More than 139,000 patients waited over 12 hours in NI emergency departments as A&E performance worsened

Northern Ireland’s emergency care system came under even greater pressure during the past year, with official figures showing hospitals treated almost 19,000 more emergency patients than the previous year while performance against key emergency care targets continued to deteriorate.

The latest Northern Ireland Hospital Statistics: Urgent and Emergency Care (2025/26) reveal emergency department attendances increased again, four-hour performance declined, the number of patients waiting more than 12 hours reached its highest level in the five-year trend presented by the report, and the Northern Ireland Ambulance Service failed to meet its most urgent Category 1 response targets in any month of the year.

For patients across Ballymena, Mid and East Antrim and the wider Northern Trust area who rely on Northern Ireland’s consultant-led emergency departments, the figures point to a health service continuing to face increasing demand while moving further away from key waiting time standards.

Emergency departments treated almost 19,000 more patients

During the year ending 31 March 2026, 820,443 people attended emergency departments across Northern Ireland.

That was an increase of 18,974 patients (2.4%) compared with 801,469 attendances in 2024/25.

Of the total attendances:

• 752,960 (91.8%) were new attendances.

• 51,384 (6.3%) were unplanned review attendances.

• 16,099 (2.0%) attended Craigavon and Daisy Hill Urgent Care Centres, where a detailed attendance breakdown was not available.

Despite treating significantly more patients, overall performance against the four-hour emergency department standard fell.

Across all emergency departments, 43.3% of patients were treated and discharged, or admitted, within four hours, compared with 45.7% during the previous year.

In other words, fewer than half of patients completed their emergency department journey within four hours.

Consultant-led emergency departments continue to face the greatest challenge

The statistics highlight the stark contrast between Northern Ireland’s main hospital emergency departments and smaller urgent care settings.

Across Type 1 emergency departments—consultant-led, 24-hour hospital emergency departments with full resuscitation facilities—just 32.5% of new and unplanned review attendances were completed within four hours.

By comparison, 84.0% of patients attending Type 3 departments, which include urgent treatment centres and minor injury units, completed their care within the same timeframe.

The figures illustrate the significantly greater pressure being experienced within Northern Ireland’s main emergency departments.

More than one in every six patients spent over 12 hours in A&E

One of the report’s most significant findings is the continued increase in the number of patients experiencing the longest waits.

During 2025/26, 139,108 patients spent more than 12 hours in an emergency department before being admitted to hospital or discharged home.

That represents 17.3% of all new and unplanned review attendances—meaning more than one in every six patients waited over 12 hours.

The figure increased from 133,285 during 2024/25.

The report also found that 57.5% of patients began treatment within two hours of being triaged.

Five-year trends show pressures continuing to build

The longer-term data included in the report shows emergency care pressures have continued to grow over recent years.

Between 2021/22 and 2025/26:

• Emergency department attendances increased by 71,861 (9.6%), rising from 748,582 to 820,443.

• Performance against the four-hour standard declined from 54.8% to 43.3%.

• The number of patients waiting longer than 12 hours increased from 78,969 (10.9%) to 139,108 (17.3%).

• The proportion of emergency department attendances referred by a GP fell from 15.3% to 12.4%.

Taken together, the figures show emergency departments are treating more patients while a smaller proportion complete their care within the four-hour standard and a growing number experience waits exceeding 12 hours.

Most Phone First callers were still referred to emergency departments

The report also provides an insight into demand for the Phone First service.

During 2025/26:

• 178,846 calls were received.

• 117,003 (65.4%) callers were referred to an emergency department.

• 61,843 callers were not referred to an emergency department.

The figures show that almost two-thirds of people using the service were still advised to attend an emergency department following clinical assessment.

Category 1 ambulance response targets missed throughout the year

The annual statistics also highlight continued pressure on the Northern Ireland Ambulance Service.

The report states that the Category 1 response targets for the most immediately life-threatening emergencies were not achieved in any month during 2025/26.

Neither the average response time target of eight minutes nor the 90th percentile target of 15 minutes was met at any point during the year.

However, the report found that Category 1T response targets were achieved in every month, with both the average response target of 19 minutes and the 90th percentile target of 30 minutes being met throughout the year.

What the ambulance response categories mean

The statistics are based on the Northern Ireland Ambulance Service’s emergency response categories, which prioritise patients according to the severity of their condition.

The highest priority is Category 1, covering 999 calls involving immediately life-threatening emergencies, where the target is an average response time of eight minutes, with 90% of calls reached within 15 minutes. The report found these targets were not achieved in any month during 2025/26.

A separate Category 1 – Transport category also covers immediately life-threatening incidents where specialist transport is required. The target is an average response time of 19 minutes, with 90% of patients reached within 30 minutes, and the report states these targets were achieved in every month of the year.

Other emergency calls are prioritised according to clinical urgency.

Category 2 covers potentially serious 999 emergencies, with response targets of 18 minutes on average and 40 minutes for 90% of incidents.

Category 3 relates to urgent problems, with a target for 90% of patients to be reached within 120 minutes, while Category 4 covers less urgent problems, where the target is 180 minutes for 90% of calls.

How Northern Ireland’s emergency care system is structured

The publication explains that Northern Ireland’s emergency care network comprises three categories of emergency department.

Type 1 departments are consultant-led, 24-hour emergency departments with full resuscitation facilities for patients requiring the highest level of emergency care.

The report notes there are currently no Type 2 emergency departments operating in Northern Ireland.

Type 3 departments include urgent treatment centres and minor injury units, providing treatment for minor injuries and illnesses that can be accessed without an appointment.

Growing demand continues to test emergency care services

The latest figures show emergency departments across Northern Ireland are continuing to manage rising numbers of patients while performance against key waiting time measures remains under sustained pressure.

Compared with a year earlier, hospitals treated almost 19,000 additional emergency patients, four-hour performance declined, more than 139,000 people waited longer than 12 hours, and the most urgent ambulance response targets were not achieved during any month of the reporting year.

The Northern Ireland Hospital Statistics: Urgent and Emergency Care (2025/26) publication is the first in this year’s Hospital Statistics series, with inpatient and outpatient activity reports due to follow in the coming months.

The full statistical publication is available on the Department of Health website at: https://www.health-ni.gov.uk/articles/emergency-care-and-ambulance-statistics