Official Statistics
All data contained within this publication are designated as official statistics.
Published by: Information & Analysis
Directorate, Department of Health
Statisticians: Adam Robinson, Ben Simpson & Siobhán
Morgan
Contact: statistics@health-ni.gov.uk
Reporting Period: 1 April 2023 – 30 June 2023
Publication Date: 31 August 2023
Date of Next Publication: 30 November 2023
Coverage: Northern Ireland
Frequency: Quarterly
A diagnostic service provides an examination, test, or procedure used to identify a person’s disease or condition and which allows a medical diagnosis to be made.
This statistical release presents information on waiting times and reporting times for diagnostic services in Northern Ireland and reports on the performance of the Health and Social Care (HSC) Trusts against the draft waiting and reporting times targets which state that:
All of the data contained in this release are published on the NISRA Data Portal and in CSV format to facilitate secondary analysis, including additional breakdowns by Health and Social Care Trust, weeks waiting and reporting times. These data are available at the following links:
https://data.nisra.gov.uk/product/HWTS
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The Northern Ireland Statistics and Research Agency has launched a consultation on proposed changes to a range of statistical outputs and is seeking the views of users on these proposals. Further information on the consultation and how to respond can be found on the consultation page.
A total of 188,881 patients were waiting for a diagnostic test, 9.0% (15,639) more than at 31 March 2023 (173,242), and 13.5% (22,471) more than at 30 June 2022 (166,410).
55.5% (104,776) of patients were waiting more than 9 weeks for a diagnostic test, compared with 51.7% (89,587) at 31 March 2023 and 52.6% (87,480) at 30 June 2022.
28.2% (53,298) of patients were waiting more than 26 weeks for a diagnostic test compared with 26.8% (46,511) at 31 March 2023 and 27.1% (45,082) at 30 June 2022.
A total of 458,178 diagnostic tests were reported on and dispatched to the referring clinician at hospitals in Northern Ireland during the quarter ending June 2023. Of these, 22.4% (102,450) were urgent tests and the remaining 77.6% (355,728) were routine tests.
Of the 102,450 urgent diagnostic tests, 78.7% (80,654) were reported on within 2 days.
At 31 June 2023, there were 188,881 patients waiting for a diagnostic test.
The number of patients waiting increased by 9.0% (15,639) since 31 March 2023 (173,242) and by 13.5% (22,471) since 30 June 2022.
This line chart shows that the number of patients waiting has risen steadily from 61,752 on 30 September 2013 to 188,881 on 30 June 2023.
At 30 June 2023, the largest waiting lists were for Non-Obstetric Ultrasound (30,666 patients) and Magnetic Resonance Imaging (26,197 patients).
Echocardiography, Computerised Tomography, Plain Film X-Rays and Pure Tone Audiometry also had more than 10,000 patients on their waiting lists.
Of services with more than 2,000 patients waiting, Sleep Studies had the greatest proportionate increase with 66.0% (1,338) more patients waiting at 30 June 2023 (3,364) than at 30 June 2022 (2,026).
The bar chart above shows the number of patients waiting for each diagnostic service at 30 June 2023, with markers comparing numbers at 30 June 2022. Only specialties with at least 2,000 patients waiting are shown.
The draft diagnostic waiting times target states that 75% of patients should wait no longer than 9 weeks for a diagnostic test, with no patient waiting longer than 26 weeks.
This target was introduced in 2016/17.
The line and stacked bar charts above illustrate the number and proportion of patients waiting less than 9 weeks for a diagnostic test between 30 June 2016 and 30 June 2023.
Across this period the target of 75% of patients waiting less than 9 weeks was not achieved, with the highest proportion under 9 weeks being 65.5% (63,855 of 97,448 patients) at 30 June 2016.
At 30 June 2023, 44.5% (84,105 of 188,881 patients) of patients were waiting less than 9 weeks for a diagnostic test, a decrease from 47.4% at 30 June 2022.
The line and stacked bar charts above illustrate the number and proportion of patients waiting longer than 26 weeks for a diagnostic test between 30 June 2016 and 30 June 2023.
Across this period the target of no patients waiting longer than than 26 weeks was not achieved, with the lowest proportion over 26 weeks being 7.1% (6,934 of 97,448 patients) at 30 June 2016.
At 30 June 2023, 28.2% (53,298 of 188,881 patients) of patients were waiting longer than 26 weeks for a diagnostic test, an increase from 27.1% at 30 June 2022.
Exclusions From This Analysis
Data on diagnostic reporting turnaround times is currently only collected by the Department of Health for a subset of imaging and physiological measurement tests. Day case endoscopies are reported on the day of the test and are therefore also excluded.
Although statistics in this section can be considered as a general indicator of reporting performance, they are not directly comparable to the waiting list statistics presented in the sections above.
There were 458,178 diagnostic tests reported on during the quarter ending 30 June 2023, of which 22.4% (102,450) were urgent tests and the remaining 77.6% (355,728) were routine tests.
The total number of tests completed decreased by 0.6% (2,608) from 460,786 during the quarter ending 31 March 2023 and increased by 4.4% (19,223) from 438,955 reported in the quarter ending 30 June 2022.
The proportion of urgent tests decreased from 22.8% during the quarter ending 31 March 2023 and increased from 20.8% during the quarter ending 30 June 2022.
The line and stacked bar charts above illustrate the number of tests reported and the number classified as urgent between June 2015 and June 2023.
Aside from a large drop in the number of tests reported during the four quarters from June 2020 to March 2021, the number of tests reported each quarter has risen gradually from 371,390 during the quarter ending June 2015 to 458,178 during the quarter ending June 2023.
The number of urgent tests reported has risen steadily from 42,601 during the quarter ending June 2015 to 102,450 during the quarter ending June 2023. The proportion of tests classified as urgent rose gradually from 11.5% (42,601 of 371,390) in the quarter ending June 2015 to 15.4% (62,970 of 408,012) in the quarter ending March 2020. There was a sharp increase to 21.0% (49,452 of 235,019) in quarter ending June 2020, largely attributable to a decrease in the number of routine tests reported. The proportion of urgent tests has remained broadly consistent since, with 22.4% (102,450 of 458,178) reported in quarter ending June 2023.
Exclusions From This Analysis
Data on diagnostic reporting turnaround times is currently only collected by the Department of Health for a subset of imaging and physiological measurement tests. Day case endoscopies are reported on the day of the test and are therefore also excluded.
Although statistics in this section can be considered as a general indicator of reporting performance, they are not directly comparable to the waiting list statistics presented in the sections above.
The draft reporting target states that all urgent diagnostic tests should be reported on within 2 days of the test being undertaken.
This target was introduced in 2012/13.
Of the 102,450 urgent diagnostic tests reported during the quarter ending June 2023, 78.7% (80,654) were reported on within 2 days.
The line and stacked bar charts above illustrate the number and proportion of urgent diagnostic tests reported on within 2 days between the quarter ending June 2015 and the quarter ending June 2023.
The target has not been met at any point during this period.
The percentage of urgent tests reported within 2 days has decreased gradually from 89.1% during the quarter ending June 2015 (37,952 of 42,601) to 78.7% (80,654 of 102,450) during the quarter ending June 2023. The highest percentage reported across this period was 92.2% during the quarter ending June 2020.
The sources for the data contained in this release are the quarterly Departmental SDR1 and DRTT returns.
SDR1 returns detail diagnostic waiting times and are provided by each of the Health and Social Care Trusts. Diagnostic reporting turnaround time information is detailed in the DRTT return provided by the Strategic Planning and Performance Directorate in the Department of Health.
HSC Trusts use the Northern Ireland Picture Archive and Communications System (NIPACS) as the mechanism for managing imaging services. The Strategic Planning and Performance Group in the Department of Health has carried out a validation exercise with Trusts to address any data quality issues.
A diagnostic service provides an examination, test, or procedure used to identify a person’s disease or condition and which allows a medical diagnosis to be made. There are three categories of diagnostic test: Imaging test; Physiological Measurement test; and Day Case Endoscopy.
The diagnostic waiting time relates to all tests with a diagnostic element. Included are tests that are part diagnostic and subsequently part therapeutic. A therapeutic procedure is defined as a procedure which involves actual treatment of a person’s disease, condition or injury. Purely therapeutic procedures are excluded from the diagnostic waiting times target. Patients currently admitted to a hospital bed and waiting for an emergency procedure, patients waiting for a planned procedure and patients waiting for procedures as part of screening programmes are also excluded from the waiting times target.
The waiting time for a diagnostic service commences on the date on which the referral for the service is received by the Health Care provider and stops on the date on which the test is performed. Patients who cannot attend have their waiting time adjusted to commence on the date they informed the HSC Trust that they could not attend, while patients who miss their appointment have their waiting time adjusted to commence on the date of the missed appointment. Time bands shown relate to the number of completed weeks a patient has been waiting for a diagnostic service. For example, a patient waiting exactly 6 weeks would be included in the 0-6 week time band and a patient waiting 6 weeks and 1 day would be included in the >6-9 week (greater than 6 weeks but waiting no longer than 9 weeks) time band. This also applies to the number of days waited for a diagnostic turnaround.
Some people will be waiting on more than one waiting list or be on the same waiting list for more than one outpatient appointment/admission/diagnostic test at the same time due to having more than one condition.
The diagnostic reporting turnaround time is the time interval between the completion of the diagnostic test and the results of that test being verified or dispatched to the referring clinician in Northern Ireland, whichever is applicable.
Diagnostic reporting times apply to a selected subset of imaging and physiological measurement diagnostic services. These services are: Magnetic Resonance Imaging; Computerised Tomography; Non-Obstetric Ultrasound; Barium Studies; DEXA Scan; Radio-Nuclide Imaging; Pure Tone Audiometry; Echocardiography; Perfusion Studies; Peripheral Neurophysiology; Sleep Studies; and Urodynamics Pressures and Flows and Plain Film X-rays.
Two major changes in diagnostic waiting list data collection and diagnostic reporting times data collection occurred in 2010/11 and 2015/16 respectively. Prior to 2010/11, diagnostic waiting information was collected and presented relating to 16 selected diagnostic services, after which the department commenced collection of waiting times data for all diagnostic services. From 2015/16 Plain Film X-Rays were included in reporting data.
Due to these changes, it is only possible to provide trend data from 2010/11 onwards for diagnostic waiting lists and from 2015/16 onwards for diagnostic reporting times.
Figures for reporting years prior these are still published in the accompanying CSV files, however users should exercise caution in how they are used and are advised against making any comparisons that cross these time points.
A number of diagnostic services may not be provided at all of the five HSC Trusts in Northern Ireland. In this situation, patients from one HSC Trust area will be waiting to be seen at a service provided at another HSC Trust. Users should therefore be cautious in how they use these data. For example, they should not be used to calculate the total number of patients waiting per head of the population residing within each HSC Trust area. Neither should the actual number of patients waiting longer than the recommended waiting time be used as indicator of poor performance within an individual HSC Trust. Users who require an indication of the latter are advised to refer to the commentary section of the publication which provides an indication of the percentage of total waiters that have been waiting over the maximum recommended waiting times, within each HSC Trust.
A number of the diagnostic services, particularly endoscopies, reported on the SDR1 returns are managed as an admission: either an inpatient admission or a day case. As such, they will be included in both the inpatient and day case waiting time and diagnostic waiting time figures. Due to the risk of multiple counting, these two sets of data should not be combined to give an estimate of the total number of patients waiting for admission or a diagnostic service.
The diagnostic waiting times and diagnostic reporting turnaround times returns (SDR1 Parts 1 and 2, DRTT) include patients living outside Northern Ireland and privately funded patients waiting for diagnostic services in Health Service hospitals in Northern Ireland.
The information on diagnostic and reporting times contained within this publication is currently under review. The Department is looking at how this information is sourced and the validation procedures that are carried out with a view to improving the quality. All quality issues identified as part of this review are being addressed on an ongoing basis.
The Department of Health’s policy is to publish revised figures with subsequent statistical releases unless it is decided that the magnitude of the change merits earlier notification.
Due to technical issues, data for cardiology physiological measurement diagnostic tests from the Royal Belfast Hospital for Sick Children have not been available since February 2020. The impact of this on the statistics in this report is minimal. At February 2020, there were 321 patients waiting 14 for this service, this was approximately 7% of the total waiting for Belfast HSC Trust’s cardiology service.
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/articles/diagnostic-waiting-times
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:
Users should note that from September 2018, these following changes appear in these data sources: Barium Studies and Fluoroscopy diagnostic waits have been combined together and Computerised Tomography has been split into General, Colonoscopy and Cardiac waits.
Statistics on waiting times for inpatients, outpatients, cancer and emergency care are available at the following link:
https://www.health-ni.gov.uk/topics/doh-statistics-and-research/hospital-waiting-times-statistics
Please contact Hospital Information Branch for assistance with accessibility requirements or alternative formats.
Email: statistics@health-ni.gov.uk
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