Overall ratings for each of the three major care settings are below average in the Midlands and East of England
| NHS region |
Care homes |
NHS acute hospitals |
GPs |
| East of England |
79% |
33% |
93% |
| London |
85% |
45% |
94% |
| Midlands |
76% |
45% |
95% |
| North East and Yorkshire |
82% |
57% |
97% |
| North West |
79% |
66% |
96% |
| South East |
83% |
76% |
94% |
| South West |
87% |
69% |
96% |
| England |
81% |
57% |
95% |
Table showing percentages of services in each NHS region with an overall rating of good or outstanding on 8 March 2023. Figures do not include trust-level ratings.
The Midlands has the lowest proportion of care homes rated Good or Outstanding in the country and the second lowest overall GP ratings.
Overall ratings for care homes, NHS acute hospitals and GP practices were all above the England average in the South West.
There is significant regional variation in ambulance handover times
Over a quarter of people had to wait more than 60 minutes for an ambulance handover in the South West in January 2023, compared to only 2% in the South East.
| NHS region |
Percentage |
| South West |
26.2% |
| East of England |
18.6% |
| Midlands |
11.2% |
| London |
8.6% |
| North East and Yorkshire |
7.7% |
| North West |
7.6% |
| South East |
2.1% |
| England |
10.4% |
Table showing percentage of ambulance handovers that were delayed by over an hour in each NHS region. Source: NHS England urgent and emergency care data.
- Although the South West has some of the highest ratings in the country, in January 2023 they had the highest proportion of ambulances waiting for over an hour to handover patients at hospitals.
- The East of England had some of the lowest ratings for acute hospitals, and the second worst performance for ambulance handovers delayed over an hour.
- Does it mean that people who use these services have a greater risk of experiencing poor outcomes?
- Of the 5 trusts with highest proportion of ambulance handovers over 60 minutes, 4 were in the South West.
The London region had some of the lowest conversion of A&E attendances to emergency admissions in the country
| Region |
Integrated care board |
Percentage |
| East of England |
NHS Mid and South Essex |
30% |
| South West |
NHS Dorset |
27% |
| South East |
NHS Buckinghamshire, Oxfordshire and Berkshire West |
26% |
| South West |
NHS Bristol, North Somerset and South Gloucestershire |
26% |
| North East and Yorkshire |
NHS South Yorkshire |
24% |
| England median |
20% |
Table showing highest five integrated care board areas for the proportion of A&E attendances that became emergency admissions in January 2023. Source: NHS England emergency admissions data.
| Region |
Integrated care board |
Percentage |
| London |
NHS South East London |
14% |
| Midlands |
NHS Derby and Derbyshire |
14% |
| London |
NHS North East London |
14% |
| South West |
NHS Cornwall and The Isles of Scilly |
14% |
| London |
NHS North Central London |
11% |
| England median |
20% |
Table showing lowest five integrated care board areas for the proportion of A&E attendances that became emergency admissions in January 2023. Source: NHS England emergency admissions data.
In the East of England, the NHS Mid and South Essex Integrated Care Board admitted 30% of all the patients who arrived at hospital via A&E in January. High proportions of these 'conversions' might be because of relatively high severity of illness or injury, or possibly a lack of alternative interventions.
Of those admitted to hospital from A&E, the time taken varied hugely from the decision to admit them to the moment they secured a bed
| Region |
Integrated care board |
Percentage |
| East of England |
NHS Mid and South Essex |
0% |
| East of England |
NHS Bedfordshire, Luton and Milton Keynes |
1% |
| South East |
NHS Hampshire and Isle of Wight |
1% |
| South East |
NHS Frimley |
2% |
| Midlands |
NHS Coventry and Warwickshire |
2% |
| England median |
12% |
Table showing lowest five integrated care board areas for the proportion of waits longer than 12 hours from decision to admit (DTA) to admission in January 2023. Source: NHS England emergency admissions data.
| Region |
Integrated care board |
Percentage |
| East of England |
NHS Norfolk and Waveney |
25% |
| London |
NHS South West London |
27% |
| London |
NHS North Central London |
28% |
| South West |
NHS Gloucestershire |
29% |
| South West |
NHS Cornwall and the Isles of Scilly |
34% |
| England median |
12% |
Table showing highest five integrated care board areas for the proportion of waits longer than 12 hours from decision to admit (DTA) to admission in January 2023. Source: NHS England emergency admissions data.
Residential and nursing adult social care capacity remains relatively steady across England
Regional variation since April 2022 may have affected local discharge pathways.
| NHS region |
Overall beds |
Nursing beds |
Residential beds |
| East of England |
-3.6% |
-5.3% |
-2.3% |
| South West |
-0.9% |
-2.6% |
0.6% |
| South East |
-0.6% |
-0.1% |
-1.2% |
| North West |
-0.5% |
-1.1% |
0.2% |
| North East and Yorkshire |
0.0% |
-3.8% |
3.2% |
| London |
1.2% |
2.5% |
-0.6% |
| Midlands |
3.3% |
3.0% |
3.5% |
| England |
0.0% |
-0.8% |
0.8% |
Table showing the percentage change in the number of beds since April 2022. Source: CQC register of services.
Since April 2022, the number of registered home care agencies has risen across the country
| NHS region |
April 2022 |
January 2023 |
Percentage change |
| East of England |
1,538 |
1,573 |
2.3% |
| South West |
1,055 |
1,090 |
3.3% |
| North West |
1,200 |
1,244 |
3.7% |
| South East |
1,796 |
1,895 |
5.5% |
| Midlands |
2,373 |
2,509 |
5.7% |
| London |
1,870 |
1,978 |
5.8% |
| North East and Yorkshire |
1,443 |
1,535 |
6.4% |
| England |
11,275 |
11,824 |
4.9% |
Table showing percentage change in the number of domiciliary care agencies since April 2022. Source: CQC register of services.
London, the South East and the Midlands had a greater than average increase in hospital patients who no longer met the criteria to stay in hospital occupying beds overnight
| NHS region |
April to August 2022 |
September 2022 to January 2023 |
Percentage change |
| London |
1,098 |
1,399 |
27% |
| South East |
1,830 |
2,127 |
16% |
| Midlands |
2,023 |
2,207 |
9% |
| North West |
2,216 |
2,342 |
6% |
| South West |
1,940 |
2,025 |
4% |
| East of England |
1,191 |
1,226 |
3% |
| North East and Yorkshire |
2,244 |
2,244 |
0% |
| England |
12,543 |
13,571 |
8% |
Table showing mean daily patients waiting for discharge for each NHS region. Source: NHS England discharge data.
The London region had the greatest proportion of reattendances to A&E within 7 days
| NHS region |
Reattendance percentage |
| London |
9.3% |
| North East and Yorkshire |
8.9% |
| North West |
8.6% |
| South East |
8.6% |
| East of England |
7.8% |
| South West |
7.8% |
| Midlands |
7.6% |
| England |
8.4% |
Table showing percentage of people reattending A&E within 7 days in each NHS region in December 2022.
The proportion of A&E attendances which were attendances within 7 days of a previous admission varied between regions, with London having the highest rate. This was reflected in 2 of the 5 ICBs with the highest rates of reattendances being from the London region.
| NHS region |
Integrated care board |
A&E reattendance within 7 days |
| London |
North Central London |
11.3% |
| North East and Yorkshire |
North East and North Cumbria |
10.0% |
| South East |
Kent and Medway |
9.9% |
| London |
North East London |
9.9% |
| Midlands |
Staffordshire and Stoke-on-Trent |
9.4% |
| England |
8.4% |
Table showing ICBs with the highest rates of A&E reattendance within 7 days in December 2022.
| NHS region |
Integrated care board |
A&E reattendance within 7 days |
| Midlands |
Birmingham and Solihull |
6.6% |
| South West |
Bath and North East Somerset, Swindon and Wiltshire |
6.5% |
| East of England |
Norfolk and Waveney |
6.4% |
| Midlands |
Derby and Derbyshire |
6.2% |
| Midlands |
Shropshire, Telford and Wrekin |
6.1% |
| England |
8.4% |
Table showing ICBs with the lowest rates of A&E reattendance within 7 days in December 2022.