Official Statistics
All data contained within this publication are designated as official statistics.
Published by: Information & Analysis
Directorate, Department of Health
Statisticians: Adam Robinson, Jenny Finlay & Liz
Graham
Contact: statistics@health-ni.gov.uk
Reporting Period: 1 January 2024 – 31 March
2024
Publication Date: 30 May 2024
Date of Next Publication: 29 August 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 as at 31 December 2023 and 31 March 2024 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 waiting for admission to 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.
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.
This statistical release presents information on waiting 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 are available at the following links:
https://data.nisra.gov.uk/product/HWTS
Figures in this section exclude the South Eastern Trust as data was not available as at 31 December 2023 or 31 March 2024.
164,476 patients were waiting for a diagnostic test in the Belfast, Northern, Southern and Western HSC Trusts on 31 March 2024, 7.3% (11,143) more than on 31 December 2023 (153,333), and 20.1% (27,545) more than on 31 March 2023 (136,931).
59.1% (97,162) of patients were waiting more than 9 weeks for a diagnostic test, compared with 60.5% (92,815) on 31 December 2023 and 51.0% (69,796) on 31 March 2023.
33.4% (55,001) of patients were waiting more than 26 weeks for a diagnostic test compared with 33.9% (52,011) on 31 December 2023 and 27.1% (37,151) on 31 March 2023.
Figures in this section exclude the South Eastern Trust as data was not available as at 31 December 2023 or 31 March 2024.
369,323 diagnostic tests were reported on at hospitals in the Belfast, Northern, Southern and Western HSC Trusts during the quarter ending March 2024. Of these, 25.2% (93,242) were urgent tests and the remaining 74.8% (276,081) were routine tests.
Of the 93,242 urgent diagnostic tests, 76.2% (71,070) were reported on within 2 days.
On 31 March 2024, there were 164,476 patients waiting for a diagnostic test in the Belfast, Northern, Southern and Western HSC Trusts.
The number of patients waiting increased by 7.3% (11,143) since 31
December 2023 (153,333) and increased by 20.1% (27,545) since 31 March
2023.
Figures in this section exclude the South Eastern Trust as data was not available as at 31 December 2023 or 31 March 2024. However, the previously published time series including all Trusts up to September 2023 has been included in Figure 1 to provide context.
This line chart shows that the number of patients waiting has risen steadily from 53,592 on 30 September 2013 to 164,476 on 31 March 2024.
Figures in this section exclude the South Eastern Trust as data was not available as at 31 March 2024.
On 31 March 2024, the largest waiting lists were for Non-Obstetric Ultrasound (27,507 patients) and Magnetic Resonance Imaging (24,951 patients).
Echocardiography, Computerised Tomography and Plain Film X-Rays also had more than 10,000 patients on their waiting lists.
Of services with more than 2,000 patients waiting, Non-Obstetric
Ultrasound had the greatest proportionate increase with 59.5% (10,259)
more patients waiting on 31 March 2024 (27,507) than on 31 March 2023
(17,248).
The bar chart above shows the number of patients waiting for each diagnostic service on 31 March 2024, with markers comparing numbers on 31 March 2023. Only specialties with at least 2,000 patients waiting are shown.
Figures in this section exclude the South Eastern Trust as data was not available as at 31 December 2023 or 31 March 2024.
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 percentage and number of patients waiting less than 9 weeks for a diagnostic test between 30 June 2016 and 31 March 2024.
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 65.6% (54,806 of 83,562 patients) on 30 June 2016.
On 31 March 2024, 40.9% (67,314 of 164,476 patients) were waiting
less than 9 weeks for a diagnostic test, an increase from 39.5% on 31
December 2023.
The line and stacked bar charts above illustrate the percentage and number of patients waiting longer than 26 weeks for a diagnostic test between 30 June 2016 and 31 March 2024.
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 6.4% (5,348 of 83,562 patients) on 30 June 2016.
On 31 March 2024, 33.4% (55,001 of 164,476 patients) were waiting longer than 26 weeks for a diagnostic test, an increase from 27.1% on 31 March 2023.
Figures in this section exclude the South Eastern Trust as data was not available as at 31 December 2023 or 31 March 2024.
Exclusions From This Analysis
Data on diagnostic reporting 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 excluded.
Although statistics in this section can be considered as a general indicator of reporting performance, they do not represent all patients coming off waiting lists above.
There were 369,323 diagnostic tests reported on during the quarter ending 31 March 2024, of which 25.2% (93,242) were urgent tests and the remaining 74.8% (276,081) were routine tests.
The total number of tests reported decreased by 2.1% (7,927) from 377,250 during the quarter ending 31 December 2023 and decreased by 1.7% (6,521) from 375,844 reported in the quarter ending 31 March 2023.
The proportion of urgent tests decreased from 26.0% during the
quarter ending 31 December 2023 and increased from 24.6% during the
quarter ending 31 March 2023.
The stacked bar chart above illustrates the number of tests reported and the number classified as urgent between June 2015 and March 2024.
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 306,239 during the quarter ending June 2015 to 369,323 during the quarter ending March 2024.
The number of urgent tests reported has risen steadily from 38,509 during the quarter ending June 2015 to 93,242 during the quarter ending March 2024. The proportion of tests classified as urgent rose gradually from 12.6% (38,509 of 306,239) in the quarter ending June 2015 to 16.5% (55,329 of 335,977) in the quarter ending March 2020. There was a sharp increase to 22.6% (43,164 of 190,670) in quarter ending June 2020, largely attributable to a decrease in the number of routine tests reported. Since then, the proportion of urgent tests has remained broadly consistent, with 25.2% (93,242 of 369,323) reported in quarter ending March 2024.
Figures in this section exclude the South Eastern Trust as data was not available as at 31 December 2023 or 31 March 2024.
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 do not represent all patients coming off waiting lists 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 93,242 urgent diagnostic tests reported during the quarter
ending March 2024, 76.2% (71,070) were reported on within 2 days.
The line and stacked bar charts above illustrate the percentage and number of urgent diagnostic tests reported on within 2 days between the quarter ending June 2015 and the quarter ending March 2024.
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 88.2% during the quarter ending June 2015 (33,975 of 38,509) to 76.2% (71,070 of 93,242) during the quarter ending March 2024. The highest percentage reported across this period was 91.7% 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 also provided by the Health and Social Care Trusts.
HSC Trusts use the Northern Ireland Picture Archive and Communications System (NIPACS) as the mechanism for managing imaging services. 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. Patients currently admitted to a hospital bed and waiting for an emergency procedure, patients waiting for a planned procedure, patients waiting for procedures as part of screening programmes, and purely therapeutic procedures are excluded from the waiting times target and from this analysis.
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 recorded from 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 patients will be on more than one waiting list or be on the same waiting list for more than one diagnostic test due to having multiple conditions. Such patients are counted more than once depending on how many times they are waiting.
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. Day case endoscopies are reported on the day of the test and are therefore excluded from diagnostic reporting times.
Two major changes in the data collection of diagnostic waiting lists and diagnostic reporting times 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 to 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 an 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 waiting and reporting times contained within this publication is currently under review. The Department is considering 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 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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