National Statistics

All data contained within this publication are National Statistics, with the exception of Breast Cancer Referrals data.

Published by: Information & Analysis Directorate, Department of Health
Statisticians: Brian Reilly, Ben Simpson & Siobhán Morgan
Contact:

Reporting Period: 1 January 2023 - 31 March 2023
Publication Date: 29 June 2023
Date of Next Publication: 28 September 2023

Coverage: Northern Ireland
Frequency: Quarterly

This statistical release presents information on waiting times for cancer services at hospitals in Northern Ireland and reports on the performance of Health and Social Care Trusts, against the draft waiting time targets for cancer care services which state that:

  • At least 98% of patients diagnosed with cancer should receive their first definitive treatment within 31 days of a decision to treat.
  • At least 95% of patients urgently referred by a GP with a suspected cancer should begin their first definitive treatment within 62 days.
  • All urgent breast cancer referrals should be seen within 14 days.

Information is detailed on the number of patients who began treatment by HSC Trust for all targets and by tumour site for the 31 and 62 day targets. All of the data contained in this release are published on the NISRA Data Portal and in CSV format to facilitate secondary analysis. These data are available at the following links:

https://data.nisra.gov.uk/product/HWTS

https://www.health-ni.gov.uk/publications/northern-ireland-waiting-time-statistics-cancer-waiting-times-January-March-2023.

Key Facts

Patients Starting Treatment Following a Decision to Treat (31 Day Target)

• In the quarter ending March 2023, 2,784 patients started their first definitive treatment, 1.6% (44) fewer than in the previous quarter (2,828), and 5.5% (146) more than in the same quarter last year (2,638).

• 87.8% (2,445) of those patients started treatment within 31 days of a decision to treat, compared with 89.3% (2,524) in the previous quarter and 86.2% (2,275) in the same quarter last year.

Patients Starting Treatment Following an Urgent GP Referral (62 Day Target)

• In the quarter ending March 2023, 1,378 patients started treatment following an urgent GP referral for suspect cancer, 0.6% (9) fewer than in the previous quarter (1,387), and 9.5% (119) more than in the same quarter last year (1,259).

• 34.8% (479) of those patients started treatment within 62 days, compared with 36.5% (506) in the previous quarter and 41% (516) in the same quarter last year.

Patients Seen by a Breast Cancer Specialist Following an Urgent Referral (14 Day Target)

• In the quarter ending March 2023, there were 3,637 patients seen by a breast cancer specialist following an urgent referral for suspect breast cancer, 1.2% (46) fewer than in the previous quarter (3,683), and 5.7% (220) fewer than in the same quarter last year (3,857).

• 84.2% (3,062) of those referrals were seen within 14 days of their urgent referral for breast cancer, compared with 77.7% (2,863) in the previous quarter and 50.8% (1,958) in the same quarter last year.

Breast Cancer Referrals

• In the quarter ending March 2023, there were 6,690 new referrals for suspect breast cancer, of which 64.8% (4,337) were urgent.

Patients starting treatment following a decision to treat

Target: At least 98% of patients urgently referred with a suspected cancer should begin their first definitive treatment within 31 days of a decision to treat.


In the quarter ending March 2023, 2,784 patients started treatment following a decision to treat, of which 87.8% (2,445) started treatment within 31 days. The target was not achieved.

The number of patients starting treatment decreased by 1.6% (44) since last quarter, and increased by 5.5% (146) from the same quarter last year.

The percentage of patients starting treatment within 31 days decreased from 89.3% in the previous quarter and increased from 86.2% in the same quarter last year.

By HSC Trust

The Western HSC Trust had the highest proportion of patients starting treatment within 31 days (98.3%, 412 of 419 patients), while the Belfast HSC Trust had the lowest (83.5%, 973 of 1,165 patients).

By HSC Trust

Figure 1: Line charts illustrating the number of patients starting treatment following a decision to treat each quarter from June 2008 to March 2023 indicating the proportion and number within the 31 day target.

Table

By Tumour Site

Of tumour sites with more than 50 patients starting treatment during the quarter, Haematological Cancers had the highest percentage treated within 31 days (99.5%) while Skin Cancers had the lowest (77.7%).

Tumour Site Total Treated Change Since Last Quarter % Within 31 Days Change in % (pp)
Urological Cancer 535 22 82.6% -2.2
Skin Cancers 449 12 77.7% -4.9
Breast Cancer 409 -26 91.4% -0.5
Lower Gastrointestinal Cancer 329 -14 94.5% 3
Lung Cancer 297 -51 88.9% -1.1
Upper Gastrointestinal Cancer 239 16 93.7% 0.9
Haematological Cancers 205 39 99.5% 0.1
Head/Neck Cancer 139 17 88.5% -5
Gynae Cancers 115 -39 80.9% -2.9
Other 30 -21 90.0% -8
Brain/Central Nervous System 27 -5 96.3% -3.7
Sarcomas 10 6 80.0% -20

Patients starting treatment following an urgent GP referral

Target: At least 95% of patients urgently referred by a GP with suspected cancer should begin their first definitive treatment within 62 days.


During the quarter ending March 2023, 1,378 patients started treatment following an urgent GP referral for suspect cancer, of which 34.8% (479) started treatment within 62 days.

The number of patients treated decreased by 0.6% (9 patients) since last quarter, and increased by 9.5% (119 patients) since the same quarter last year.

The percentage of patients starting treatment within 62 days decreased from 36.5% in the previous quarter and decreased from 41% in the same quarter last year.

By HSC Trust

Note: Cases in which a patient was initially referred to one Trust for assessment and then subsequently transferred to another Trust for treatment are allocated 0.5 to each Trust.

The Southern HSC Trust reported the highest proportion of patients starting treatment within 62 days at 44.2% (97 of 219.5 patients). The lowest proportion was reported by the Belfast HSC Trust at 28.4% (118 of 415 patients).

Time Series

Note: In June 2009 the target was increased from 75% to 95%
Figure 2: Line charts illustrating the number of patients starting treatment following an urgent GP referral each quarter from June 2008 to March 2023 indicating the proportion and number within the 62 day target.

Table

By Tumour Site

Of tumour sites with more than 50 patients starting treatment during the quarter, Breast Cancer had the highest percentage treated within 62 days (87%) while Urological Cancer had the lowest (13.5%).

Tumour Site Total Treated Change Since Last Quarter % Within 62 Days Change in % (pp)
Urological Cancer 363 2 13.5% -6.7
Skin Cancers 278 7 45.3% 2.2
Breast Cancer 184 -19 87.0% 5.2
Lower Gastrointestinal Cancer 178 10 19.1% -1.1
Upper Gastrointestinal Cancer 100 22 28.0% 2.4
Lung Cancer 83 -15 43.4% 7.7
Gynae Cancers 65 -20 15.4% -2.3
Head/Neck Cancer 58 -2 13.8% -12.9
Haematological Cancers 55 19 43.6% -6.4
Other 10 -14 30.0% -7.5
Brain/Central Nervous System 2 1 0.0% -100
Sarcomas 2 0 50.0% -50

Breast Cancer

Target: All urgent breast cancer referrals should be seen within 14 days.


During the quarter ending March 2023, 3,637 patients were seen by a breast cancer specialist following an urgent referral, of which 84.2% (3,062) were seen within 14 days.

The number of patients seen decreased by 1.2% (46 patients) from last quarter, and decreased by 5.7% (220 patients) from the same quarter last year.

The percentage of patients seen within 14 days increased from 77.7% in the previous quarter and increased from 50.8% in the same quarter last year.

During the quarter ending March 2023, the Belfast HSC Trust achieved the target of seeing all 685 urgent breast cancer referrals within 14 days.

Time Series

Figure 3: Line charts illustrating the number of urgent breast cancer referrals each quarter from June 2008 to March 2023 indicating the proportion and number seen within the 14 day target.

Table

Breast Cancer Referrals

During the quarter ending March 2023, 6,690 referrals were received by HSC Trusts for suspect breast cancer, of which 64.8% (4,337) were classified as urgent.

The number of patients referred and the proportion categorised as urgent has remained broadly steady since June 2016, with the exception of a reduction in the number of routine referrals during the quarter ending June 2020.

Time Series

Figure 4: Line chart illustrating the number of breast cancer referrals from June 2016 to March 2023.

Table

Data Sources, Quality and Guidance


Data sources and quality

Data used to report on the 31 and 62 day targets are sourced from the Cancer Patient Pathway System (CaPPS), the data system used to administer cancer treatment services within Health and Social Care Trusts in Northern Ireland.

Data used to report on the breast cancer activity and referrals are sourced from the Patient Administration System, an administrative system used to manage, record and monitor hospital waiting lists within Health and Social Care Trusts in Northern Ireland. Hospital Information Branch introduced this methodology for the collection of breast cancer waiting time information in April 2017. Information was originally sourced from the Departmental SDR2 Return in aggregate format.

Regionally consistent data collection for cancer waiting times has been in place since April 2008. Cancer referrals data has been collected from April 2016.

All data presented in this publication have been validated and quality assured by Hospital Information Branch in conjunction with HSC Trusts.


31 Day Target (decision to treat to first definitive treatment)

The 31 day target relates to all patients who received a first definitive treatment for cancer during each of the three months covered in the publication, irrespective of their source or type of referral.

This is measured from the date on which the patient and the clinician agree the planned treatment and ends on the date the patient receives their first definitive treatment for cancer. Adjustments are made to the completed waiting time in the event of a patient cancelling or self-deferring treatment or because of suspension for either medical or social reasons.


62 Day Target (urgent GP referral to first definitive treatment)

The 62 day target relates to patients who received a first definitive treatment for cancer during each of the three months covered in the publication, following an urgent referral for suspect cancer from a General Practitioner or a routine GP referral that has subsequently been reclassified as urgent by a cancer specialist. Referrals from sources other than a GP, routine referrals and patients who have not been given an ICD 10 diagnosis are excluded.

This is measured from the date an initial urgent GP referral for suspect cancer is received by the HSC Trust and ends on the date the patient receives their first definitive treatment for cancer. Adjustments are made to the completed waiting time in the event of a patient cancelling or self-deferring treatment or because of suspension for either medical or social reasons.

Prior to June 2009, the target relating to waiting time for treatment following an urgent GP referral for suspect cancer was that at least 75% of patients urgently referred with a suspect cancer should begin their first definitive treatment within 62 days of referral.


14 Day Target (urgent breast cancer referrals)

Breast cancer activity reported against the 14 day target relates to all urgent referrals for suspect breast cancer that were first seen during each of the three months covered in the publication, irrespective of the source of referral. Figures include routine referrals that have subsequently been reclassified by a breast specialist as urgent and exclude urgent referrals reclassified as routine.

This is measured from the date an initial breast cancer referral is first received by the HSC Trust, and ends on the date that the patient attends their first outpatient appointment with a breast cancer specialist. Adjustments are made to the completed waiting time in the event of a patient cancelling, self-deferring or failing to attend a first outpatient appointment.


Breast Cancer Referrals

Figures provided in the Breast Cancer Referrals section reflect all new referrals received for suspect breast cancer irrespective of the source or urgency of referral. Referrals for breast cancer can be for advice, assessment or both.


Patients referred and treated in different Trusts

The measurement of a patient’s waiting time against the 62 day target includes cases in which a patient was initially referred to one Trust for consultant assessment but was then subsequently transferred to another Trust for treatment. In such cases, the responsibility for that patient is shared, with 0.5 allocated to the Trust where the patient was first assessed and 0.5 to the Trust of first treatment. For example, if a patient is initially referred for assessment in the Southern HSC Trust and is then transferred to the Belfast HSC Trust where they receive treatment 70 days after their initial GP referral, both the Southern and Belfast HSC Trusts will report 0.5 of a patient treated who waited over 62 days.

For the 31 day target, all patients are reported against the Trust providing their treatment.

Breast cancer activity and referrals are all reported against the Trust the patient is referred to.


ICD 10 codes and tumour sites

The 31 and 62 day targets relate to patients who received a first definitive treatment for cancer having been given an ‘International Classification of Diseases 10’ (ICD 10) diagnosis. Patients that have not been given an ICD 10 diagnosis are excluded.

Tumour sites are assigned by aggregation of applicable ICD 10 codes.

Data for all cancers are included except for basal cell carcinoma.


Breakdown by Trust and tumour site

A breakdown of these statistics by Trust and tumour site is not routinely published. Due to the relatively small number of patients involved and disclosure control needed to preserve the privacy of individual patients, the inferences that could be drawn from the data at this level of breakdown are impacted.


Patients resident outside Northern Ireland and private patients

These statistics include patients living outside Northern Ireland and privately funded patients seen in Health and Social Care hospitals in Northern Ireland.


Further technical guidance

Technical guidance and definitions, as well as notes on how to use the date contained within this statistical release are available at the following link:

https://www.health-ni.gov.uk/publications/cancer-waiting-times-guidance-and-returns

Additional Information and Data


Data from this publication

Data detailed in this publication are also available on the NISRA Data Portal and in CSV format to aid secondary analysis.

The Data Portal allows users to filter results, plot interactive charts and read data via API queries and to download data in CSV, XLSX, JSON-stat and PX formats. It can be accessed at the following link: https://data.nisra.gov.uk/product/HWTS

CSV files are available to download at the following link: https://www.health-ni.gov.uk/publications/northern-ireland-waiting-time-statistics-cancer-waiting-times-January-March-2023.


Other waiting times publications

Statistics on waiting times for inpatients, outpatients, diagnostic services and emergency care are available at the following link: https://www.health-ni.gov.uk/topics/doh-statistics-and-research/hospital-waiting-times-statistics


National Statistics

National Statistics Logo
The United Kingdom Statistics Authority has designated these statistics as National Statistics, in accordance with the Statistics and Registration Service Act 2007 and signifying compliance with the Code of Practice for Statistics.

National Statistics status means that official statistics meet the highest standards of trustworthiness, quality and public value.

It is the Department of Health’s responsibility to maintain compliance with the standards expected of National Statistics. If we become concerned about whether these statistics are still meeting the appropriate standards, we will discuss any concerns with the Authority promptly. National Statistics status can be removed at any point when the highest standards are not maintained and reinstated when standards are restored.

The statistics underwent a full assessment against the Code of Practice in 2011. Designation was awarded in December 2013.

Since the assessment by the Office for Statistics Regulation, we have continued to comply with the Code of Practice for Statistics.

Further information on the Code of Practice for Statistics is available at: https://code.statisticsauthority.gov.uk/


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