This mornings TV took some time, along with fancy graphics, to outline how the NHS waiting times had increased.   The specific figure they presented being the percentage of patients at A&E who were seen within 4 hours.   This seems like a reasonable statistic to use from the perspective of a patient as it suggests the likelihood that should I need to turn up at A&E I would be seen in 4 hours of less.   I suspect the fact that it is so potential meaningful for prospective patients, the average TV viewer, is why they picked this statistic over others.

The issue with this is what it doesn’t tell us the additional context which may be important in interpreting the figures.    Over the period under consideration did the number of patients attending A&E remain static or did they in fact increase which may be a contributing factor to increased waiting times?     A briefing report by Carl Baker from November 2016 suggested that in 2016 the number of A&E patients at major A&E departments increased 6.3% over attendance levels in 2015.   Were there any changes in the demographics of patients attending A&E as an increase in elderly people attending may mean that patients are less likely to be able to be quickly seen and discharged, again contributing to increased waiting times.    What about the staffing levels of A&E over the period?   Did this change as a reduction in staffing may account for increased waiting times?   Also the figures look specifically at average data for the whole of England; were there any regional variations?   Personally I live in the South West and feel that it is difficult to access a doctor which may mean that I would attend A&E on occasions where someone with more ready access to a GP would not.    Are there also differences between A&Es serving urban and rural areas?   Are there differences between A&Es serving large versus those serving smaller populations or population densities?

In the current performance indicator and accountability led environment we often focus on specific figures such the percentage of patients seen in 4 hours or the number of pupils achieving A*-C or Progress 8, PISA, EMSA, TIMMS, PIPS or other measures.    Each of these pieces of data is informative and tells us something however equally there are a lot of things that it doesn’t tell us.    We need to ask what doesn’t this data tell us and seek data to add context.

Only with context is data useful.

Accident and Emergency Statistics: Demand, Performance and Pressure, C Baker (2016), House of Commons Briefing Library (6964)