Accredited Official Statistics

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

Published by: Information & Analysis Directorate, Department of Health
Statisticians: Brian Reilly, Thomas Cash & Heidi Rodgers
Contact:

Reporting Period: 1 July 2024 - 30 September 2024
Publication Date: 9 January 2025
Date of Next Publication: 27 March 2025

Coverage: Northern Ireland
Frequency: Quarterly

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. Given the relatively recent transition of Belfast Trust most, although not all, of its data for this quarter, and no validated data for the previous quarter, were available at the time of publication.

Data for South Eastern and Belfast HSC Trusts are not directly comparable with the other Trusts. These figures, sourced from encompass, are considered to be ‘official statistics in development’, which are a subset of Official Statistics in line with the Code of Practice for Statistics. While caution must be exercised when using these figures, they are a meaningful representation of what they measure and are of sufficient quality for publication and use.

Charts and figures in the ‘Breast Cancer Referrals Received’ section do not include Belfast HSC Trust data. This is to allow comparisons to be made for the four other HSC Trusts over previous years and any Northern Ireland level figures only include data for Northern, South Eastern, Southern and Western HSC Trusts.


This statistical release presents information on waiting times for cancer services at hospitals in Northern Ireland and reports on the performance of the five Health and Social Care Trusts against the draft waiting time targets 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 in Excel file format to facilitate secondary analysis. This file is available at the following link:

https://www.health-ni.gov.uk/publications/northern-ireland-waiting-time-statistics-cancer-waiting-times-july-september-2024.

Key Facts

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

• In the quarter ending September 2024, 2,842 patients started their first definitive treatment.

• The number of patients starting treatment in all five HSC Trusts increased by 2.5% (69) from the same quarter last year. As validated data for Belfast HSC Trust for Quarter Ending June 2024 were not available at the time of publication, the number of patients starting treatment in the other four Trusts increased by 1.2% (21) since last quarter.

• The percentage of patients starting treatment within 31 days in all five HSC Trusts was 87.9%, the same as the same quarter last year. As validated data for Belfast HSC Trust for Quarter Ending June 2024 were not available at the time of publication, the percentage of patients starting treatment within 31 days in the other four Trusts increased from 90.8% in the previous quarter to 91.4% this quarter.

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

• In the quarter ending September 2024, 1,383 patients started their first definitive treatment.

• The number of patients treated in all five HSC Trusts increased by 2.0% (26) from the same quarter last year. As validated data for Belfast HSC Trust for Quarter Ending June 2024 were not available at the time of publication, the number of patients treated in the other four Trusts increased by 10.8% (97) since last quarter.

• The percentage of patients starting treatment within 62 days in all five HSC Trusts decreased from 34.0% in the same quarter last year compared to 32.9% this quarter. As validated data for Belfast HSC Trust for Quarter Ending June 2024 were not available at the time of publication, the percentage of patients starting treatment within 62 days in the other four Trusts decreased from 35.8% in the previous quarter to 34.1% this quarter.

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

• In the quarter ending September 2024, there were 3,449 patients seen by a breast cancer specialist following an urgent referral for suspect breast cancer.

• The number of patients seen in all five HSC Trusts increased by 3.8% (126) from the same quarter last year. As validated data for Belfast HSC Trust for Quarter Ending June 2024 were not available at the time of publication, the number of patients seen in the other four Trusts decreased by 8.8% (266) from last quarter.

• The percentage of patients seen within 14 days in all five HSC Trusts decreased from 52.9% in the same quarter last year compared to 30.0% this quarter. As validated data for Belfast HSC Trust for Quarter Ending June 2024 were not available at the time of publication, the percentage of patients seen within 14 days in the other four Trusts increased from 30.7% in the previous quarter to 33.5% this quarter.

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 September 2024, 2,842 patients started their first definitive treatment.

The number of patients starting treatment in all five HSC Trusts increased by 2.5% (69) from the same quarter last year. As validated data for Belfast HSC Trust for Quarter Ending June 2024 were not available at the time of publication, the number of patients starting treatment in the other four Trusts increased by 1.2% (21) since last quarter.

The percentage of patients starting treatment within 31 days in all five HSC Trusts was 87.9%, the same as the same quarter last year. As validated data for Belfast HSC Trust for Quarter Ending June 2024 were not available at the time of publication, the percentage of patients starting treatment within 31 days in the other four Trusts increased from 90.8% in the previous quarter to 91.4% this quarter.

By HSC Trust

No HSC Trust met the target of 98% percent of patients starting treatment within 31 days.


Figure 1: Patients starting treatment within 31 days of a decision to treat

Quarter Ending June 2008 to Quarter Ending September 2024

As validated data for Belfast HSC Trust for Quarter Ending June 2024 were not available at the time of publication, the time series for Belfast and Northern Ireland are currently incomplete.

Time Series

Figure 1: Line charts illustrating the number of patients starting treatment following a decision to treat each quarter from June 2008 to September 2024 indicating the percentage and number within the 31 day target.

Table

By Tumour Site

Figures in this section do not include comparisons to last quarter as validated data for Belfast HSC Trust for Quarter Ending June 2024 were not available at the time of publication.

Of tumour sites with more than 50 patients in the Northern, South Eastern, Southern and Western HSC Trusts starting treatment during the quarter ending September 2024, Haematological Cancers had the highest percentage treated within 31 days (98.8%) while Gynaecological Cancers had the lowest (77.7%).


Table 2: Total patients treated and patients treated within 31 days

01 July 2024 to 30 September 2024

Tumour Site Total Treated % Within 31 Days
Urological Cancer 608 85.2%
Breast Cancer 405 84.4%
Skin Cancers 404 87.4%
Lower Gastrointestinal Cancer 358 92.2%
Lung Cancer 292 84.6%
Upper Gastrointestinal Cancer 226 91.2%
Haematological Cancers 169 98.8%
Gynaecological Cancers 139 77.7%
Head/Neck Cancer 100 93.0%
Other 55 98.2%
Leukaemia 27 92.6%
Sarcomas 26 92.3%
Brain/Central Nervous System 20 95.0%
Thyroid 10 80.0%

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.

In the quarter ending September 2024, 1,383 patients started their first definitive treatment.

The number of patients treated in all five HSC Trusts increased by 2.0% (26) from the same quarter last year. As validated data for Belfast HSC Trust for Quarter Ending June 2024 were not available at the time of publication, the number of patients treated in the other four Trusts increased by 10.8% (97) since last quarter.

The percentage of patients starting treatment within 62 days in all five HSC Trusts decreased from 34.0% in the same quarter last year compared to 32.9% this quarter. As validated data for Belfast HSC Trust for Quarter Ending June 2024 were not available at the time of publication, the percentage of patients starting treatment within 62 days in the other four Trusts decreased from 35.8% in the previous quarter to 34.1% this quarter.

By HSC Trust

The Western HSC Trust reported the highest percentage of patients starting treatment within 62 days at 41.6% (107 of 257.5). The lowest percentage was reported by the Northern HSC Trust at 25.3% (46 of 182).


Figure 2: Patients starting treatment within 62 days of an urgent GP referral for suspect cancer

Quarter Ending June 2008 to Quarter Ending September 2024

As validated data for Belfast HSC Trust for Quarter Ending June 2024 were not available at the time of publication, the time series for Belfast and Northern Ireland are currently incomplete.

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 September 2024 indicating the percentage and number within the 62 day target.

Table

By Tumour Site

Figures in this section do not include comparisons to last quarter as validated data for Belfast HSC Trust for Quarter Ending June 2024 were not available at the time of publication.

Of tumour sites with more than 50 patients in the Northern, South Eastern, Southern and Western HSC Trusts starting treatment during the quarter ending September 2024, Haematological Cancers had the highest percentage treated within 62 days (49.0%) while Head/Neck Cancer had the lowest (15.3%).


Table 4: Total patients treated and patients treated within 62 days

01 July 2024 to 30 September 2024

Tumour Site Total Treated % Within 62 Days
Urological Cancer 384 22.7%
Skin Cancers 273 37.7%
Breast Cancer 180 47.8%
Lower Gastrointestinal Cancer 153 26.8%
Upper Gastrointestinal Cancer 88 38.6%
Lung Cancer 86 34.9%
Gynaecological Cancers 64 31.2%
Head/Neck Cancer 59 15.3%
Haematological Cancers 51 49.0%
Other 33 42.4%
Sarcomas 12 50.0%

Patients seen following an urgent breast cancer referral

Data users should note that breast cancer referrals statistics are not designated as Accredited Official Statistics.

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


In the quarter ending September 2024, there were 3,449 patients seen by a breast cancer specialist following an urgent referral for suspect breast cancer.

The number of patients seen in all five HSC Trusts increased by 3.8% (126) from the same quarter last year. As validated data for Belfast HSC Trust for Quarter Ending June 2024 were not available at the time of publication, the number of patients seen in the other four Trusts decreased by 8.8% (266) from last quarter.

The percentage of patients seen within 14 days in all five HSC Trusts decreased from 52.9% in the same quarter last year compared to 30.0% this quarter. As validated data for Belfast HSC Trust for Quarter Ending June 2024 were not available at the time of publication, the percentage of patients seen within 14 days in the other four Trusts increased from 30.7% in the previous quarter to 33.5% this quarter.

No HSC Trust achieved the target of seeing all urgent breast cancer referrals within 14 days. Western HSC Trust saw the highest percentage of patients within 14 days (99.7%).


Figure 3: Breast Cancer patients seen within 14 days following an urgent referral

Quarter Ending June 2008 to Quarter Ending September 2024

As validated data for Belfast HSC Trust for Quarter Ending June 2024 were not available at the time of publication, the time series for Belfast and Northern Ireland are currently incomplete.

Time Series

Figure 3: Line charts illustrating the number of urgent breast cancer referrals seen each quarter from June 2008 to September 2024 indicating the percentage and number seen within the 14 day target.

Table

Breast Cancer Referrals Received

Figures in this section do not include the Belfast HSC Trust as validated data were not available for this Trust at the time of publication.

Data users should note that breast cancer referrals statistics are not designated as Accredited Official Statistics.

Adding the number of referrals for suspect breast cancer at each HSC Trust to make a Northern Ireland total may inflate the ‘true demand’ on the service regionally as any referrals transferred from one Trust to another will create a duplicate referral.

Revised: the text which follows was amended on 10 January 2025 to amend a figure for Northern HSC Trust and remove a reference to Belfast HSC Trust.


During the quarter ending September 2024, 4,655 referrals were received by HSC Trusts for suspect breast cancer, of which 68.6% (3,194) were classified as urgent.

During the quarter ending September 2024, the highest number of referrals (1,607) were received by the Northern HSC Trust for suspect breast cancer, of which 51.8% (832) were classified as urgent. The South Eastern HSC Trust received the lowest number of breast cancer referrals (961), 79.6% (765) of which were urgent referrals.

A patient may be referred more than once if they are transferred to another consultant or a different Trust, or if they did not attend first treatment appointment and have been referred again.

Across each HSC Trust the number of patients referred and the percentage 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.


Figure 4: New referrals received for suspect breast cancer, by HSC Trust

Quarter Ending June 2016 to Quarter Ending September 2024

Time Series

Figure 4: Line charts illustrating the number of breast cancer referrals received each quarter from June 2016 to September 2024 indicating the number and percentage that were classified as urgent.

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 (PAS), 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.

Data for the South Eastern HSC Trust from 9 November 2023 onwards, and for the Belfast HSC Trust from 6 June 2024 onwards, are sourced from ‘encompass’, which is a new electronic patient record system. The system also went live in Northern HSC Trust on 7 November 2024, and its rollout across the other Trusts will continue in 2025. Figures sourced from encompass are considered to be ‘official statistics in development’, which are a subset of Official Statistics in line with the Code of Practice for Statistics. While caution must be exercised when using these figures, they are a meaningful representation of what they measure and are of sufficient quality for publication and use.

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 (GP) 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

Data users should note that breast cancer referrals statistics are not designated as Accredited Official Statistics.

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 is reported against the Trust the patient is referred to.

Breast cancer referrals are reported against the Trust the patient is referred to. However, as some referrals will be transferred to another Trust, this referral can be recorded under both the intial Trust and the Trust that has accepted transfer of the patient.


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.


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 in Excel file format to aid secondary analysis.

XLSX files are available to download at the following link: https://www.health-ni.gov.uk/publications/northern-ireland-waiting-time-statistics-cancer-waiting-times-july-september-2024.


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


Accredited Official Statistics

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Accredited Official Statistics are called National Statistics in the Statistics and Registration Service Act 2007. These official statistics were independently reviewed by the Office for Statistics Regulation (OSR) in 2011. They comply with the standards of trustworthiness, quality and value in the Code of Practice for Statistics and should be labelled ‘Accredited Official Statistics’ (designation awarded in December 2013).

Our statistical practice is regulated by the OSR, which sets the standards of trustworthiness, quality and value in the Code of Practice for Statistics that all producers of official statistics should adhere to.

You are welcome to contact us directly with any comments about how we meet these standards.

Alternatively, you can contact OSR by emailing or via the OSR website Office for Statistics Regulation (https://osr.statisticsauthority.gov.uk).

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

Find out more about the Code of Practice for Statistics at: https://code.statisticsauthority.gov.uk/

Find out more about Official Statistics at: https://uksa.statisticsauthority.gov.uk/about-the-authority/uk-statistical-system/types-of-official-statistics/


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