BACKGROUND QUALITY REPORT NORTHERN IRELAND WAITING TIME STATISTICs INPATIENT AND DAY CASE WAITING TIMES
Introduction
Context for the quality report.
This statistical release presents information on waiting times for admission for either inpatient or day case treatment in Northern Ireland and reports on the performance of the Health and Social Care (HSC) Trusts against the draft Ministerial waiting time target.
Hospital Information Branch (HIB) introduced methodology for the collection of inpatient waiting time information at the beginning of 2007/08.
The Code of Practice for Statistics states that statistical methods should be consistent with scientific principles and internationally recognised best practices and be fully documented. Quality should be monitored and assured taking account of internationally agreed practices.
The full text of the Code is available at: https://code.statisticsauthority.gov.uk/ Each Official and National Statistics output produced by Hospital Information Branch (HIB) within the Department of Health (DoH) contains key quality information in respect of the specific content of the statistical output. This information is provided in the definitions, notes to tables or notes to editors.
Relevance
The degree to which the statistical product meets user needs in both coverage and content.
The statistical release details information on the number of patients waiting, and length of time waiting, for inpatient and day case admissions in HSC Trusts at quarter’s end. This data is presented in relation to 13 and 52 week ministerial targets, including a breakdown by HSC Trust, and specialty. Further breakdowns of median and 95th percentile waits are presented.
Further information is presented regarding the number of completed waits during the quarter.
Data contained in this release are published primarily to provide an indication of HSC performance. They allow the public and the DoH Health Committee to assess the performance of the DoH, Strategic Planning and Performance Group (SPPG) and HSC Trusts in providing timely access to hospital services in Northern Ireland. These data also provide policy makers with the necessary information to formulate and evaluate health services and are helpful in assessing the effectiveness of resource allocation in providing services that are fully responsive to patient needs.
Additionally, hospital waiting time information is used to inform the media, special interest groups, academics, and by the DoH to respond to parliamentary/assembly questions and ad hoc queries from the public. An additional aim of this publication is to make waiting time information publicly available to those people using health services in Northern Ireland.
Feedback from HSC Trusts and SPPG is routinely sought to ensure both the methodology and presentation of this report continue to evolve to suit user needs.
Accuracy and Reliability
The proximity between an estimate and the unknown true value.
Data contained within the DOH Inpatient Waiting Time Dataset, are National Statistics. National Statistics are produced to high professional standards set out in the UK Statistics Authority Code of Practice for Official Statistics. They are produced free from political interference. They are required to comply with the Code’s eight Principles and three supporting Protocols including the Protocol on Release Practices.
The HSC Business Services Organisation has developed a specific universe on the HSC Data Warehouse entitled ‘Inpatients Waiting – Monthly’, populated with data on patients waiting for all types of inpatient admission and updated monthly. HIB use a Business Objects query, agreed with HSC Trusts, to extract anonymous patient level data from this universe two days after the end of each quarter.
This information is exported, cleansed, and analysed to ensure that only patients waiting for inpatient admission that meet agreed criteria are included.
On 9 November 2023 the South Eastern Health and Social Care (HSC) Trust launched ‘encompass’ - a new electronic patient record system. The system also went live in Belfast HSC Trust on 6 June 2024 and in Northern HSC Trust on 7 November 2024, and its rollout across the other Trusts will continue in 2025.
All waiting time information presented in this bulletin has been validated and quality assured by HSC Trusts prior to publication. Data is validated via circulated excel workbooks outlining:
Total number of patients awaiting admission at end of quarter, by intended management, for confirmation.
Number of patients waiting by specialty and length of time waiting (in time bands), for confirmation.
Number of patients waiting for scope procedures, by procedure and length of time waiting (in time bands), for confirmation.
A list of noted irregularities in waiting time position within each specialty, as compared to previous quarters and years.
A list of potential duplicate records is provided. HSC Trusts indicate whether these records should be removed.
Cases where erroneous dates are recorded for either date of birth or date of decision to admit are detailed for correction.
In some cases, patients may be recorded under one HSC Trust but are being treated in another HSC Trust’s facilities or at a Day Case Procedure Centre (DPC). These patients’ waiting times should be reported under the HSC Trust or DPC where treatment is provided. Details of cases to be reallocated are therefore sent to both relevant HSC Trusts for confirmation.
HSC Trusts validate these data, provide amendments where necessary and confirm finalised figures are correct once satisfied.
A number of patients waiting for inpatient procedures are not recorded on the Patient Administration System (PAS). HSC Trusts submit a list of anonymous patient level records that are added into the cleansed file to create the final DOH Inpatient Waiting Time Dataset.
The ‘Inpatient and Day Case Waiting Times Publication – Supporting Documentation’ booklet details the technical guidance and definitions used, as well as notes on how to use the data contained within this statistical release. This booklet is available to view or download from: https://www.health-ni.gov.uk/publications/inpatient-and-day-case-waiting-times-supporting-documentation
Previous data are revised if necessary and appropriate. All revisions are conducted in line with HIB’s Revisions Policy which can be found in the Statistics Charter online at: https://www.health-ni.gov.uk/publications/doh-statistics-charter
Timeliness and Punctuality
Timeliness refers to the time gap between publication and the reference period. Punctuality refers to the gap between planned and actual publication dates.
Data is published on a quarterly basis on the last Thursday of the month, two months after the end of the reporting period.
The ‘Schedule of Publications’, which provides twelve months advance notice of releases, is available at: https://www.healthni.gov.uk/publications/statistical-releases-calendar
In the majority of cases, the target publication deadlines are met. However, in the event of a change to a pre-announced release date, the delay is announced, explained and updated regularly
Accessibility and Clarity
Accessibility is the ease with which users are able to access the data, also reflecting the format in which the data are available and the availability of supporting information. Clarity refers to the quality and sufficiency of the metadata, illustrations and accompanying advice.
The statistical publication is publicly available to download free of charge in HTML format at: https://www.healthni.gov.uk/articles/inpatient-waiting-times
The statistical tables are also available to download in CSV format, suitable for further analysis, from this webpage. If requested, HIB can provide documents in other formats.
Data quality issues are outlined at the end of the data file, and full metadata is available in an online guidance document, available at:
The publication is also accessible through the UK National Statistics Publication Hub at:
Coherence and Comparability
Coherence is the degree to which data that are derived from different sources or methods, but refer to the same topic, are similar. Comparability is the degree to which data can be compared over time and domain.
There is currently no other official source of inpatient and day case hospital waiting times statistics in Northern Ireland. Internal briefings within the HSC Trusts and SPPG also source their data from the HSC Data Warehouse, ensuring consistency between internal and published data.
Users may misinterpret waiting time data as the average time patients wait within each specialty. Documentation provided clarifies that data refers to the length of time patients were waiting at a specific point in time. Patients included within this data may have only recently been added to the waiting list. Thus, waiting times reported may not correlate with the total expected wait for any procedure.
It is expected that there will be some compatibility issues with the legacy source and encompass data. These will be assessed fully once all HSC Trusts are on encompass.
Between 2007 and 2016, various banding has been utilised to group patients waiting into time bands, found in the downloadable datafile. These include:
For the quarters ending June 2007 to March 2010 all patients waiting over 26 weeks have been included in the ‘>26 week’ time band.
From the quarter ending June 2010, patients waiting over 26 weeks have been split into the timebands ‘>26 - 36 weeks’ and ‘> 36 weeks’.
From the quarter ending June 2012, patients waiting over 26 weeks have been split into the timebands ‘>26 - 30 weeks’, ‘>30-36 weeks’ and ‘> 36 weeks’.
From the quarter ending June 2013, patients waiting over 26 weeks have been split into the timebands ‘>26 - 30 weeks’, ‘>30 weeks’.
From the quarter ending June 2014, patients waiting greater than 26 weeks have been included in the ’ > 26 weeks timeband’ From the quarter ending June 2016, patients waiting over 26 weeks have been split into the timebands ‘>26 - 52 weeks’, ‘> 52 - 65 weeks’, ‘> 65 - 78 weeks’, ‘> 78 - 91 weeks’, ’> 91 - 104 weeks and > 104 weeks.
Whilst this affects the comparability of individual timebands across a time series, the number of patients breaching targets in each period is clearly reported and remains comparable across all reported quarters.
While it is our intention to direct users to waiting time information elsewhere in the UK, users should be aware that hospital waiting times in other administrations are not always measured in a comparable manner to those in Northern Ireland. Details of the hospital waiting times published elsewhere in the UK can be found as detailed below.
England
http://www.england.nhs.uk/statistics/rtt-waiting-times/
Scotland
http://www.isdscotland.org/Health-Topics/Waiting-Times/
Wales
https://www.wales.nhs.uk/nhswalesaboutus/nhswaitingtimes/
Statisticians in all four home nations have collaborated as part of the ‘UK Comparative Waiting Times Group’. Technical documents are available from the Governmental Statistical Service (GSS) at: https://gss.civilservice.gov.uk/user-facing-pages/health-and-care-statistics/health-waiting-time-statistics/
Trade-offs between Output Quality Components
Trade-offs are the extent to which different aspects of quality are balanced against each other.
The information detailed in this release is collected, processed and reported to high levels of quality. Feedback and suggestions for improvement are sought from both data providers and users.
Assessment of User Needs and Perceptions
The processes for finding out about users and uses, and their views on the statistical products.
Data presented in this publication helps to meet the information needs of a wide range of internal and external users.
Inpatient waiting time data are used in: Ministerial answers to both Written and Oral Assembly questions Departmental responses to correspondence received from the NI Assembly Health Committee, Public Accounts Committee, Northern
Ireland Audit Office and other stakeholder bodies such as the Patient Client Council
Ministerial briefing material
Health compendium publications
Outside government, the information in these statistical publications is used by a number of charities, voluntary organisations, journalists and members of the general public. It is also used by researchers looking at HSC Trust performance and by service users and other members of the general public to hold HSC Trusts and government to account.
User feedback is invited in this publication. Readers are provided with contact details for the relevant statistician.
We gain awareness of users of our data from ad hoc requests for information and from the receipt of invitations to relevant meetings and conferences.
Users needs are prioritised, taking account of the resources available.
Performance, Cost and Respondent Burden
The effectiveness, efficiency and economy of the statistical output.
The HSC Data Warehouse is largely supported by the HSC Trusts. HIB staff utilise Business Objects to schedule data downloads. Data validations are currently submitted by HIB staff to HSC Trust staff electronically. Validation processes are routinely reviewed to ensure burden on all parties is minimised.
Confidentiality, Transparency and Security
The procedures and policy used to ensure sound confidentiality, security and transparent practices.
Data validations sent to HSC Trusts may contain personal information, including Health and Care Number, Date of Birth, Postcode, Gender and details of medical information. These are therefore password protected when transferred. New passwords are created on a quarterly basis, which are communicated separately from the relevant data.
All data held by IAD is kept on a secure network, and is only accessible by relevant staff.
The Department of Health Data Protection policy statement can be found at: https://www.health-ni.gov.uk/articles/dhssps-dataprotection-policystatement
Information Analysis Directorate’s commitment to Confidentiality and Security can be found at:
https://www.health-ni.gov.uk/publications/doh-statistics-charter/