43sd.xls" }, { "name": "NHS England, A&E attendances by provider, August 2026 (XLS)", "licence": "Open Government Licence v3.0", "url": "https://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2026/09/August-26-AE-by-provider-r5ic5.xls" }, { "name": "NHS England, Statistical Commentary August 2026 (PDF)", "licence": "Open Government Licence v3.0", "url": "https://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2026/09/Statistical-commentary-August-2026-WE76sa.pdf" } ], "caveats": [ "Annual percentages are attendance weighted: a year is total attendances seen within four hours divided by total attendances that year. Earlier editions of this page averaged the year's monthly percentages instead, which gives a quiet month the same weight as a busy one. Weighted and averaged agree to within 0.1 percentage points in 13 of the 15 full years and differ by more only in 2020 and 2021, when attendances moved sharply month to month: 2020 reads 86.4% weighted against 86.9% averaged.", "The NHS Constitution standard is that 95% of patients are admitted, transferred or discharged within four hours of arrival. This is distinct from any internal operational or recovery targets NHS England may set.", "The four hour standard covers all A&E attendances at the reporting trust. Type 1 figures cover major emergency departments only; Type 2 covers single specialty units; Type 3 covers other units and minor injury units.", "The 12 hour wait figure is the decision to admit measure only: the time from a clinical decision to admit the patient to the point they leave the department. This is the NHS Constitution measure and does not include patients who waited 12 hours without a decision to admit.", "From May 2019 to June 2023, 14 Clinical Review of Standard field testing trusts submitted attendance figures but not four hour performance figures. This affects the cohort used for performance calculations during that period and introduces a discontinuity when those trusts were reintroduced in June 2023.", "Trust level figures are for August 2026 only and can show larger month to month variation than the national aggregate. Single month trust comparisons should be read with that in mind.", "Children's hospital trusts (Alder Hey, Birmingham Women's and Children's NHS Foundation Trust, Sheffield Children's NHS Foundation Trust) serve a substantially different patient mix and are not directly comparable to general adult major emergency departments.", "The 2012 annual 12 hour wait total (37) is lower than both 2011 and 2013. The published monthly series carries zero returns for April, May and October 2012, so the annual total should be treated as a lower bound for that year. The series also shows a zero return for May 2013.", "Contains public sector information licensed under the Open Government Licence v3.0." ] }