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, Jenny Finlay & Liz Graham
Contact:

Reporting Period: 1 October 2023 - 31 December 2023
Publication Date: 28 March 2024
Date of Next Publication: 27 June 2024

Coverage: Northern Ireland
Frequency: Quarterly

On 9th November 2023 the South Eastern Health and Social Care (HSC) Trust launched “Encompass” - a new electronic patient record system. Its roll out across the other Trusts will follow on a phased basis throughout 2024/25. Consequently, the data for South Eastern for the quarter ending December 2023 was not available at the time of this publication, as the Trust transitions to completely digitised health records. Therefore, charts and figures presented throughout this report have excluded patients in the South Eastern Trust to allow comparisons to be made for the four remaining HSC Trusts compared with previous time points. As such, any NI level figures presented throughout this report only include those for Belfast, Northern, 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 four 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 on the NISRA Data Portal and in Excel file format to facilitate secondary analysis. These 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-october-december-2023.

Key Facts

Figures in this section exclude the South Eastern Trust as data was not available at time of publication.

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

• In the quarter ending December 2023, 2,281 patients in the Belfast, Northern, Southern and Western Trusts started their first definitive treatment, 1.4% (32) more than in the previous quarter (2,249), and 1.1% (25) fewer than in the same quarter last year (2,306).

• 89.1% (2,033) of those patients started treatment within 31 days of a decision to treat, compared with 89.2% (2,006) in the previous quarter and 88.6% (2,042) in the same quarter last year.

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

• In the quarter ending December 2023, 1,076 patients in the Belfast, Northern, Southern and Western Trusts started their first definitive treatment, 0.1% (1) more than in the previous quarter (1,075), and 3.3% (37) fewer than in the same quarter last year (1,113).

• 30.0% (323) of those patients started treatment within 62 days, compared with 34.3% (369) in the previous quarter and 34.9% (388) in the same quarter last year.

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

• In the quarter ending December 2023, there were 3,046 patients in the Belfast, Northern, Southern and Western Trusts seen by a breast cancer specialist following an urgent referral for suspect breast cancer, 17.2% (446) more than in the previous quarter (2,600), and 2.7% (79) more than in the same quarter last year (2,967).

• 40.5% (1,235) of those patients were seen within 14 days of their urgent referral for breast cancer, compared with 65.2% (1,695) in the previous quarter and 73.5% (2,182) in the same quarter last year.

Patients starting treatment following a decision to treat

Figures in this section exclude the South Eastern Trust as data was not available at time of publication.

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 December 2023, 2,281 patients in the Belfast, Northern, Southern and Western Trusts started treatment following a decision to treat, of which 89.1% (2,033) started treatment within 31 days. The target was not achieved at a regional level.

The number of patients starting treatment increased by 1.4% (32) since last quarter, and decreased by 1.1% (25) from the same quarter last year.

The percentage of patients starting treatment within 31 days changed slightly from 89.2% in the previous quarter and increased from 88.6% in the same quarter last year.

By HSC Trust

The Western HSC Trust had the highest percentage of patients starting treatment within 31 days of a decision to treat (97.6%). No 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 December 2023

Time Series

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

Table

By Tumour Site

Of tumour sites with more than 50 patients in the Belfast, Northern, Southern and Western Trusts starting treatment during the quarter ending December 2023, Haematological Cancers had the highest percentage treated within 31 days (98.8%) while Gynaecological Cancers had the lowest (72.0%).


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

01 October 2023 to 31 December 2023

Tumour Site Total Treated Change Since Last Quarter % Within 31 Days % Within 31 Days change since last quarter
Urological Cancer 466 11 82.2% 0.0
Breast Cancer 327 -22 92.4% 3.0
Lung Cancer 276 -9 95.7% 5.1
Lower Gastrointestinal Cancer 259 -19 89.6% 3.6
Skin Cancers 248 -14 87.5% -6.4
Upper Gastrointestinal Cancer 203 37 89.2% -2.4
Haematological Cancers 170 -1 98.8% 0.0
Gynaecological Cancers 143 22 72.0% -9.8
Head/Neck Cancer 113 17 95.6% 0.8
Other 38 5 97.4% -2.6
Brain/Central Nervous System 29 3 100.0% 0.0
Sarcomas 9 2 100.0% 0.0

Patients starting treatment following an urgent GP referral

Figures in this section exclude the South Eastern Trust as data was not available at time of publication.

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


Note: Cases in which a patient was initially referred to one Trust for assessment and then subsequently transferred to another Trust for treatment are split evenly and counted as being 0.5 from each Trust. During the quarter ending December 2023 there were 73 patients that were seen first at South Eastern Trust that were transferred to the other Trusts for treatment. This results in a total count of 1039.5 cases (1,076 - (73 * 0.5)) associated with the four Trusts being reported.


During the quarter ending December 2023, 1,076 patients in the Belfast, Northern, Southern and Western Trusts started treatment following an urgent GP referral for suspect cancer, of which 30.0% (323) started treatment within 62 days. Of these patients, 73 were first seen in the South Eastern Trust.

The number of patients treated increased by 0.1% (1) since last quarter, and decreased by 3.3% (37) since the same quarter last year.

The percentage of patients starting treatment within 62 days decreased from 34.3% in the previous quarter and decreased from 34.9% in the same quarter last year.

By HSC Trust

The Western HSC Trust reported the highest percentage of patients starting treatment within 62 days at 39.6% (113.5 of 286.5). The lowest percentage was reported by the Belfast HSC Trust at 23.0% (89 of 386).


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

Quarter Ending June 2008 to Quarter Ending December 2023

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 December 2023 indicating the percentage and number within the 62 day target.

Table

By Tumour Site

Of tumour sites with more than 50 patients in the Belfast, Northern, Southern and Western Trusts starting treatment during the quarter ending December 2023, Breast Cancer had the highest percentage treated within 62 days (54.7%) while Lower Gastrointestinal Cancer had the lowest (16.0%).


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

01 October 2023 to 31 December 2023

Tumour Site Total Treated Change Since Last Quarter % Within 62 Days % Within 62 Days change since last quarter
Urological Cancer 327 19 18.7% -1.5
Skin Cancers 154 -5 37.7% -19.6
Breast Cancer 139 -18 54.7% -9.7
Lower Gastrointestinal Cancer 131 -26 16.0% -1.8
Upper Gastrointestinal Cancer 79 20 29.1% 5.4
Gynaecological Cancers 73 10 20.5% 1.5
Lung Cancer 65 -3 41.5% 6.2
Head/Neck Cancer 52 -2 17.3% -14.2
Haematological Cancers 44 7 61.4% 18.1
Other 11 3 45.5% 20.5
Brain/Central Nervous System 1 -1 100.0% 50.0

Patients seen following an urgent breast cancer referral

Figures in this section exclude the South Eastern Trust as data was not available at time of publication.

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


During the quarter ending December 2023, 3,046 patients in the Belfast, Northern, Southern and Western Trusts were seen by a breast cancer specialist following an urgent referral, of which 40.5% (1,235) were seen within 14 days.

The number of patients seen increased by 17.2% (446) from last quarter, and increased by 2.7% (79) from the same quarter last year.

The percentage of patients seen within 14 days decreased from 65.2% in the previous quarter and decreased from 73.5% in the same quarter last year.

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 (99.8%).


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

Quarter Ending June 2008 to Quarter Ending December 2023

Time Series

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

Table

Breast Cancer Referrals Received

Figures in this section exclude the South Eastern Trust as data was not available at time of publication.

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.


During the quarter ending December 2023, the highest number of referrals (1,740) were received by the Northern HSC Trust for suspect breast cancer, of which 57.6% (1,003) were classified as urgent. The Southern Trust received the lowest number of breast cancer referrals (1,159), however 74.4% (863) of these were urgent referrals.

The total of 5,417 breast referrals represents approximately 5,076 individual patients referred for breast cancer treatment during the Quarter ending December 2023.

Approximately 6.1% of patients (311 out of 5,076) in Northern Ireland were referred more than once for breast cancer treatment during the Quarter ending December 2023.

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 December 2023

Time Series

Figure 4: Line charts illustrating the number of breast cancer referrals received each quarter from June 2016 to December 2023 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.

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

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 on the NISRA Data Portal and in Excel file 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

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-october-december-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

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