State of the NationGuernsey · Healthcare · 2013–2025
A&E waiting times & life expectancy.
Both series exist in gov.gg’s own reports — buried in contract-KPI appendices and an annual wellbeing bulletin — and, as far as we could find, never pulled out as a standalone chart until now.
- Within four hours, 2025
- 88%Within four hours, 2025
- Below the 95% standard
- 7.0 ptsBelow the 95% standard
- Consecutive years below the standard
- 8 yrsConsecutive years below the standard
- Life expectancy, 2022-24 (years)
- 83.6Life expectancy, 2022-24 (years)
A&E: admitted or discharged within four hours, 2018–2024
Life expectancy at birth, 3-year rolling average
ED performance: States of Guernsey, Secondary Healthcare Contract KPI Report 2024 (published Apr 2025); gov.gg/secondaryhealthcare (index of all editions, 2018-2024). Life expectancy: States of Guernsey, Annual Better Life Indicators Report, 2023 and 2024 editions; States of Guernsey, Facts and Figures Booklet 2024, Figure 3.15 (p.76). Jersey life expectancy: opendata.gov.je, "Mortality of Jersey residents" - Life expectancy; gov.je, Jersey in Figures - health statistics index; Health and Care Jersey, Quality and Performance Reports (A&E four-hour standard, not open-data).
Beyond A&E
Hospital activity, wider waiting times & bed capacity
The same Secondary Healthcare Contract KPI report that supplies the A&E chart above also covers overall hospital activity, waiting times for consultant referrals and radiology, and the bed-capacity pressure from delayed discharges.
16,083 admissions
2024 inpatient admissions, +2.0% on 15,772 in 2023.
22,605 referrals
New outpatient referrals, 2024, +2.5% on 2023.
4,666 procedures
Main theatre procedures, 2024, +0.6% on 2023.
2,207 waiting
Inpatient waiting list, end of 2024 - a 21% reduction on the 2,799 waiting at end of 2023.
Medical Specialist Group (MSG) & Committee for Health & Social Care, “Secondary Healthcare Contract: 2024 Key Performance Indicators”, published April 2025 - States of Guernsey, Secondary Healthcare Contract KPI Report 2024 (published Apr 2025); gov.gg/secondaryhealthcare (index of all editions, 2018-2024). MSG is the private LLP holding the Secondary Healthcare Contract for the Bailiwick since 2018; KPIs are reported jointly with HSC across six themes. There were also 4 hospital-acquired infections in 2024 (2023: 5) from 15,888 admissions (target: 0), and formal complaints resolved within the 20-operational-day target fell to 62% (2023: 77%, target >75%) - the report links the drop to a 59% rise in formal complaints without a matching rise in resources to investigate them.
% of patients seen within the contractual waiting time, 2018–2024
Delayed Transfer of Care, days per month, 2018–2024
Both charts: “2018-2024 Results” trend tables in the same MSG/HSC KPI report (PQ1a/PQ1c and PQ6). Consultant-referral waiting-time performance has fallen from 81.5% in 2018 to a low of 53% in 2023, recovering only partially to 62% in 2024 - a steeper decline than the A&E series above; radiology has stayed much closer to target throughout. Delayed Transfer of Care - the aggregate days per month that patients stay in hospital after being fit for discharge, because no nursing/care-home bed is available or a needs assessment is pending - has missed its <100 days/month target every year since 2018, peaking at 629 in 2022; 18 patients were in this position at the end of 2024 (2023: 14), excluding the rehabilitation ward.
For context
The wider picture
NHS England's own longer run on the same four-hour standard, and Jersey's published run of the same measure.
UK: NHS England, % of A&E attendances within 4 hours
From a 95.4% high (Jun 2013) to a 49.6% low (Dec 2022). These are five individually cited readings — a mix of monthly and quarterly figures at uneven intervals — so the connecting line shows direction of travel, not a monthly series.
Jersey: % of ED patients admitted or discharged within 4 hours
Same measure, same four-hour clock — arrival to departure or admission — but Jersey publishes no target for it. The measure only entered Jersey’s reporting in January 2024, monthly at first, then every two months from mid-2025; the x-axis is true to time, so unreported months show as longer segments. May 2024’s edition gave no figure. Low of 68% (Jan 2025), latest 77.9% (Apr 2026) — between Guernsey’s 89% and NHS England’s recent mid-70s.
UK: NHS England, A&E Waiting Times and Activity statistics; Nuffield Trust, QualityWatch, "A&E waiting times". Jersey: Health and Care Jersey, Quality and Performance Reports (gov.je States Reports archive, January 2024 to April 2026 editions); gov.je, hospital waiting times. Jersey values are each edition’s “% Patients in Emergency Department for less than or equal to 4 Hours” latest value; the Jan and Feb 2024 editions published the inverse (“more than 4 Hours”, 28.3% and 29.6%) and are shown as their exact complements.
Quality of life
Avoidable deaths & mental wellbeing
The measures that say whether health is improving for islanders rather than whether the hospital is hitting its targets. The cost barrier to getting seen has its own section below.
158 / 100k
Age-standardised avoidable mortality, 2022–24, down from 186 in 2019–21. 307 deaths, 16% of all deaths.
12.1%
Low mental wellbeing across the population in 2023, but 26.8% among aged 16–24.
Avoidable mortality is falling, with a caveat. Of the 307 avoidable deaths in 2022–24, 93 were treatable and 214 preventable, with 38% linked to neoplasms and 26% to circulatory causes. The male rate is 190 per 100,000 against 117 for women. The report cautions that confidence intervals are too wide to say whether the fall in the rate is a true reduction. The fall in years of life lost, from 358 to 257 per 10,000, is statistically supported.
Low mental wellbeing by group, 2023
- Aged 16–2426.8%
- In affordable housing28.1%
- Household income under £20,00020.5%
- Own their home8.3%
- Household income £100,000+5.2%
No woman aged 16 to 24 in the 2023 sample recorded high wellbeing, against 18.3% of men the same age. The reported figure is 0.0%.
Contract KPIs against the 95% target, 2025
- Emergency Department, four-hour waits88%(was 89%)
- Radiology87%(was 95%)
- Outpatient contract waiting times64%(was 66%)
- Inpatient contract waiting times57%(was 54%)
- Combined referrals to consultants61%(was 62%)
Every waiting-time target was missed. Delayed transfers of care ran at 298 median days a month against a target under 100. The 2025 report states it is the last in this format, with a new framework and revised definitions from 2027.
Guernsey Mortality Trends (rev. April 2026); Guernsey & Alderney Wellbeing Survey 2023; Secondary Healthcare Contract KPIs. The mental-wellbeing headline is defined relative to the 2023 sample’s own mean and standard deviation, so it cannot be compared with the figure published for 2018. On fixed England thresholds the two waves are 10.5% against 10.1%, which the report does not treat as a significant change. Avoidable mortality is published ad hoc, not annually: only the 2021 and 2024 editions exist, and the 2022–24 point is provisional.
Named surgeons
Joint replacement volumes by surgeon
The UK National Joint Registry publishes a profile for every surgeon who operates at the Princess Elizabeth Hospital. It is the only place any Guernsey consultant's caseload is published by name.
| Surgeon | Total hips | Total knees | All joint procedures |
|---|---|---|---|
| Mr George Cooper | 373 (avg 165) | 243 (avg 184) | 750+ (avg 479) |
| Mr Richard Hopcroft | 134 (avg 165) | 163 (avg 184) | 378+ (avg 485) |
| Mr Christopher Joslin | 47 (avg 165) | 45 (avg 184) | 104 (avg 379) |
| Mr Mark Webber | Shoulders: 32 (avg 48) | n/a | 52 (avg 84) |
Volumes are mixed. These are three-year totals for 1 April 2023 to 31 March 2026, against the NJR’s national average for surgeons doing the same procedures. Guernsey’s busiest joint surgeon does more than twice the national average of total hip replacements. The other three record fewer procedures than average, one of them well under a third of it. The registry also publishes risk-adjusted 90-day mortality for each surgeon, on the profiles linked above. It does not publish revision or complication rates by surgeon, and no other Guernsey specialty publishes anything comparable.
National Joint Registry, Princess Elizabeth Hospital profile. Guernsey data has been submitted to the NJR since November 2019. A “+” means the NJR suppresses at least one line of fewer than five procedures. Each surgeon’s comparison total differs because the NJR averages only over the procedure types that surgeon performs.
The price of being seen
The cost barrier to getting seen
Guernsey has no free GP: primary care is paid for, so the question that matters is not how long you wait but whether cost stops you going at all. The Wellbeing Survey asks exactly that.
Still face a cost barrier
41.6%
▼ 5.7pp · down from 47.3% in 2018
Deterred from a dentist
26.8%
down from 32.3% in 2018
Deterred from the GP
22.3%
broadly flat from 23.5%
Pay for care themselves
48.1%
self-funded, not insured or States-funded
Funded by the States
3.6%
via Income Support
Put off by cost in the last 12 months, by service, 2023
Mental health support has no 2018 baseline. Physiotherapist, chiropodist and optician were re-scoped between waves and should not be trended.
The barrier is falling, but slowly. In 2023, 58.4% of islanders said cost had not stopped them using a health service, up 5.7 points from 52.7% in 2018. Put the other way, 41.6% still face a cost barrier to some form of care, down from 47.3% five years earlier. Roughly four in ten islanders still meet a price at the door.
It bites hardest at the dentist, where 26.8% were deterred by cost, down from 32.3%, and at the GP, at 22.3%. Nearly half of islanders, 48.1%, pay for their own treatment; only 3.6% are funded by the States, through Income Support.
Why it matters. A charge at the front door is not only a fairness question. Care deferred on cost tends to present later and more acutely, which is where the hospital figures elsewhere on this page come in. Guernsey’s emergency department has missed its 95% four-hour target for 8 years running, at 88% in 2025, and age-standardised avoidable mortality ran at 158 per 100,000 in 2022–24.
Neither series proves the cost barrier is the cause, and we do not claim it does. But a system that turns people away on price in primary care is the kind that pushes presentation into the emergency department and into avoidable harm.
Guernsey & Alderney Wellbeing Survey 2023. The cost-barrier questions are marked “Repeated” in the survey’s own Appendix A, with a 2018 comparator for the adult dentist and GP only. Mental-health support is a new question, and physiotherapy, chiropody and optician were re-scoped between waves, so those are shown for 2023 alone. The islander-wide barrier figures are the exact complement of the share who said cost had not stopped them using any service.
Workforce
The cost of HSC's off-island recruitment
How much the Committee for Health & Social Care spends relocating staff from off-island, and how reliant it remains on that pipeline - assembled from a single written question that has never been published as a report.
These are payments to all HSC staff receiving relocation support in each year, whenever they joined - the answer states it was not possible to isolate costs for employees who joined within the period, and the 2020–22 figures include ongoing payments to people who started between 2018 and 2020. A year’s cost is therefore not the cost of that year’s recruits.
Off-island recruits, by year
- 2020167 (49% of new recruits)
- 2021165 (44% of new recruits)
- 2022137 (37% of new recruits)
- 2023177 (46% of new recruits)
- 2024220 (51% of new recruits)
Reliance on off-island recruitment ranged from 37% (2022) to 51% (2024) of new starters, with no clear downward trend across the five years. The answer notes that the first three years of this period were affected by the Covid pandemic, which led to lower staff turnover and so fewer new recruits.
Staff turnover 2020–2024, by recruitment source
- On-island: starters / leavers1033 / 451
- Off-island: starters / leavers866 / 367
Off-island recruits were 45% of all HSC recruitment across the period, and 42% of them had already left States employment by the time of the answer. Of the 866 off-island recruits, 13% recorded long-term sickness absence (defined as longer than 21 consecutive days) and 20% reported stress. Much of the period was during Covid, which the answer notes may have distorted the pattern.
Policy & Resources Committee, "Response to a Question Pursuant to Rule 14" (ref. 2025-16, subject "Relocation Allowances", asked by Deputy Le Tissier, received 2 June 2025, replied 16 June 2025). Figures combine the relocation allowance package with other off-island recruitment costs, as summed in the answer itself; salary and individual allowance detail were not part of this disclosure.
Budget 2027
Health and Social Care in the 2027 Budget
Published 6 October 2026. HSC is the single biggest committee by a wide margin, and the single biggest driver of the committee overshoot.
£267.5m under Option A
0.9% above the authorised 2026 budget of £265.3m, well short of what the committee submitted. Under Option B the budget rises to £270.6m (2%), the single biggest difference between the two options.
Substance Use Strategy 2027–2032
Continues to identify tobacco taxation as a public-health intervention. Tobacco duty rises 5% in real terms, below the committee’s own request of RPI + 10% in the 2026 Budget. Vaping duty of £2.20 per 10ml, agreed in the 2026 Budget, comes into force immediately after the Budget debate.
Long-Term Care Fund gap £7m a year
Preliminary estimate: that much additional annual income is needed to put the fund on a sustainable footing. Not included in the Tax Reform policy letter’s £19m estimate, which covered the Guernsey Insurance Fund only. Updated actuarial reviews are underway, part of the Supported Living and Ageing Well Strategy.
Long-term care
The care fund’s surplus is shrinking, and the scheduled shift to residents covers about three fifths of the gap
| £m | 2025 actual | 2026 forecast | 2027 budget |
|---|---|---|---|
| Care benefits paid | 29.7 | 33.9 | 36.8 |
| Fund surplus | 12.0 | 11.6 | 9.6 |
Care benefits grow 14.3% and then 8.6%, which is 11.4% a year, and the surplus falls from £12.0m to £9.6m. Much of that is the one-off rise in bed rates agreed in February 2025. The same package moves living costs onto residents. In 2025 terms the weekly benefit falls by £135 between January 2026 and January 2030 for residential, dementia and nursing beds alike (residential: £800 to £665).
The States do not publish the number of beds. Spending of £18.2m on residential care and £14.5m on nursing care in the 2026 budget implies around 582 to 656 beds. Holding that flat, the shift is worth about £4.1m to £4.6m a year by 2030, or 59% to 66% of the £7m a year the Budget says the fund needs. Three things work against it: more beds, annual indexation of rates at RPIX plus 1%, and any cost that moves to General Revenue because a resident cannot pay. If income grows 3% a year and spending grows 5%, the surplus is gone in 2039; at 7%, in 2034.
Bridgehead arithmetic on States figures, not a States forecast. Bed numbers are implied from 2026 budget spend and held flat. The range reflects dementia beds, which may sit in the residential line and carry a higher benefit.
Budget 2027 report, Appendix VI p.143 and paragraph 4.39; ESS policy letter P.2025/113 for the uprating inputs and pension spending; pensioner counts from the ESS July headcounts. Projections are Bridgehead arithmetic on those figures.
Nurses and medical consultants: £118.7m of pay
The 2027 Budget sets the HSC cash limit but does not publish a 2027 pay bill by staff group. On the 2026 Forecast basis, nurses and medical consultants cost £118.7m, or 44% of the HSC Option A cash limit of £267.5m, before any other input is paid for. Each 0.5% pay movement across all groups is worth £2m General Revenue.
A States pay settlement of 4% in line with March RPIX adds around £4.7m to this group alone, before any workforce growth. Appendix VI, p.105.