In November and December 2019, NHS performance metrics showed a decrease in A&E performance against the 4-hour target, with more patients experiencing longer waits. The percentage of cancer patients starting treatment within the target time also declined, while the number of patients waiting over 36 weeks for treatment increased. Conversely, delayed transfers of care decreased, indicating some improvement in patient flow within the healthcare system.

1. NHS Activity &
Performance Summary
November/December
2019
23 January 2020

2. A&E performance against the 4
hour target decreased this month,
and more patients spent longer
than 12 hours in A&E. The number of patients
waiting over 8 weeks
for diagnostic tests was
similar, but the number
waiting over 14 weeks
for therapy services
decreased.
The percentage of patients waiting less
than 26 weeks from referral to treatment
decreased and the number waiting
longer than 36 weeks increased.
The average number
of daily referrals
received decreased
over the month.
The percentage of cancer
patients starting treatment within
the target time decreased for
patients on both the urgent and
not via urgent pathways.
Average daily calls
to the ambulance
service increased
from last month;
the target was not
met for the second
time since the
clinical response
model was
introduced.
The number of
delayed
transfers of care
decreased this
month.

3. 80.5% of patients
newly diagnosed with cancer
via the Urgent route started
treatment within target time
(62 days), down 0.9
percentage points from
October.
94.7% of patients
newly diagnosed with cancer
not via the Urgent route
started treatment within
target time (31 days), down
2.2 percentage points from
October.
NHS Cancer Waiting Times
November
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Apr-12 Apr-13 Apr-14 Apr-15 Apr-16 Apr-17 Apr-18 Apr-19
Percentageofpatients
Percentage of patients starting treatment
within the target times
Not via Urgent suspected route
Urgent Suspected route
Source: Cancer waiting times data, Welsh Local Health Boards

4. 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Sep-
11
Mar-
12
Sep-
12
Mar-
13
Sep-
13
Mar-
14
Sep-
14
Mar-
15
Sep-
15
Mar-
16
Sep-
16
Mar-
17
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17
Mar-
18
Sep-
18
Mar-
19
Sep-
19
PercentageofPatientPathways
Waiting less than 36 weeks Waiting less than 26 weeks
Patient pathways waiting to start treatment
Source: Referral to treatment times, NHS Wales Informatics Services (NWIS)
84.7% of patient
pathways waiting to start
treatment in November
had been waiting less
than 26 weeks, 0.1
percentage points less
than October.
Referral to Treatment Times
November
22,879 patient
pathways had been
waiting over 36 weeks to
start treatment in
November, an increase of
1,734 since October.

5. 0
5,000
10,000
15,000
20,000
25,000
30,000
Oct-09 Oct-10 Oct-11 Oct-12 Oct-13 Oct-14 Oct-15 Oct-16 Oct-17 Oct-18 Oct-19
Numberofpatients
Diagnostics waiting over 8 weeks
Therapies waiting over 14 weeks
Source: Diagnostic and therapy services waiting times, NHS Wales Informatics Service
Number of patients waiting over the standard time for
diagnostic and therapy services
287 people were
waiting over 14 weeks
for therapy services in
November, a decrease
of 95 compared to
October.
NHS diagnostic and therapy service waiting times
November
3,883 patients were
waiting over 8 weeks for
diagnostic tests in
November, this is similar
to October (up 2 patients).

6. 0
10
20
30
40
50
60
70
80
90
100
Apr-12
Jul-12
Oct-12
Jan-13
Apr-13
Jul-13
Oct-13
Jan-14
Apr-14
Jul-14
Oct-14
Jan-15
Apr-15
Jul-15
Oct-15
Jan-16
Apr-16
Jul-16
Oct-16
Jan-17
Apr-17
Jul-17
Oct-17
Jan-18
Apr-18
Jul-18
Oct-18
Jan-19
Apr-19
Jul-19
Oct-19
Percentofpatients
Time spent in NHS accident and emergency
departments
Under 12 hours
Under 4 hours
Source: Emergency Department Data Set (EDDS)
Time spent in NHS accident and emergency departments
December
6,656 patients
spent 12 hours or
more in A&E in
December, 766 more
than in November.
72.1% of
patients spent less
than 4 hours in A&E
in December, 2.3
percentage points less
than in November.

7. Delayed Transfers of Care
December
454 delayed
transfers of care
were reported in the
December 2019
census, down from
513 in November
2019.
0
100
200
300
400
500
600
700
800
900
'05 '06 '07 '08 '09 '10 '11 '12 '13 '14 '15 '16 '17 '18 '19
Delayed Transfers of Care: October 2004 to December
2019
Delays
Last 3 months average
Source: Delayed transfers of care database, NHS Wales Informatics Services (NWIS)
NOTE: an increase in October 2009 was probably partly due to revised procedures

8. Ambulance services
December
The percentage of red calls arriving at the
scene within 8 minutes in December 2019
was up from the previous month but below the
65% target for the second time.
Please see note on the next page.
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Dec'15
Jan'16
Feb'16
Mar'16
Apr'16
May'16
Jun'16
Jul'16
Aug'16
Sep'16
Oct'16
Nov'16
Dec'16
Jan'17
Feb'17
Mar'17
Apr'17
May'17
Jun'17
Jul'17
Aug'17
Sep'17
Oct'17
Nov'17
Dec'17
Jan'18
Feb'18
Mar'18
Apr'18
May'18
Jun'18
Jul'18
Aug'18
Sep'18
Oct'18
Nov'18
Dec'18
Jan'19
Feb'19
Mar'19
Apr'19
May'19
Jun'19
Jul'19
Aug'19
Sep'19
Oct'19
Nov'19
Nov'19
Percentage
Red calls - % of emergency responses arriving at the
scene within 8 minutes
Source: Welsh Ambulance Services NHS Trust

9. Ambulance services
Ambulance response times
As part of the continual review of the clinical response model, the Welsh
Ambulance Service regularly reviews call handling practices and the
categorisation of incidents. An update to call handling practices in summer
2019 appears to have resulted in an increased Red incident volume. Further
work is being undertaken to understand this change. Therefore, it is not
possible to compare red incident volumes in recent months at present.
Increases in red incident volumes may also impact on performance due to the
additional resources required to attend a red incident.

10. Web Links
NHS Cancer Waiting Times
NHS activity and performance summary dashboard
StatsWales
Annual publication
Referral to Treatment Times
NHS activity and performance summary dashboard
StatsWales
Annual publication
NHS diagnostic and therapy service waiting
times
NHS activity and performance summary dashboard
StatsWales
Annual publication
Ambulance services
NHS activity and performance summary dashboard
StatsWales
Annual publication
Delayed Transfers of Care
NHS activity and performance summary dashboard
StatsWales
Annual publication
Time spent in NHS accident and emergency
departments
NHS activity and performance summary dashboard
StatsWales
Annual publication
Further information
Contact: stats.healthinfo@gov.wales