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 January 2023 – 31 March
2023
Publication Date: 25 May 2023
Date of Next Publication: 31 August 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:
Data are presented by HSC Trust, diagnostic category, diagnostic test, and time band. Further information is available in the accompanying CSV files at:
Target: By March 2023, 75% of patients should wait no longer than 9 weeks for a diagnostic test, with no patient waiting longer than 26 weeks.
At 31 March 2023, there were 173,572 patients waiting for a diagnostic test, of which 48.3% (83,830) were waiting less than 9 weeks and 26.9% (46,630) were waiting longer than 26 weeks. Neither element of the target was achieved.
The number of patients waiting increased by 163.3% (107,653) over the 10 years since March 2013 (65,919), by 11.1% (17,302) since March last year (156,270) and by 7.0% (11,376) since December 2022 (162,196).
Figure 1 (above): Stacked column chart illustrating the number of patients waiting for a diagnostic service each quarter from March 2013 to March 2023, indicating numbers within the 9 week and 26 week targets.
At 31 March 2023, there were 26,533 patients waiting for a non-obstetric ultrasound, representing 15.3% of all patients waiting for diagnostic tests.
Of services with more than 500 patients waiting, Arthroscopy had the highest proportion of patients both waiting more than 9 weeks (93.1%, 1,557) and waiting more than 26 weeks (80.3%, 1,342) of 1,672 patients.
Patients waiting for MRI tests accounted for the largest number of patients waiting more than 9 weeks (8,431 patients) while patients waiting for Echocardiography accounted for the largest number waiting more than 26 weeks (6,771 patients).
Figure 2 (above): Stacked bar chart illustrating the number of patients
waiting for each diagnostic service in March 2023 with a breakdown of
waiting times by targets.
*Diagnostic services with fewer than 500
tests reported have been grouped into the ‘Other’ category, and are
detailed in the accompanying table.
Target: By March 2023, all urgent diagnostic tests should be reported on within 2 days of the test being undertaken
Note: Diagnostic reporting turnaround times relate only to a selected subset of Imaging and Physiological Measurement tests. Day case endoscopies are reported on the day of the test and as such are not included.
There were 460,786 diagnostic tests reported on during quarter ending March 2023, of which 22.8% (104,829) were urgent tests and the remaining 77.2% (355,957) were routine tests.
The total number of tests completed has risen gradually since 2015, increasing by 24.1% (89,396 tests) from 371,390 tests during the quarter ending June 2015 to 460,786 in the quarter ending March 2023.
Across this period, the number of urgent tests has increased by 146.1% (62,228 tests) from 42,601 in the quarter ending June 2015 to 104,829 in the quarter ending March 2023.
Figure 3 (above): Stacked column chart illustrating the trend in numbers of tests reported each quarter from June 2015 to March 2023, including breakdown of routine and urgent tests.
There were 104,829 urgent tests reported on during quarter ending March 2023, of which 76.8% (80,554) were reported on within two days.
The number of urgent tests reported on has increased by 146.1% (62,228 tests) from 42,601 tests in quarter ending June 2015 to 104,829 tests in quarter ending March 2023.
Across this same period, the proportion of tests reported within two days reduced from 89.1% (37,952) to 76.8% (80,554).
Figure 4 (above): Stacked column chart illustrating the trend in numbers of urgent tests reported each quarter from June 2015 to March 2023, alongside numbers reported within the two day target.
During quarter ending March 2023, there were 156,877 non chest plain film tests reported, representing 34.0% of all reported tests.
General computerised tomography accounted for 33.0% (34,579) of all urgent tests.
Of tests accounting for more than 1% of urgent tests reported, non chest plain film tests had the highest proportion of urgent turnaround times breaching the ministerial target, with 53.8% (4,227) of 7,851 tests having a turnaround time over 2 days.
Figure 5.1 (above): Bar chart illustrating the number of tests reported
and dispatched for each diagnostic service in March 2023 broken down by
priority.
*Services accounting for less than 1% of tests reported
have been grouped into the ‘Other’ category.
Figure 5.2 (above): Bar chart illustrating the number of urgent tests
reported and dispatched for each diagnostic service in March 2023 broken
down by turnaround time.
*Services accounting for less than 1% of
tests reported have been grouped into the ‘Other’ category.
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.
Data for Plain Film X-rays is only available from April 2015 onwards. Users should take account of this if comparing total diagnostic reporting times prior to this date.
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 in CSV format to aid secondary analysis, at the following link:
From September 2018, the CSV file has a number of changes: 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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