NHS data sources
Plain English Data uses publicly available data published by NHS England to help people understand how NHS services are performing in their area. All data is published under the Open Government Licence v3.0 and is free to use.
This page explains where our data comes from, how we process it, and what it does and doesn't tell you.
We are not affiliated with, endorsed by, or connected to NHS England, the Department of Health and Social Care, or any NHS trust or organisation. This is an independent project that uses publicly available open data.
A&E performance against the 4 hour wait target
What we show
How each NHS trust's A&E department performs against the standard that patients should be admitted, transferred, or discharged within 4 hours of arrival. You can see how each hospital trust compares to the national average and how performance has changed over time.
The chart shows both the percentage of patients seen within 4 hours (as lines) and the absolute number of attendances (as stacked bars). The green portion of each bar represents patients seen within target; the red portion represents those who waited longer. This helps you see both the proportion and the scale — a trust seeing 50,000 patients a month has a very different challenge to one seeing 10,000, even if their percentages are similar.
Where the data comes from
The data comes from the Monthly A&E Attendances and Emergency Admissions collection (known as MSitAE), published by NHS England. It is collected from NHS trusts, NHS foundation trusts, and independent sector organisations via the Strategic Data Collection Service (SDCS).
NHS England publishes this data monthly, typically on the second Thursday of each month, covering the previous calendar month. We update our data within a week of each publication.
Source: NHS England — A&E Waiting Times and Activity
What's included
The data covers all types of A&E department:
- Type 1: Major A&E departments — consultant-led, open 24 hours. This is what most people think of as "A&E."
- Type 2: Single-specialty A&E departments, such as eye hospitals.
- Type 3: Other A&E units, minor injury units, walk-in centres, and urgent care centres.
Our headline percentage ("% seen within 4 hours") uses the "all types" figure, which combines all three types. This gives the overall picture but tends to look better than Type 1 alone, because minor units (Type 3) typically see patients much faster.
What the data doesn't tell you
- It's at trust level, not individual hospital level. A trust like "Mid and South Essex NHS Foundation Trust" operates multiple hospital sites. The data is an average across all sites within that trust. From November 2025, NHS England has started publishing site-level data through the ECDS supplementary analysis, which we may incorporate in future.
- It doesn't tell you how long individuals waited. The 4-hour figure is a threshold: what percentage were seen within 4 hours. It doesn't show the distribution — whether most people over 4 hours waited 4 hours 15 minutes or 12 hours.
- Seasonal patterns are normal. Performance drops every winter (December–February) as demand rises and more complex cases present. A hospital showing a dip in January isn't necessarily declining — it may be following the same seasonal pattern as every other hospital.
- The 95% target hasn't been met nationally since 2013–14. In 2022, an interim target of 76% was introduced (later revised to 78%). When we describe a trust as "above" or "below" average, we mean the current England average — not the 95% standard.
Data quality notes
- Between May 2019 and May 2023, fourteen NHS trusts were excluded from 4-hour performance reporting because they were field-testing new emergency care standards. Data for these trusts during this period is either missing or not comparable. We show a gap in the chart for these trusts during the affected period.
- Some months' data gets revised after initial publication. We use the latest available version of each month's data.
- Minor injury units and walk-in centres that report zero attendances in a given month are still included in the dataset.
How we generate the summary sentence
The "short version" sentence on each trust's page is generated automatically from the data. It:
- Converts the percentage into a natural fraction where possible (e.g. 75% becomes "about 3 in 4")
- Compares the trust's latest month to the England average for the same month
- Calculates the trend over the last 3 months
- Describes whether performance is improving, declining, or stable
No editorial judgment is applied. The sentences are factual descriptions of the numbers.
Licensing
All NHS data used on this site is published under the Open Government Licence v3.0 (OGL).
Under the OGL, we are free to copy, adapt, and republish this data, including for commercial purposes, provided we acknowledge the source.
Attribution: Contains public sector information licensed under the Open Government Licence v3.0.
Questions or corrections
If you believe any data on this site is being displayed incorrectly, or if you have questions about our methodology, please get in touch.
For questions about the underlying data itself, contact NHS England's A&E data team at [email protected].