health · the national record
A&E waiting times in England
Every major emergency department in England has now missed the four hour standard for years. In May 2026, 75.7% of all attendances were seen within four hours across all department types, against the 95% NHS Constitution standard. For Type 1 major A&E departments the figure was 61.9%. Not a single one of the 121 reporting trusts with a Type 1 department met the standard in that month. This page traces how England reached this point, from 97% in 2010 to where it stands now.
How to read this
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.
National figures are from the Monthly A&E Time Series covering August 2010 to May 2026, published 11 June 2026. Trust level figures are from the May 2026 provider CSV, same publication. All figures match the published Statistical Commentary for May 2026.
The four hour standard
From 97% to fewer than two thirds in Type 1
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 71.2%. Not one trust with a major emergency department met the standard in May 2026.
Annual figures are averages of monthly performance percentages. 2010 covers August to December only; 2026 covers January to May only. The standard has not been met nationally in any full year since 2015.
Trolley waits
12 hour waits: from dozens to half a million
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, across all of England, it happened 130 times in the whole year. In 2025 it happened 554,044 times, over four thousand times a day on average. In a single month, May 2026, there were 50,212 such waits.
The decision to admit 12 hour wait is the NHS Constitution measure. 2010 and 2026 are part years. The jump from 2021 to 2022 is not an artefact: the monthly figures confirm a step change from roughly 12,000 in December 2021 to over 16,000 in January 2022, rising to over 54,000 by December 2022. Note: the 2012 figure is lower than 2011 and 2013; this appears to reflect months with zero or null returns in the published data and should be treated with caution.
Demand
More than 28 million attendances in the latest 12 months
Total A&E attendances in May 2026 were 2,457,398, up 2.5% on May 2025. Across the 12 months to May 2026, there were 28,083,802 attendances. By comparison, in 2011 there were around 21.4 million across the full year. Demand has risen by roughly a third over 15 years, while performance has dropped by around 35 percentage points on the all types measure.
The 2020 drop reflects the sharp fall in attendances during the COVID-19 pandemic. Annual figures cover the calendar year January to December.
By trust, May 2026
The trusts under most pressure
No trust with a major Type 1 emergency department met the 95% standard in May 2026. The league table below ranks all 122 trusts reporting Type 1 attendances by their four hour performance in that month. 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 fewer than four in ten patients within four hours.
Worst performing trusts (four hour rate, Type 1, May 2026)
Children's hospital trusts (Alder Hey, Birmingham Women's and Children's, Sheffield Children's) serve a different patient 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 May 2026 only.
Best performing trusts (four hour rate, Type 1, May 2026)
The standard
A target set in 2004, unmet in any calendar year since 2015
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 on a full calendar year basis in 2014. Since 2022 the national figure has been stuck between 71% and 75% for all department types, and between 57% and 61% for Type 1 major departments alone. In May 2026, zero out of 121 reporting trusts with a Type 1 department met the standard.
- 2004
95% four hour standard introduced.
- 2014
Last year England met the 95% standard nationally on all types performance (94.4% average; the standard was met in some individual months).
- 2019
All types performance had fallen to 84.7%. Type 1 at 76.3%.
- 2022
Step change. All types falls to 71.2%; 12 hour trolley waits reach 348,135 for the year, from 8,272 in 2019.
- May 2026
All types 75.7%; Type 1 61.9%. Zero trusts meet the 95% standard. 50,212 trolley waits in a single month.
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 this raises
For trusts, NHS England and government
- 1.
The 95% standard has not been met nationally since 2014. Is it still the right target, and what would it take to return to it?
- 2.
Twelve hour trolley waits have grown from around 130 in 2011 to over half a million in 2025. How much of this is emergency department capacity, how much is bed availability upstream, and how much is social care discharge downstream?
- 3.
Performance varies from 36% to 94% across Type 1 trusts in a single month. What are the best performing non specialist trusts doing that others could adopt?
- 4.
Total attendances have risen by roughly a third 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?
- 5.
Children's hospital trusts consistently outperform adult departments. Is their patient mix, staffing model, or flow management doing something that adult departments cannot replicate?
Sources & method
Data provenance
- NHS England, A&E Attendances and Emergency Admissions Monthly Statistics, May 2026 ↗· Open Government Licence v3.0
- NHS England, Monthly A&E Time Series May 2026 (XLS) ↗· Open Government Licence v3.0
- NHS England, Statistical Commentary May 2026 (PDF) ↗· Open Government Licence v3.0
Caveats & data notes
- 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 May 2026 only and can show larger month to month variation than the national aggregate. Single month trust comparisons should be treated with caution.
- 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. Inspection of the monthly series shows two null return months (April and May 2012) and a further null in October 2012. The annual total should be treated as a lower bound for that year.
- Contains public sector information licensed under the Open Government Licence v3.0.
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