A National Statistics Publication
All data contained within this publication are National Statistics, with the exception of ‘Use of Operating Theatres’, ‘Independent Sector’, ‘Hospital Births’, ‘Children Under 17 Years’ and ‘Older Adults Aged 65 and Over’ data.
Published by: Information & Analysis Directorate, Department of Health
Statisticians: Stephanie Anderson, Jennifer Hillen, Jenny Finlay & Siobhán Morgan
Reporting Period: 1 April 2022 – 31 March 2023
Publication Date: 3 August 2023
Date of Next Publication: 1 August 2024
Coverage: Northern Ireland
Frequency: Annual
Please note that as this publication is presented in HTML format for the first time we would welcome any feedback. Contact: statistics@health-ni.gov.uk
This publication presents information on inpatient and day case activity at Health and Social Care Trusts in Northern Ireland during the year ending 31 March 2023. It details information on Available Beds, Occupied Beds, Occupancy Rates, Average Length of Stay, Theatre Activity and Hospital Births. Data are presented by HSC Trust, Hospital, Programme of Care and Specialty as appropriate. Data detailed in this publication are also available in spreadsheet format (Microsoft Excel) to aid secondary analysis, at the link: https://www.health-ni.gov.uk/publications/hospital-statistics-inpatient-and-day-case-activity-202223.
| Type | 2022-2023 | Difference From Last Year | Percentage Change From Last Year | Difference From 5 Years Ago | Percentage Change From 5 Years Ago |
|---|---|---|---|---|---|
| Inpatients | 255,747.0 | 4569 | 1.8% | -39341 | -13.3% |
| Day Cases | 286,332.0 | 26676 | 10.3% | -30674 | -9.7% |
| Total Admissions | 542,079.0 | 31245 | 6.1% | -70015 | -11.4% |
| Independent Sector Admissions | 32,398.0 | 12359 | 61.7% | 20990 | 184.0% |
| Average Available Beds | 6,127.0 | 322.8 | 5.6% | 303.1 | 5.2% |
| Average Occupied Beds | 5,033.9 | 417.4 | 9.0% | 164.6 | 3.4% |
| Average Length of Stay (days) | 7.2 | 0.5 | 7.5% | 1.2 | 20.0% |
| Theatre Cases | 98,150.0 | 14881 | 17.9% | -21857 | -18.2% |
| Hospital Births | 20,355.0 | -1440 | -6.6% | -2700 | -11.7% |
During 2022/23 there was a total of 542,079 admissions to hospitals in Northern Ireland.
This was an increase of 31,245 (6.1%) from 510,834 in 2021/22. Over half (52.8%, 286,332) were day case admissions while the remaining 47.2%, (255,747) were inpatient admissions.
There was a decrease of 70,015 (11.4%) on the number admitted in 2018/19 (612,094).
Figure 1 (above): line chart illustrating the number of admissions for each financial year from 2018-2019 to 2022-2023.
During 2022/23 admissions increased within acute services, elderly care, and learning disability. There were fewer admissions in all programmes of care in 2022/23 compared with 2018/19.
Figure 2 (above): bar charts illustrating the number of admissions by programme of care for each financial year from 2018-2019 to 2022-2023.
As shown in figure 3a Belfast HSC Trust had the highest number of admissions during 2022/23, accounting for 30.5% (165,404) of the total admissions. This was followed by 18.0% (97,481) in Western HSC Trust, 17.7% (96,214) in South Eastern HSC Trust, 17.3% (93,645) in Northern HSC Trust and 16.5% (89,335) in Southern HSC Trust. For Trust trends over time please see figure 3b on the second chart tab.
Figure 3a (above): bar chart illustrating the number of admissions in each HSC Trust in 2022-2023.
Figure 3b (above): stacked bar chart illustrating the number of inpatient and day case admissions for each financial year from 2018-2019 to 2022-2023 for all Trusts. Chart can also be filtered by HSC Trust.
Data users should be aware that not all inpatient services are provided at each of the five HSC Trusts in Northern Ireland. In some circumstances patients from one HSC Trust area will be admitted to another HSC Trust. It is therefore not possible to accurately calculate the number of inpatient admissions per head of the population in any HSC Trust area, as HSC Trusts that provide services for the whole of Northern Ireland will have a higher number of admissions per head of the population than those which provide more localised services.
Data users should be aware that not all inpatient services are provided at each of the five HSC Trusts in Northern Ireland. In some circumstances patients from one HSC Trust area will be admitted to another HSC Trust. It is therefore not possible to accurately calculate the number of inpatient admissions per head of the population in any HSC Trust area, as HSC Trusts that provide services for the whole of Northern Ireland will have a higher number of admissions per head of the population than those which provide more localised services.
Between 2021/22 and 2022/23, the average number of available beds increased by 5.6% (322.8) from 5,804.2 beds to 6,127.0 beds. Between 2018/19 and 2022/23, there was an increase of 5.2% (303.1), from 5,823.9 to 6,127.0.
During 2022/23 there was an average of 5,033.9 occupied beds, an increase of 417.4 (9.0%) on the 4,616.5 occupied beds during the previous year, and an increase of 164.6 (3.4%) from 2018/19.
The occupancy rate of beds in hospitals in Northern Ireland was 82.2% during 2022/23; this was an increase from 79.5% in 2021/22.
Figure 4 (above): bar chart illustrating the number of available and occupied beds for all trusts for each financial year from 2018-2019 to 2022-2023. Chart can also be filtered by HSC Trust.
Of the 6,127.0 average available beds in Northern Ireland in 2022/23, 35.7% (2,188.9) were located in Belfast HSC Trust. Western HSC Trust had the lowest proportion of available beds with 14.8% (907.1) of the Northern Ireland total.
During 2022/23, Southern HSC Trust had the highest occupancy rate of all five trusts at 88.1%, while the lowest rate of occupancy was in the Belfast HSC Trust at 75.2%.
Of the 6,127.0 average available beds in Northern Ireland in 2022/23, 35.7% (2,188.9) were located in Belfast HSC Trust. Western HSC Trust had the lowest proportion of available beds with 14.8% (907.1) of the Northern Ireland total.
During 2022/23, Southern HSC Trust had the highest occupancy rate of all five trusts at 88.1%, while the lowest rate of occupancy was in the Belfast HSC Trust at 75.2%.
Throughput is a measurement of the average number of inpatient admissions treated in each available bed open overnight each year. There has been an overall decrease in throughput, from 50.7 admissions per bed in 2018/19 to 41.7 admissions per bed in 2022/23.
Figure 5 (above): line chart illustrating the average admissions per available bed for each financial year from 2018-2019 to 2022-2023.
In 2022/23, Southern HSC Trust had the highest throughput with 49.0 admissions per bed, while Belfast HSC Trust had the lowest with 33.6 admissions per bed.
Figure 6 (above): bar chart illustrating the average admissions per available bed during 2022-2023 for each HSC Trust.
Average length of stay in hospitals increased from 6.0 days in 2018/19 to 7.2 days in 2022/23.
Figure 7 (above): line chart illustrating the average length of stay for each financial year from 2018-2019 to 2022-2023.
In 2022/23, Belfast HSC Trust had the longest average length of stay with 8.2 days, followed by South Eastern HSC Trust with 7.2 days. Western HSC Trust had the shortest with 6.5 days. The location of regional specialties such as cardiac surgery, thoracic surgery and forensic psychiatry in the Belfast HSC Trust may explain the longer average length of stay.
Figure 8 (above): bar chart illustrating the average length of stay for each HSC Trust in 2022-2023.
Data users should note that ‘Use of Operating Theatres’ statistics are not designated as National Statistics.
Information in relation to the use of operating theatres is presented by session type, hospital and HSC Trust. The use of operating theatres relates to the number of cases operated on by National Confidential Enquiry into Patient Outcome and Death (NCEPOD) classification.
Theatre cases are classified as Immediate, Urgent, Expedited or Elective. In 2022/23, there were 98,150 theatre cases across all HSC Trust hospitals in Northern Ireland; this was an increase of 17.9% (14,881) compared with 83,269 theatre cases in 2021/22.
Across all Programmes of Care, the number of cases operated on was highest in Belfast HSC Trust, with 34.0% (33,394) of all theatre usage. Northern Trust had the lowest use of operating theatres with 11.6% (11,374).
Across all HSC Trusts, Elective cases accounted for 70.7% of all theatre activity, followed by 14.0% of cases recorded as Expedited, 12.1% as Urgent and 3.3% as Immediate.
Figure 9 (above): line chart illustrating the number of cases operated on by session type for each financial year from 2018-2019 to 2022-2023.
In 2022/23, the top 5 HSC Trust hospitals with the highest number of cases operated on, accounted for over half (52.3%, 51,375 cases) of all theatre activity in Northern Ireland.
Figure 10 (above): bar chart illustrating the number of cases operated on by hospital in 2022-2023.
During 2022/23, the top 5 specialties accounted for 68.1% (66,795) of all theatre activity. The highest number of cases in Northern Ireland was recorded under General Surgery with 20.4%, followed by Trauma & Orthopaedic Surgery 17.1%, Urology 12.1%, Ophthalmology 9.7% and Obstetrics with 8.8% of all theatre cases.
Of all 98,150 theatre cases, 90.7% (89,033) were under the Acute Programme of Care.
Figure 11 (above): treemap illustrating the number of admissions in each specialty in 2022-2023.
During 2022/23 there was a total of 475,943 admissions to hospitals in Northern Ireland under the Acute programme of care accounting for approximately 87.8% of all admissions in 2022/23. Admissions increased by 29,690 (6.7%) on the 446,253 admitted in 2021/22. There was a decrease of 64,733 (12.0%) on the 540,676 admitted in 2018/19.
Figure 12 (above): line chart illustrating the number of acute admissions for each financial year from 2018-2019 to 2022-2023.
Of the 475,943 acute admissions in 2022/23, 6.8% were elective, 33.8% non-elective, 36.9% day cases and 22.6% were regular day/night attenders.
Figure 13 (above): line chart illustrating the number of acute admissions by type for each financial year from 2018-2019 to 2022-2023.
In 2022/23, 48.9% of admissions to hospital under the acute programme of care in Belfast HSC Trust were either elective (10.3%) or day case (38.6%) admissions. This is the highest proportion for any HSC Trust within Northern Ireland. Of all the admissions to Southern HSC Trust in 2022/23, 3.9% were elective. This is the smallest proportion of elective admissions in any of the five HSC Trusts.
Figure 14 (above): treemap illustrating the number of acute admissions in each HSC Trust in 2022-2023.
In 2022/23, 16.6% of admissions to hospital under the acute programme of care were under the Nephrology specialty, with 15.5% of admissions under General Medicine, 10.2% General Surgery, 6.3% Gastroenterology and 5.8% Haematology (Clinical).
Figure 15 (above): treemap illustrating the number of acute admissions in each specialty in 2022-2023.
The day case rate is given as a percentage of elective admissions (including day cases and elective inpatients).
The day case rate has increased from 81.4% in 2018/19 to 84.4% in 2022/23. The greatest increase occurred between 2020/21 and 2021/22 when the day case rate increased from 82.6% to 84.3% of all elective admissions.
A method of reducing excess bed days and pre-operative length of stay is to increase the use of day case surgery for procedures such as tonsillectomies, cataract extractions and varicose vein removal where it is clinically safe to do so.
Figure 16 (above): line chart illustrating the day case rate for each financial year from 2018-2019 to 2022-2023.
Within the acute programme of care, Southern HSC Trust had a day case rate of 90.5% in 2022/23 which was the highest of the five HSC Trusts. Belfast HSC Trust had the lowest day case rate with 79.0% of elective admissions recorded as day cases. However, this may be explained by the provision of specialised regional services by the Belfast HSC Trust and on occasion, the higher numbers of complex cases.
Figure 17 (above): bar chart illustrating the day case rate for each HSC Trust in 2022-2023.
Within the acute programme of care, from 2018/19 to 2022/23 the top nine specialties by day case rate consistently maintained a rate of over 90%.
Figure 18 (above): line chart illustrating the day case rate for each specialty in 2018-2019 to 2022-2023. Top 10 specialties are those with the highest day case rate for 2022/23.
Top 10 specialties are those with the highest day case rate for 2022/23.
Between 2021/22 and 2022/23 there was an increase of 7.3% (297.2) in the average number of available beds in the acute programme of care from 4,084.9 to 4,382.1 beds. In the period between 2018/19 and 2022/23, the average available beds increased by 507.1 from 3,875.0 to 4,382.1.
During 2022/23 there was an average of 3,544.3 occupied beds. This was an increase of 369.1 bed days (11.6%) on the 3,175.2 during the previous year, and an increase of 306.4 bed days (9.5%) on the number of occupied beds in 2018/19.
The occupancy rate for acute specialties in hospitals in Northern Ireland was 80.9% during 2022/23; this was an increase from 77.7% in 2021/22.
Figure 19 (above): bar chart illustrating the number of acute available and occupied beds for all trusts for each financial year from 2018-2019 to 2022-2023. Chart can also be filtered by HSC Trust.
The average length of stay for admissions within the acute programme of care has increased between 2018/19 and 2022/23, from 5.3 days in 2018/19, to 6.7 days in 2022/23.
Figure 20 (above): line chart illustrating the average length of stay in the acute programme of care for each financial year from 2018-2019 to 2022-2023.
In 2022/23, admissions under the acute programme of care in Western HSC Trust had the lowest average length of stay at 5.5 days. This is in contrast to Belfast HSC Trust where the average length of stay was highest at 7.9 days.
Figure 21 (above): line chart illustrating the average length of stay in the acute programme of care in each HSC Trust in 2022-2023.
During 2022/23, the longest average length of stay across all acute specialties in Northern Ireland was under the Rehabilitation specialty where admissions lasted for an average of 44.6 days. During 2022/23, the shortest average length of stay across all acute specialties in Northern Ireland was under the Paediatric Dentistry and Accident & Emergency specialties where admissions lasted for an average of 1.4 days.
Figure 22 (above): bar chart illustrating the average length of stay in the acute programme of care in each specialty in 2022-2023.
Data users should note that ‘Acute Services Independent Sector Activity’ statistics are not designated as National Statistics.
An Independent Sector provider is a private sector healthcare company that is contracted by the HSC Trust in the provision of healthcare or in the support of the provision of healthcare. All Independent Sector admissions occurred within the Acute Programme of Care.
In 2022/23 there were 32,398 admissions to hospitals in Northern Ireland for an inpatient or day case procedure with an Independent Sector provider that was commissioned by the Health Service. This was an increase of 12,359 (61.7%) when compared with 2021/22 and an increase of 20,990 (184.0%) when compared with 2018/19.
Figure 23 (above): line chart illustrating the number of acute admissions in the Independent Sector for each financial year from 2018-2019 to 2022-2023.
Of the 32,398 admissions to hospitals in Northern Ireland for an inpatient or day case procedure with an Independent Sector provider, the majority (92.0%; 29,807) were admitted for day case treatment while the remaining 8.0% (2,591) were admitted as an inpatient.
South Eastern HSCT and Belfast HSCT accounted for the highest percentage of admissions, 41.2% (13,350) and 22.8% (7,392) respectively, with an Independent Sector provider in Northern Ireland. Southern HSC Trust had the lowest proportion of Independent Sector provider admissions, with 10.6% (3,425) of all Independent Sector admissions.
Figure 24 (above): stacked bar chart illustrating the number of acute inpatient and day case admissions in the Independent Sector for each HSC Trust in 2022-2023.
Admissions under the maternity and child health programme of care accounted for 8.0% of all admissions in 2022/23.
Only consultant-led admissions are counted on the KH03A statistical monitoring return, therefore it is not possible to calculate birth rates per admission, as four HSC Trusts operate midwife-led units. Please note, prior to 2022/23, Southern Trust Maternity and Child Health figures included midwife-led admissions and beds.
In 2022/23 there were 43,564 admissions to hospitals in Northern Ireland under the maternity programme of care, a decrease of 134 (0.3%) when compared with 2021/22 and a decrease of 2,774 (6.0%) when compared with 2018/19. The greatest change in maternity admissions was from 2019/20 (47,672) to 2020/21 (42,203).
Figure 25 (above): line chart illustrating the number of maternity and child health admissions for each financial year from 2018-2019 to 2022-2023.
In 2022/23, 27.8% (12,094) of admissions to hospital under the maternity and child health programme of care were in Belfast HSC Trust, followed by 23.6% (10,271) in Southern HSC Trust.
Figure 26 (above): bar chart illustrating the number of maternity and child health admissions in each HSC Trust in 2022-2023.
The average number of available beds decreased by 1.3% from 410.4 in 2021/22 to 405.0 in 2022/23. Average occupied beds decreased from 225.3 to 222.4 over the same period. Average available beds were 11.5% lower (52.8) in 2022/23 than in 2018/19, with average occupied beds falling by 16.3% from 265.6 to 222.4.
Of the 405.0 average available beds in Northern Ireland in 2022/23, 23.8% (96.4) were located in Northern HSC Trust. Western HSC Trust had the smallest percentage of available beds, with 16.5% (66.9).
The occupancy rate for maternity specialties in hospitals in Northern Ireland was 54.9% during 2022/23; this is the same as in 2021/22, but a decrease from 58.0% in 2018/19.
Figure 27 (above): bar chart illustrating the number of maternity and child health available and occupied beds for all trusts for each financial year from 2018-2019 to 2022-2023. Chart can also be filtered by HSC Trust
Data users should note that ‘Hospital Births’ statistics are not designated as National Statistics.
Hospital Births statistics relate only to births that occurred, either while admitted to an HSC Trust Hospital in Northern Ireland; or while en route to an HSC Trust hospital, immediately prior to admission. Therefore, these figures do not reflect the number of home births in Northern Ireland, and are not comparable to Birth Registrations data.
The total number of births in hospital in Northern Ireland decreased by 6.6% (1,440) from 21,795 births in 2021/22 to 20,355 births in 2022/23. Between 2018/19 and 2022/23 total births decreased by 2,700, from 23,055 in 2018/19.
Figure 28 (above): bar chart illustrating the number of hospital births for each financial year from 2018-2019 to 2022-2023.
During 2022/23, the majority of live births (88.1%) were consultant-led births. The remaining 11.9% of live births were midwife-led. Still births accounted for 0.3% (71) of all births.
In 2022/23, just under a quarter (4,900, 24.1%) of all births were in the Southern HSC Trust, followed by Belfast HSC Trust with 23.1% of all births (4,701). Western HSC Trust had the lowest percentage of births with 16.5% (3,349). Births in the Royal Maternity Hospital accounted for 23.1% (4,701) of births in 2022/23, with the Ulster and Craigavon Area Hospitals accounting for 18.5% and 14.6% of births respectively.
Figure 29 (above): treemap illustrating the number of hospital births in each hospital in 2022-2023.
Of the 20,355 births in Northern Ireland in 2022/23, 49.0% (9,982) were normal vertex and normal cephalic deliveries. A total of 7,951 (39.1%) births were carried out by caesarean section (4,245 elective and 3,706 emergency).
Figure 30 (above): bar charts illustrating the type of hospital births for each financial year from 2018-2019 to 2022-2023.
South Eastern HSC Trust had the highest caesarean section rate with 43.5% (1,642), of all births within the Trust being via caesarean, while Belfast HSC Trust had the lowest rate with 33.2% (1,561).
South Eastern HSC Trust had the highest caesarean section rate with 43.5% (1,642), of all births within the Trust being via caesarean, while Belfast HSC Trust had the lowest rate with 33.2% (1,561).
Admissions under the Elderly Care programme of care accounted for 3.3% of all admissions in 2022/23. There were 18,112 admissions to hospital in Northern Ireland under the Elderly Care programme of care, an increase of 1,878 (11.6%) when compared with 2021/22, but a decrease of 1,623 (8.2%) when compared with 2018/19.
Figure 31 (above): line chart illustrating the number of elderly care admissions for each financial year from 2018-2019 to 2022-2023.
In 2022/23, 31.1% (5,628) of elderly care admissions were in Belfast HSC Trust while Western HSC Trust had the fewest, accounting for 13.3% (2,415) of all Elderly Care admissions.
Figure 32 (above): bar chart illustrating the number of elderly care admissions in each HSC Trust in 2022-2023.
Within the last five years, the greatest number of day cases in the elderly care programme of care was 188 in 2021/22. In 2022/23 there were 16 more day cases compared to 5 years ago in 2018/19 and 59 less than in 2021/22.
Figure 33 (above): bar chart illustrating the number of elderly care day cases by HSC Trust in 2018-2019 to 2022-2023. There were no day cases in the Northern HSC Trust
From 2021/22 to 2022/23, the average number of available beds in the Elderly Care programme of care increased 28.0 beds (3.8%) from 744.2 to 772.2 beds. Between 2018/19 and 2022/23, there was a decrease of 101.3 (11.6%) from 873.5 to 772.2 beds.
During 2022/23, there was an average of 721.5 occupied beds. This was an increase of 37.1 bed days (5.4%) on the 684.4 during the previous year, and a decrease of 59.7 (7.6%) on the number of occupied beds in 2018/19.
The occupancy rate for elderly care in hospitals in Northern Ireland was 93.4% during 2022/23; this was an increase on the 92.0% in 2021/22.
Figure 34 (above): bar chart illustrating the number of elderly care available and occupied beds for all trusts for each financial year from 2018-2019 to 2022-2023. Chart can also be filtered by HSC Trust
The average length of stay for Elderly Care admissions has increased by 0.1 day between 2018/19 (14.5 days) and 2022/23 (14.6 days). Between 2021/22 and 2022/23 the average length of stay decreased by 1.0 day.
Figure 35 (above): line chart illustrating the average length of stay in the elderly care programme of care for each financial year from 2018-2019 to 2022-2023.
Admissions under the Mental Health programme of care accounted for 0.8% of all admissions in 2022/23. Mental health admissions decreased by 808 (15.5%) between 2018/19 (5,209) and 2022/23 (4,401).
Figure 36 (above): line chart illustrating the number of mental health admissions for each financial year from 2018-2019 to 2022-2023.
In 2022/23, 35.0% (1,542) of a total of 4,401 admissions under the Mental Health programme of care were in Western HSC Trust. Southern HSC Trust had the lowest percentage of mental health admissions with 14.6% (642) of the total.
Figure 37 (above): bar chart illustrating the number of mental health admissions in each HSC Trust in 2022-2023.
Between 2021/22 and 2022/23, the average number of available beds in the mental health programme of care increased by 0.9% (4.5) from 487.9 to 492.4. In the period between 2018/19 and 2022/23, there was a decrease of 18.3 (3.6%) from 510.7 to 492.4.
During 2022/23, there was an average of 488.6 occupied beds. This was an increase of 22.1 bed days (4.7%) on the 466.5 during the previous year, and an increase of 6.9 bed days (1.4%) on the number of occupied beds in 2018/19.
The occupancy rate for mental health specialties in hospitals in Northern Ireland in 2022/23 was 99.2% during 2022/23; this was an increase from 95.6% in 2021/22.
Figure 38 (above): bar chart illustrating the number of mental health available and occupied beds for all trusts for each financial year from 2018-2019 to 2022-2023. Chart can also be filtered by HSC Trust
Further information on hospital activity within the Mental Health and Learning Disability programmes of care during 2022/23 will be published on 1st September 2023 at: https://www.health-ni.gov.uk/topics/mental-health-and-learning-disability-statistics
Further information on hospital activity within the Mental Health and Learning Disability programmes of care during 2022/23 will be published on 1st September 2023 at: https://www.health-ni.gov.uk/topics/mental-health-and-learning-disability-statistics
Admissions under the learning disability programme of care accounted for approximately 0.01% of all admissions. The number of learning disability admissions decreased by 77 from 136 in 2018/19 to 59 in 2022/23 (56.6%).
Figure 39 (above): line chart illustrating the number of learning disability admissions for each financial year from 2018-2019 to 2022-2023.
Between 2021/22 and 2022/23, the average number of available beds in the learning disability programme of care decreased by 2.0% (1.5) from 76.8 to 75.3 beds. From 2018/19 to 2022/23, there was a decrease of 31.5 (29.5%) from 106.8 to 75.3.
During 2022/23, there was an average of 57.1 occupied beds. This was a decrease of 8 bed days (12.3%) on the 65.1 during the previous year, and a decrease of 45.8 bed days (44.5%) on the number of occupied beds in 2018/19.
The occupancy rate for learning disability specialties in hospitals in Northern Ireland in 2022/23 was 75.8%; this was a decrease from 84.8% in 2021/22.
Figure 40 (above): bar chart illustrating the number of learning disability available and occupied beds for all trusts for each financial year from 2018-2019 to 2022-2023. Chart can also be filtered by HSC Trust
This section presents information on inpatient and day case activity at Health and Social Care Trusts in Northern Ireland during the year ending 31 March 2023 for children under the age of 17 years old. This only includes data from within the acute programme of care, and does not include births. Please note, the data below are a subset of the overall data presented above. This section is not National Statistics.
During 2022/23, there were a total of 42,393 admissions to hospitals in Northern Ireland for children under the age of 17. This was an increase of 3,146 (8.0%) on the number admitted in 2021/22 (39,247) and a decrease of 6,725 (13.7%) on the number admitted in 2018/19.
Almost three-quarters (73.5%, 31,172 were inpatient admissions while the remaining 26.5% (11,221) were day case admissions.
Figure 41 (above): line chart illustrating the number of inpatient and day case admissions for each financial year for children from 2018-2019 to 2022-2023.
As shown in figure 42a Belfast HSC Trust had the highest number of admissions of children during 2022/23, accounting for 33.3% (14,119) of the total admissions. This was followed by 20.4% (8,630) in Southern HSC Trust, 16.3% (6,926) in South Eastern HSCT Trust, 15.2% (6,424) in Western HSC Trust and 14.8% (6,294) in Northern HSC Trust. For Trust trends over time please see figure 42b on the second chart tab.
Figure 42a (above): bar chart illustrating the number of admissions in each HSC Trust for children in 2022-2023.
Figure 42b (above): stacked bar chart illustrating the number of inpatient and day case admissions for each financial year for children from 2018-2019 to 2022-2023 for all Trusts or can be filtered by HSC Trust.
Of the 42,393 acute admissions of children in 2022/23, 7.0% were elective, 66.5% non-elective, 26.4% day cases and 0.1% were regular day/night attenders.
Figure 43 (above): line chart illustrating the number of acute admissions of children by type for each financial year from 2018-2019 to 2022-2023.
In 2022/23, 50.0% of child admissions to hospital under the acute programme of care in Belfast HSC Trust were either elective (9.3%) or day case (40.7%) admissions. This is the highest proportion for any HSC Trust within Northern Ireland. Of all the admissions to South Eastern HSC Trust in 2021/22, 4.4% were elective. This is the smallest proportion of elective admissions in any of the five HSC Trusts.
Figure 44 (above): treemap illustrating the number of acute admissions in each HSC Trust in 2022-2023.
In 2022/23, 60.3% of admissions to hospital under the acute programme of care for children were under the Paediatrics specialty, with 6.9% of admissions under General Practice Other, 5.0% Ear Nose and Throat, 4.0% Trauma & Orthopaedic Surgery and 3.9% Paediatric Surgery .
Figure 45 (above): treemap illustrating the number of acute admissions of children in each specialty in 2022-2023.
The Paediatrics specialty saw 25,622 admissions of children in 2022/23, an increase of 952 (3.9%) from 2021/22 (24,670) and a decrease of 457 (1.8%) from 2018/19 (26,079). While this was the highest specialty by admissions by a large margin, other specialties also saw a decrease from 2018/19, but an increase from 2021/22. For example, General Practice (Other) saw an increase of 803 (37.5%) from 2021/22, but a drop of 1,400 (32.2%) compared with 2018/19.
Figure 46 (above): line chart illustrating the number of acute admissions of children in the top specialties from 2018-2019 to 2022-2023.
The day case rate is given as a percentage of elective admissions (including day cases and elective inpatients).
The day case rate for children has decreased from 79.5% in 2018/19 to 78.9% in 2022/23. The greatest change occurred between 2019/20 to 2020/21 when the day case rate decreased from 78.6% to 76.2% of all elective admissions.
A method of reducing excess bed days and pre-operative length of stay is to increase the use of day case surgery for procedures such as tonsillectomies, where it is clinically safe to do so.
Figure 47 (above): line chart illustrating the day case rate for children for each financial year from 2018-2019 to 2022-2023.
For admissions of under 17s, South Eastern HSC Trust had a day case rate of 86.5% in 2022/23, which was the highest of the five HSC Trusts. Southern HSC Trust had the lowest day case rate with 70.2% of elective admissions recorded as day cases.
Figure 48 (above): line chart illustrating the day case rate for children for each HSC Trust in 2022-2023.
This section presents information on inpatient and day case activity at Health and Social Care Trusts in Northern Ireland during the year ending 31 March 2023 for adults aged 65 and over. This only includes data from within the acute and elderly care programmes of care. Please note, the data below are a subset of the overall data presented above. This section is not National Statistics.
During 2022/23, there were a total of 241,222 admissions to hospitals in Northern Ireland for older adults aged 65 and over. This was an increase of 16,202 (7.2%) on the number admitted in 2020/21 (225,020) and a decrease of 17,626 (6.8%) on the number admitted in 2018/19.
In 2022/23, over half (57.6%, 138,888) were day case admissions while the remaining 42.4% (102,334) were inpatient admissions.
Figure 49 (above): line chart illustrating the number of inpatient and day case admissions for each financial year for adults aged 65 and over from 2018-2019 to 2022-2023.
As shown in figure 50a Belfast HSC Trust had the highest number of admissions of older adults during 2022/23, accounting for 28.3% (68,366) of the total admissions. This was followed by 19.5% (46,988) in Northern HSC Trust, 19.3% (46,485) in South Eastern HSC Trust, 17.1% (41,218) in Western HSC Trust and 15.8% (38,165) in Southern HSC Trust. For Trust trends over time please see figure 50b on the second chart tab.
Figure 50a (above): bar chart illustrating the number of admissions in each HSC Trust for older adults in 2022-2023.
Figure 50b (above): stacked bar chart illustrating the number of inpatient and day case admissions for each financial year for adults aged 65 and over from 2018-2019 to 2022-2023 for all Trusts or can be filtered by HSC Trust.
In 2022/23, there were 223,110 acute admissions of older adults, of which 5.6% were elective, 32.2% non-elective, 33.9% day cases and 28.3% were regular day/night attenders.
Figure 51 (above): line chart illustrating the number of acute admissions of adults aged 65 and over by type for each financial year from 2018-2019 to 2022-2023.
In 2022/23, 44.5% of older adult admissions to hospital under the acute programme of care in Northern HSC Trust were either elective (3.7%) or day case (40.8%) admissions. This is the highest proportion for any HSC Trust within Northern Ireland. Of all the admissions to Southern HSC Trust in 2022/23, 2.9% were elective. This is the smallest proportion of elective admissions in any of the five HSC Trusts.
Figure 52 (above): treemap illustrating the number of acute admissions of adults aged 65 and over in each HSC Trust in 2022-2023.
In 2022/23, 22.8% of admissions to hospital under the acute programme of care for older adults were under the Nephrology specialty, with 18.2% of admissions under General Medicine, 8.6% General Surgery, 6.8% Haematology (Clinical), and 6.8% Cardiology
Figure 53 (above): treemap illustrating the number of acute admissions of adults aged 65 and over within each specialty in 2022-2023.
Across all of the top specialties for older adults, there was a drop from 2018/19 to 2020/21 with the break out of the COVID-19 pandemic. These then tended to increase in 2021/22 and again in 2022/23, with the exception of nephrology which decreased slightly this year.
Figure 54 (above): line chart illustrating the number of admissions of adults aged 65 and over for each financial year from 2018-2019 to 2022-2023 within the top specialties.
The day case rate is given as a percentage of elective admissions (including day cases and elective inpatients).
The day case rate has increased for older adults from 81.3% in 2018/19 to 85.9% in 2022/23. The greatest increase occurred between 2019/20 to 2020/21 when the day case rate increased from 81.8% to 83.4% of all elective admissions.
A method of reducing excess bed days and pre-operative length of stay is to increase the use of day case surgery for procedures such as tonsillectomies, cataract extractions and varicose vein removal, where it is clinically safe to do so.
Figure 55 (above): line chart illustrating the day case rate for adults aged 65 and over for each financial year from 2018-2019 to 2022-2023.
For admissions of adults aged 65 and over, Southern HSC Trust had a day case rate of 92.7% in 2022/23, which was the highest of the five HSC Trusts. Belfast HSC Trust had the lowest day case rate with 77.7% of elective admissions recorded as day cases.
Figure 56 (above): line chart illustrating the day case rate for adults aged 65 and over in 2022-2023.
In 2022/23, 84,175 adults over the age of 65 were admitted to a hospital in Northern Ireland at least once. Of these individuals, 50,097 (59.5%) were only admitted once, 17,623 (20.9%) were admitted two times, and 16,455 (19.5%) were admitted more than two times within the year. According to the Northern Ireland Census 2021, there were 329,226 people in Northern Ireland aged 65 and over in 2021. Therefore, approximately 25.6% of the older adult population were admitted to hospital at least once in 2022-23.
Figure 57 (above): bar chart illustrating the number of times individuals aged 65 and over were admitted to hospitals in 2022-2023.
Since 2018/19, the proportion of individuals aged 65 and over who have been admitted on only one occasion to hospitals has remained relatively steady, with 52,668 (58.4%) in 2018/19 and 50,097 (59.5%) in 2022/23. Similarly, 19,226 (21.3%) individuals were admitted twice within the financial year for 2018/19, and 17,623 (20.9%) within 2022/23. For three or more admissions, 18,284 (20.3%) people fell into this category in 2018/19, and 17,623 (19.5%) in 2022/23.
Figure 58 (above): line chart illustrating the number of times individuals aged 65 and over were admitted to hospitals from 2018-2019 to 2022-2023.
All information presented in this bulletin has been provided by HSC Trusts or downloaded by Hospital Information Branch (HIB) from an electronic patient-level administrative system within an agreed timescale and quality assured by HIB prior to release.
Queries arising from validation checks are presented to HSC Trusts for clarification and if required, returns may be amended. Once complete, all figures are sent to HSC Trusts for final sign-off.
Trend analyses are used to monitor annual variations and emerging trends.
Data Considerations:
Data providers are supplied with technical guidance documents outlining the methodologies that should be used in the collection, reporting and validation of each of these data returns. These documents can be accessed at the following link:
https://www.health-ni.gov.uk/articles/inpatient-and-day-case-activity
It is not possible to accurately identify ambulatory care pathway activity, and as such this activity has been excluded from this publication. Similarly, use of virtual wards within Emergency Care Departments has been excluded from this publication. Patient transfers within the same Trust have been counted as multiple admissions.
The data for individual hospitals on certain indicators (e.g. ‘Average Available Beds’) will not always sum to the HSC Trust total or the overall NI total due to rounding. In addition, certain indicators (e.g. ‘Throughput’) have been derived from unrounded figures for greater accuracy. They may therefore differ slightly from values obtained through using rounded figures in the formulae. Percentages have been rounded to one decimal place and therefore totals may not sum to 100.
The main uses of these data are to monitor inpatient and day case activity, to help assess Trust performance, for corporate monitoring, to inform and monitor related policy, and to respond to parliamentary/assembly questions and ad-hoc queries.
Inpatient and day case activity information is available for elsewhere in the UK, however, users should be aware that this data in other administrations is not always measured in a comparable manner to Northern Ireland. Inpatient and day case activity information published elsewhere in the UK can be found as detailed below:
England:
Scotland:
http://www.isdscotland.org/Health-Topics/Hospital-Care/Inpatient-and-Day-Case-Activity/
Wales:
https://dhcw.nhs.wales/information-services/health-intelligence/pedw-data-online/
1. Programme of Care
Activity has been grouped into POCs on the basis of the main specialty of the consultant in charge of the patient. In a small number of cases, this may lead to differences between the strict POC and the specialty of the consultant in charge.
2. Inpatients
Inpatient admissions include both (a) patients admitted electively with the expectation that they will remain in hospital for at least one night, and (b) non-elective admissions (e.g. emergency admissions). A patient who is admitted with this intention but who leaves hospital for any reason without staying overnight is still counted as an inpatient. Day cases and regular attenders are not included.
3. Day Case
A patient admitted electively during the course of a day with the intention of receiving care who does not require the use of a hospital bed overnight and who returns home as scheduled. If this original intention is not fulfilled and the patient stays overnight, such a patient should be counted as an inpatient. Regular attenders have been included within the day case statistics for all programmes of care but presented separately for the acute programme of care.
4. Admissions
Total admissions has been taken to be the sum of all day cases, inpatients (elective and non-elective) and regular attenders. Deaths and discharges have been used as an approximation for admissions.
5. Average Available/Occupied Beds
The average number of available and occupied beds during the year in wards that are open overnight, measured at midnight. Beds reserved for day care admission or regular day admission are not included.
6. Percentage Occupancy
A measurement of the percentage of time that beds are occupied. Day cases and regular attenders are excluded from the calculation. Note: In exceptional circumstances, the number of average occupieds bed may exceed the number of average available beds. This can be due to both patient management and/or recording methods.
Occupancy (%) = (Average Daily Occupied Beds) / (Average Daily Available Beds) × 100
7. Throughput
A measurement of the average number of inpatient admissions treated in each available bed open overnight each year. Day Cases and regular attenders are excluded from the calculation. Where small values of average available and average occupied beds have resulted in a throughput value greater than 365, this has been set to ‘-‘, as 365 is the maximum possible value of throughput.
Throughput = (Total Inpatients) / (Total Available Beds)
8. Average Length of Stay
A measurement of the average length of time spent in hospital. Day Cases and regular attenders are excluded from the calculation. Note: The calculation of average length of stay assumes that patients spend the entire length of their stay in hospital within the same specialty. On occasions, patients may be transferred between specialties during the same stay in hospital. In these circumstances, such transfers may slightly skew the average length of stay at a specialty level.
Average Length of Stay = (Average Daily Occupied Beds x Days in Year) / (Total Inpatients)
9. Elective Inpatient
A patient for whom the decision to admit could be separated in time from the actual admission. This excludes emergency admissions and maternity or delivery episodes.
10. Non-Elective Inpatient
A patient for whom admission is unpredictable and at short notice because of clinical need.
11. Regular Day/Night Attender
A patient who is admitted electively and regularly for a planned sequence of days or nights and who returns home for the remainder of the 24 hour period. This method of admission is particularly common for Renal Dialysis and Chemotherapy. Regular attenders have been included within the day case statistics for all programmes of care with the exception of acute services.
12. Day Case Rate
The number of day cases is given as a percentage of elective inpatients.
Day Case Rate = (Total Day Cases) / (Total Elective Inpatients + Total Day Cases) × 100
13. Specialty
A specialty is a particular branch of medicine or surgery. Each consultant is assigned a main specialty from a list recognised by the Royal Colleges and Faculties. Information is recorded against the specialty of the treating consultant.
14. Use of Operating Theatres
It is not possible to split cases operated on under the obstetrics specialty in Altnagelvin Hospital into the 4 National Confidential Enquiry into Patient Outcome and Death (NCEPOD) classifications, therefore all non-elective cases are reported under the urgent category. Information relating to availability and use of operating theatres excludes the following: - Obstetric delivery room containing a delivery bed; - Dental treatment room or surgery containing a dental chair; - X-ray room, whether diagnostic or therapeutic; - Room only used to carry out endoscopy.
15. Immediate
Immediate life, limb or organ-saving intervention – resuscitation simultaneous with intervention. Normally within minutes of decision to operate. a) Life-saving b) Other e.g. limb or organ saving
16. Urgent
Intervention for acute onset or clinical deterioration of potentially life-threatening conditions, for those conditions that may threaten the survival of limb or organ, for fixation of many fractures and for relief of pain or other distressing symptoms. Normally within hours of decision to operate.
17. Expedited
Expedited patient requiring early treatment where the condition is not an immediate threat to life, limb or organ survival. Normally within days of decision to operate.
18. Elective
Elective intervention planned or booked in advance of routine admission to hospital. Timing to suit patient, hospital and staff.
19. Acute Services Independent Sector Activity
This is the number of health service patients who were admitted for acute inpatient or day case treatment with an Independent Sector provider. An Independent Sector provider is a private sector healthcare company that is contracted by the HSCT in the provision of healthcare or in the support of the provision of healthcare.
20. Live/Still Birth
A birth can be classified as ‘live’ or ‘still’. A still birth is where, after a gestation period of at least 24 weeks, the baby shows no identifiable signs of life at delivery. Figures relate to only those births that occurred within a hospital, i.e. home births are not included.
21. Consultant-led Unit
Consultant-led units are maternity units where assistance from an obstetrician, anaesthetist or neonatologist/paediatrician is available. Consultant-led units need to be able to care for women with complex needs.
22. Midwife-led Unit
Midwife-led units are maternity units run solely by midwives. They can either stand alongside a consultant-led unit or be free standing. Midwife led units will only admit women experiencing a straightforward pregnancy and birth.
The data contained in this publication are presented on an annual basis. They represent inpatient and day case activity at inpatient services at Health and Social Care (HSC) hospitals in Northern Ireland and Independent Sector providers. This publication refers to all acute, maternity, elderly care, mental health and learning disability hospitals.
Data are presented on the number of available and occupied beds and inpatient admissions in Northern Ireland. Data are presented by the HSC hospital of admission, which are then aggregated up to HSC Trust, in Northern Ireland.
Acute data are split by admission method into elective inpatient, non-elective inpatient, day case and regular attenders. The sum of the elective inpatients and non-elective inpatients totals the number of inpatients. Similarly, the sum of the day cases and the regular attenders equals the total number of day cases within the acute POC.
Non acute data are split by admission method into inpatient and day case admissions. Patients who are treated at an accident and emergency department but are not subsequently admitted are not included.
Available and occupied beds for all programmes of care and non-acute activity data are sourced via the Departmental Return KH03a. Acute activity data are sourced from the Hospital Inpatient System.
Average Available/Occupied Beds – this is the number of available and occupied beds during the year in wards that are open overnight.
Specialty – this is the number of admissions within each medical speciality. Medical specialty is determined by the consultant in charge of the treatment of the patient. Each consultant employed by an HSC Trust will have an allocated specialty of employment, and it will be this specialty against which the patient’s admission will be reported.
Programme of Care (PoC) – this relates to the number of admissions within each Programme of Care which is a classification that aggregates specialties on the basis of the type of health care they provide, into a higher level classification.
These are not National Statistics.
Data provider - Theatre Management System through the Business Objects Data Warehouse.
Cases Operated On – These data provide insight into the usage of theatre resources by different specialties.
This relates to the number of health service patients who were admitted for an acute inpatient procedure with an Independent Sector provider. Data are presented by specialty and commissioning HSC Trust (the HSC Trust responsible for the patient’s waiting time), in Northern Ireland. These are not National Statistics.
Data provider - Departmental Return IS1 Part 2 by the Strategic Performance and Planning Group (SPPG), which is responsible for the regional commissioning of independent sector provision.
Independent Sector provision is introduced when the demand for certain types of inpatient service is greater than the capacity within HSC hospitals. When this situation results in increases in both the number of patients waiting and the length of time waiting, patients may be admitted for a procedure undertaken by an Independent Sector provider. The cost of treating these patients is met by the transferring HSC Trust.
Data on the number of births in HSC Hospitals in Northern Ireland. Data are split by both live and still births and method of delivery and presented by hospital and type of unit. These are not National Statistics.
Data provider - Northern Ireland Maternity System (NIMATS) through the Business Objects Data Warehouse.
This relates to the number of births in hospital, (home births are not included) and provides information on which HSC Trusts have the highest numbers of births.
Programmes of Care are divisions of healthcare, into which activity and finance data are assigned, so as to provide a common management framework. They are used to plan and monitor the health service, by allowing performance to be measured, targets set and services managed on a comparative basis. In total, there are nine Programmes of Care; however, only five of these are relevant to hospital activity. The relevant hospital specialties within each of the Programmes of Care are shown below.
POC 1 - Acute Services 100 General Surgery, 101 Urology, 110 T & O Surgery, 120 ENT, 130 Ophthalmology, 140 Oral Surgery, 141 Restorative Dentistry, 142 Paediatric Dentistry, 143 Orthodontics, 150 Neurosurgery, 160 Plastic Surgery, 170 Cardiac Surgery, 171 Paediatric Surgery, 172 Thoracic Surgery, 180 Accident & Emergency, 190 Anaesthetics, 191 Pain Management, 300 General Medicine, 301 Gastroenterology, 302 Endocrinology, 303 Haematology (Clinical), 311 Clinical Genetics, 314 Rehabilitation, 315 Palliative Medicine, 320 Cardiology, 330 Dermatology, 340 Thoracic Medicine, 350 Infectious Diseases, 360 Genito-Urinary Medicine, 361 Nephrology, 370 Medical Oncology, 400 Neurology, 401 Clinical Neuro-Physiology, 410 Rheumatology,
420 Paediatrics, 421 Paediatric Neurology, 450 Dental Medicine, 502 Gynaecology, 620 GP Other, 800 Clinical Oncology, 810 Radiology, 822 Chemical Pathology, 823 Haematology, 990 Joint Consultant Clinics, 999 Other Specialties
POC 2 - Maternity and Child Health 501 Obstetrics, 510 Obstetrics (Ante Natal), 520 Obstetrics (Post Natal), 540 Well Babies (Obstetrics), 550 Well Babies (Paediatrics)
POC 4 - Elderly Care 430 Geriatric Medicine, 715 Old Age Psychiatry
POC 5 - Mental Health 710 Mental Illness, 711 Child & Adolescent Psychiatry, 712 Forensic Psychiatry, 713 Psychotherapy
POC 6 - Learning Disability 700 Learning Disability
Hospital Information Branch is responsible for the collection, quality assurance, analysis and publication of timely and accurate information derived from a wide range of statistical information returns supplied by the Health & Social Care (HSC) Trusts and Strategic Performance and Planning Group (SPPG). Statistical information is collected routinely from a variety of electronic patient level administrative systems and pre-defined survey return templates. The Head of Branch is Principal Statistician, Siobhán Morgan. The Branch aims to present information in a meaningful way and provide advice on its uses to customers in the HSC Committee, Professional Advisory Groups, policy branches within the DoH, other Health organisations, academia, private sector organisations, charity/voluntary organisations as well as the general public. The statistical information collected is used to contribute to major exercises such as reporting on the performance of the HSC system, other comparative performance exercises, target setting and monitoring, development of service frameworks as well as policy formulation and evaluation. In addition, the information is used in response to a significantly high volume of Parliamentary / Assembly questions and ad-hoc queries each year. Information is disseminated through a number of key statistical publications, including: Inpatient Activity, Outpatient Activity, Emergency Care, Mental Health & Learning Disability and Waiting Time Statistics (Inpatient, Outpatient, Diagnostics and Cancer).
This Statistical bulletin and others published by Hospital Information Branch are available to download from the DoH Internet site at: Internet address: https://www.health-ni.gov.uk/topics/doh-statistics-and-research
Other Department of Health publications are availabke here: https://www.health-ni.gov.uk/topics/dhssps-statistics-and-research/hospital.statistics
National Statistics status means that official statistics meet the highest standards of trustworthiness, quality and public value. All official statistics should comply with all aspects of the Code of Practice for Statistics. They are awarded National Statistics status following an assessment by the Authority’s regulatory arm. The Authority considers whether the statistics meet the highest standards of Code compliance, including the value they add to public decisions and debate.
The designation of these statistics as National Statistics was appointed on 3rd June 2013, following an assessment by the Office for Statistics Regulation, against the Code of Practice for Statistics.
It is a producer’s responsibility to maintain compliance with the standards expected of National Statistics. If we become concerned about whether these statistics are still meeting the appropriate standards, we will discuss any concerns with the Authority promptly. National 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 at: http://www.statisticsauthority.gov.uk/assessment/code-of-practice/.
Find out more about National Statistics at: http://www.statisticsauthority.gov.uk/national-statistician/types-of-official-statistics/.
