Attendances at accident and emergency departments in England fell from 25.0m in 2019-20 to 17.4m in 2020-21, a drop of 30.3%1, new NHS Digital figures show.

This bucks the recent year-on-year trend of rising attendances for every year prior since at least 2011-12.

NHS Digital's Hospital Accident and Emergency Activity 2020/21 also shows that the sharpest falls were seen in April-June 2020 and December 2020-February 20212, as well as in attendances at minor injury units and walk in centres.

The report, created in partnership with NHS England and NHS Improvement, brings together data from three sources:

: Newly published annual data for the first time from NHS Digital's Emergency Care Dataset (ECDS)5

:Previously published data from NHS England and NHS Improvement's A&E Attendances and Emergency Admissions Monthly Situation Reports (MSitAE).

It includes attendances from all types of accident and emergency departments ranging from major A&E departments and single specialty, consultant-led emergency departments to minor injury units and walk-in centres.

The report also includes breakdowns by providers and demographics such as gender, ethnicity, age and deprivation, as well as a Home Nations comparison.

Other ECDS/HES data in the report also shows:

Age

In 2020-21, there was a drop in attendances for all age groups. In this, the sharpest drop was seen in those aged 24 years and under.

Within specific age bands, the proportion of overall attendances for those aged 0-24 years decreased by 5.2 percentage points from 32.1% in 2019-20 to 26.9% in 2020-21. Conversely, the proportion for those aged 25 years and older increased from 66.0% in 2019-20 to 73.1% in 2020-21, even though the total number of attendances dropped for this age group.

Deprivation

People residing in the most deprived 10% of areas accounted for 2.2m attendances, twice as many compared with those residing in the least deprived 10% of areas (1.1m attendances). This is in line with similar proportions reported in recent years.

Activity

Monday is the busiest day of the week, accounting for 16% of all attendances during 2020-21 (2.6m attendances). The most popular time of arrival on a Monday is between 11am and 1pm, accounting for 15% of attendances on this day (379,000 attendances).

The number of reattendances10 to A&E within 7 days was 1.4 million and accounted for 10.4% of all reported attendances, an increase of 1.7 percentage points on 2019-20 (8.7% of all reported attendances).

The number of attendances spending over 12 hours in A&E was 303,000 in 2020-21. This is a 42.1% decrease since 2019-20 (523,000) and an 8.2% decrease since 2018-19 (330,000 attendances). The proportion of total attendances spending over 12 hours in A&E in 2020-21 was 1.87%, (compared to 2.33% in 2019-20 and 1.49% in 2018-19). This measures the entire duration of stay in A&E11.

MSitAE data in the report shows:

From 2011-12 to 2019-20, the percentage of A&E attendances who are admitted to hospital rose steadily from 17.1% to 19.3%. This percentage increased to 23.8% for 2020-21.

The percentage of attendances spending four hours or less in A&E rose from 84.2% in 2019-20 to 86.8% in 2020-2112.

The number of attendances fell for both major A&E departments and minor injury units/walk in centres. Attendances at major A&E departments fell 22.8% from 16.4m in 2019-20 to 12.6m in 2020-21, and minor injury units/walk in centres fell 44.6% from 8.6m in 2019-20 to 4.8m in 2020-21.