Altnagelvin ED fails to meet 12-hour treatment target

In March 2025, 2,430 of the 5,038 patients who presented at Altnagelvin Area Hospital’s Emergency Department (ED) waited more than 12 hours before receiving medical treatment.

In the same month, 95% of patients admitted to hospital waited 91 hours and 47 minutes in the ED, and 95% of those discharged home from the ED waited 22 hours and 55 minutes.

These figures were revealed in ‘Urgent and Emergency Care Waiting Time Statistics for Northern Ireland (January - March 2025)’.

Published by the Department of Helth (DoH) on April 24, it reported on the performance of emergency departments against the DoH ministerial target, including additional information on a number of clinical quality indicators set by the DoH.

Altnagelvin Emergency Department (ED) is classed as Type 1 - a consultant-led, 24-hour service with full resuscitation facilities and designated accommodation for the reception of emergency care patients.

In terms of emergency care activity, the total number of people presenting at Altnagelvin ED fell by 591 between March 2024 (5,629) and March 2025 (5,038). These figures included new and unplanned review attendances.

An unplanned review attendance to ED is a visit that is not anticipated or scheduled, typically because the patient’s condition has worsened or a new concern has arisen.

The DoH targets on emergency care waiting times in the North state: “95% of patients attending any Type 1, 2 or 3 emergency department are either treated and discharged home, or admitted, within four hours of their arrival in the department; and no patient attending any emergency department should wait longer than twelve hours,” and “at least 80% of patients to have commenced treatment, following triage, within two hours”.

In March 2024, of the 5,629 patients who presented at Altnagelvin ED, 1,677 waited four hours for treatment and 1,372 waited 12 hours, leaving 2,580 waiting longer than 12 hours.

In March 2025, of the 5,038 patients who presented, 1,435 waited four hours for treatment and 1,173 waited 12 hours, leaving 2,430 waiting longer than 12 hours.

In fact, none of the comparable EDs across the North achieved the Department of Health’s (DoH) 12-hour target during March 2025.

Upon arrival at an ED, a health-care professional will assign patients one of five levels on the Manchester Triage Scale (MTS), which act as a guide for the time to the start of treatment.

These are: Level 1, immediate, 0 minutes waiting time; Level 2, very urgent, 10 minutes waiting time; Level 3, urgent, 60 minutes waiting time; Level 4, standard, 120 minutes waiting time; and Level 5, non-urgent, 240 minutes waiting time.

In Altnagelvin ED the number of patients assigned a Level 1 / 2 MTS increased by 3.7% from 36.4% in March 2024 to 40.1% in March 2025. However, Level 3 MTSs fell by 1.3% and Level 4 / 5 MTSs fell by 2.4% for the same two months.

During March 2025, Altnagelvin ED had the highest proportion of patients triaged at level 1 / 2 in the North.

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In terms of performance against the target to commence treatment within two hours of triage, Altnagelvin ED achieved: 53.1% in March 2024; 52.2% in January 2025; 48.6% in February 2025; and 51.8% in March 2025.

None of the EDs in the North achieved the 80% target in March 2025.

Regarding the time from triage to a patient starting treatment, in March 2025 the maximum length of time 95% of the patients presenting at Altnagelvin ED had to wait from triage to the start of their treatment was five hours and 45 minutes. In March 2024 this was five hours and 10 minutes.