Northern Ireland Outpatient Waiting Time Statistics
National Statistics
All statistics contained within this publication are National Statistics except for outpatient activity statistics.
Published by: Information & Analysis Directorate, Department of Health
Statisticians: Brian Reilly, Jenny Finlay & Liz Graham
Contact: statistics@health-ni.gov.uk
Reporting Date: 31 December 2023
Publication Date: 29 February 2024
Date of Next Publication: 30 May 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 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 a first outpatient appointment in the South Eastern Trust to allow comparisons to be made for the four remaining HSC Trusts compared with previous time points. As such, any NI level figures presented throughout this report only include those for Belfast, Northern, Southern and Western HSC Trusts.
This statistical release presents information on waiting times for a first consultant-led outpatient appointment in Northern Ireland and reports on the performance of the Health and Social Care (HSC) Trusts against the draft waiting times target, which states that:
“50% of patients should wait no longer than nine weeks for a first outpatient appointment; with no patient waiting longer than 52 weeks.”
Information is detailed on the number of patients waiting and length of time waiting by HSC Trust and specialty. Provisional statistics on outpatient activity are also included.
All of the data contained in this release are published on the NISRA Data Portal and in CSV format to facilitate secondary analysis. These are available at the following links:
https://data.nisra.gov.uk/product/HWTS
Statistics in this report refer to the number of patients waiting and the length of time they had been waiting as at the reporting date. They do not indicate completed waiting times or expected future waiting times.
Key Figures
First Consultant-led Outpatient Appointment Waiting Times
Figures in this section exclude the South Eastern Trust as data was not available as at 31 December 2023.
341,910 patients were waiting for a first consultant-led outpatient appointment at hospitals in the Belfast, Northern, Southern and Western HSC Trusts on 31 December 2023, 1% (3,331) more than than on 30 September 2023 (338,579), and 9.8% (30,514) more than on 31 December 2022 (311,396).
53.6% of patients were waiting for an appointment under the General Surgery, Ophthalmology, ENT, Gynaecology or Dermatology specialties.
The median waiting time was 49.6 weeks and the 95th percentile waiting time was 257.4 weeks.
84.1% (287,475) of patients were waiting more than nine weeks for a first consultant-led outpatient appointment on 31 December 2023, compared with 82.9% (280,769) on 30 September 2023 and 83% (258,429) on 31 December 2022.
47.8% (163,561) of patients were waiting more than 52 weeks for a first consultant-led outpatient appointment on 31 December 2023, compared with 47.4% (160,626) on 30 September 2023 and 47.9% (149,165) on 31 December 2022.
Outpatient Waiting List
Figures in this section exclude the South Eastern Trust as data was not available for the positon as at 31 December 2023. However, the previously published time series including all Trusts up to 30 September 2023 has been included in Figure 1 to provide context
As at 31 December 2023, there were 341,910 patients waiting for a first consultant-led outpatient appointment at hospitals in the Belfast, Northern, Southern and Western Trusts.
The number of patients waiting has increased by 1% (3,331) from 30 September 2023 and increased by 9.8% (30,514) from 31 December 2022.
Figure 1: Patients Waiting for a First Consultant-led Outpatient Appointment
30 June 2008 to 31 December 2023
This line chart shows that the number of patients waiting has risen steadily from 83,292 on 31 March 2013 to 341,910 on 31 December 2023.
Waiting List by Specialty
Figures in this section exclude the South Eastern Trust from both time points as data was not available for the position as at 31 December 2023.
At 31 December 2023, the largest waiting lists were for General Surgery (46,355 patients) and Ophthalmology (44,816 patients).
Of specialties with at least 5,000 patients waiting, the greatest proportionate growth was in the Oral Surgery specialty, which grew by 76.2% (2,864 patients). The greatest proportionate reduction was in the Urology specialty, with 9.5% (881) fewer patients.
Figure 2: Patients Waiting for a First Consultant-led Outpatient Appointment by Specialty
31 December 2023 compared with 31 December 2022
The bar chart above shows the number of patients waiting for an appointment in each specialty at 31 December 2023, with markers comparing numbers at 31 December 2022. Only specialties with at least 5,000 patients waiting are shown.
Median and 95th Percentile Waiting Times
Figures in this section exclude the South Eastern Trust from the entire time series as data was not available for the position as at 31 December 2023.
Exclusions From This Analysis
Paedaetrics, Genito-Urinary Medicine, Learning Disabilty and Old Age Psychiatry specialties are excluded from this analysis due to limited data availability.
Information required to produce this analysis is not available prior to 30 June 2020.
The median waiting time is the middle value when all patients are ordered by length of time waiting. This is preferred over the mean as an average of waiting times because waiting times tend to be skewed by longer waits and therefore more patients are waiting for less time than the mean.
The 95th percentile waiting time is the length of time that 95% of patients have been waiting equal to or less than i.e. one in twenty patients have been waiting longer than this time. The 95th percentile is used as an indication of the range of current waiting times without being distorted by extreme values or the prioritisation of urgent waits.
At 31 December 2023, the median waiting time for a first outpatient appointment was 49.6 weeks and the 95th percentile was 257.4 weeks (approximately 4 years and 49 weeks).
Figure 3: Median and 95th Percentile Waiting Times
30 June 2020 to 31 December 2023
This line chart shows that the median waiting time has increased from 42.0 weeks at 30 June 2020 to a peak of 58.3 weeks at 31 March 2021 then decreased to 49.6 weeks at 31 December 2023. The 95th percentile waiting time has increased steadily from 166.0 weeks at 30 June 2020 to 257.4 weeks at 31 December 2023.
Waiting Times by Specialty
Figures in this section exclude the South Eastern Trust as data was not available for the position as at 31 December 2023.
Exclusions From This Analysis
Paedaetrics, Genito-Urinary Medicine, Learning Disability and Old Age Psychiatry specialties are excluded from this analysis due to limited data availability.
There is a large variation in median and 95th percentile waiting times across different specialties. Low medians relative to the 95th percentile can be an indication of large numbers of patients recently joining a list or a greater proportion of urgent patients within a specialty.
Figure 4: Median and 95th Percentile Waiting Times by Specialty
31 December 2023
The bar chart above shows the median and 95th percentile waiting times for specialties where at least 5,000 patients were waiting for appointments at 31 December 2023. The longest median waiting time was 102.9 weeks in the Oral Surgery specialty.
Rheumatology, Neurology, Oral Surgery, General Medicine, Ophthalmology, Dermatology, General Surgery and Plastic Surgery specialties all had median waiting times over 1 year.
At least one in twenty (5%) patients waiting for Rheumatology, Neurology, Oral Surgery, General Medicine, Urology or Ophthalmology had been waiting over 5 years.
Performance against Targets
Figures in this section exclude the South Eastern Trust from the entire time series as data was not available for the position as at 31 December 2023.
The draft waiting times target states that 50% of patients should wait no longer than 9 weeks for a first consultant-led outpatient appointment; with no patient waiting longer than 52 weeks.
This target was introduced in 2016/17.
Figure 5: Patients Waiting Under 9 Week Target
30 June 2016 to 31 December 2023
The line and stacked bar charts above illustrate the percentage and number of patients waiting less than 9 weeks 30 June 2016 to 31 December 2023.
Across this period the target of 50% of patients waiting less than 9 weeks was not achieved, with the highest proportion under 9 weeks being 35.4% (64,205 of 181,353 patients) at 30 June 2016.
As at 31 December 2023, 15.9% of patients were waiting less than 9 weeks, a decrease from 17% at 31 December 2022 and a decrease from 25.7% at 31 December 2018.
Figure 6: Patients Waiting Over 52 Week Target
30 June 2016 to 31 December 2023
The line and stacked bar charts above illustrate the percentage and number of patients waiting over 52 weeks from 30 June 2016 to 31 December 2023.
Across this period the target of no patients waiting longer than 52 weeks was not achieved, with the highest proportion over 52 weeks being 54.5% (149,992 of 275,121 patients) at 31 March 2021.
At 31 December 2023, 47.8% of patients were waiting longer than 52 weeks, a decrease from 47.9% at 31 December 2022 and an increase from 31.7% in 31 December 2018.
Performance by HSC Trust
Figures in this section exclude the South Eastern Trust as data was not available for the position as at 31 December 2023.
Draft target: 50% of patients should wait no longer than 9 weeks and no patient should wait longer than 52 weeks for a first consultant-led outpatient appointment.
Data shown in this section indicates the Health and Social Care Trust responsible for a patient’s care. As Day Case Procedure Centres are a regional service, they have been reported separately from HSC Trusts.
Figure 7: Waiting Times by HSC Trust and Day Case Procedure Centres
31 December 2023
The proportionate stacked bar chart above breaks down the length of time patients have been waiting by the Health and Social Care Trust responsible for their service.
No Trust met the target to have 50% of patients waiting less than 9 weeks, nor the target to have no patients waiting longer than 52 weeks.
Outpatient Activity
Provisional Statistics
Outpatient attendance data are fully validated once per year. Statistics in this section are subject to revision in subsequent releases and do not hold National Statistics status.
Fully validated outpatient activity statistics are published annually at the following link:
Figures in this section exclude the South Eastern Trust from the entire time series as data was not available for the quarter ending December 2023.
Between 01 October and 31 December 2023, there were 100,048 attendances at first outpatient appointments, of which 1.7% (1,717) were at independent sector providers commissioned by HSC Trusts and the remaining 98.3% (98,331) at HSC Trust hospitals.
Figure 8: Number of First Outpatient Attendances Commissioned by HSC Trusts
Quarter Ending June 2008 to Quarter Ending December 2023
The bar chart above indicates the number of patients who attended first outpatient appointments in each quarter between June 2008 and December 2023. The number of patients attending remained steady from 2008 to March 2020. A sharp decrease was observed in June 2020 and since then activity has risen steadily and has almost returned to prior levels.
ICATS Waiting List
Integrated Clinical Assessment and Treatment Services (ICATS) are outpatient services provided by multi-disciplinary teams of health service professionals. They provide assessment, treatment and advisory services in a variety of primary, community and secondary care settings. Patients who do not require urgent treatment are referred to ICATS teams, if the patient’s condition requires the attention of a consultant, arrangements are made for the patient to be referred for a hospital outpatient appointment.
As ICATS services are not consultant-led, patients waiting for an ICATS appointment are not included in the statistics for consultant-led outpatient services presented in the sections above.
Figures in this section exclude the South Eastern Trust as data was not available for the positon as at December 2023.
At 31 December 2023, there were 18,597 patients waiting for a first ICATS outpatient appointment. The number of patients waiting has decreased by 2.1% (401) from 30 September 2023 and increased by 0.0% (2) from 31 December 2022.
Figure 9: Patients Waiting for a First ICATS Outpatient Appointment
30 June 2011 to 31 December 2023
This line chart shows that the number of patients waiting for a first ICATS outpatient appointment rose steadily from 4,873 on 30 June 2011 to 13,176 on 31 December 2020. A sharp increase to a peak of 19,518 on 30 September 2022 occurred and has remained steady since.
Data Sources, Quality and Guidance
Data sources
The sources for the data contained in this release are the HSC Trust’s Patient Administration Systems, the DoH Outpatient Waiting Times Dataset and the DoH CH3, QOAR, R-QOAR, V-QOAR and IS1 returns.
First consultant-led outpatient appointment
An outpatient appointment is to enable a patient to see a consultant or a member of their team following an outpatient referral. The majority of referrals will be from a GP however they may also be received from a range of other sources.
These appointments provide an opportunity for consultation, investigation and minor treatment. Appointments can be face-to-face or virtual and patients are not admitted into hospital.
A first attendance is the first of a series or the only attendance at an outpatient service.
Measurement of waiting times
Statistics in this report refer to the number of patients waiting and the length of time they had been waiting as at the reporting date. They do not indicate completed waiting times or expected future waiting times.
Waiting time for a first outpatient appointment begins on the date the HSC Trust receives a referral to a consultant-led service.
Patients who cannot attend or miss their appointment have their waiting time recorded from the date they informed the HSC Trust that they could not attend or the date of the missed appointment.
Patients suspended for medical or social reasons as at the reporting date are not included in the statistics. If re-instated, the period of suspension is excluded from the waiting time.
Time bands relate to the number of completed weeks a patient has been waiting. 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 time band.
Reporting patients against Health and Social Care Trusts
A number of services may not be provided at a patient’s local HSC Trust, and instead are provided as centralised services for Northern Ireland.
As patients are reported against the HSC Trust responsible for the service to which they have been referred, users should be aware of this when making comparisons across Trusts.
In some cases a consultant from one HSC Trust may provide a “visiting” service at another HSC Trust, and so the patient may not be reported at the HSC Trust at which they attend. Patients are reported against the HSC Trust responsible for the service to which they have been referred.
Day Case Procedure Centres
From February 2019, Day Case Procedure Centres (DPCs) are being introduced to deliver large volumes of non-complex routine surgery.
Patients waiting for specific non-urgent surgical treatments can be referred to a DPC for treatment rather than attend the hospital site they may ordinarily have been referred to.
Patients waiting for an outpatient appointment at a Day Case Procedure Centre are included in these statistics.
As these services are managed on a regional basis, patients are not allocated as waiting at a particular HSC Trust and where a Trust split is used in these statistics, the patients are instead reported separately against Day Case Procedure Centres.
Patients with multiple waits
Some patients will be on more than one waiting list or be on the same waiting list for more than one appointment due to having multiple conditions. Such patients are counted more than once depending on how many times they are waiting.
Patients resident outside Northern Ireland and private patients
Statistics on patients waiting for outpatient appointments include patients living outside Northern Ireland and privately funded patients waiting for treatment in Health Service hospitals in Northern Ireland.
Outpatient activity
Provisional statistics on outpatient activity are presented to provide contextual information in relation to waiting lists. Hospital data are sourced from the HSC Trusts and Independent Sector data are provided by the Strategic Planning and Performance Group in the Department of Health.
These data are not National Statistics and have not been validated or quality assured by HSC Trusts prior to publication. Data quality is addressed on an ongoing basis and figures are subject to revision in subsequent publications as hospital records may not be fully up to date as at the publication date.
Provisional statistics on outpatient activity do not include:
• ICATS appointments
• Ward attenders
Further technical guidance
Technical guidance and definitions, as well as notes on how to use the data contained within this statistical release are available at the following link: https://www.health-ni.gov.uk/articles/outpatient-waiting-times
Additional Information and Data
Data from this publication
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: https://www.health-ni.gov.uk/publications/northern-ireland-waiting-time-statistics-outpatient-waiting-times-december-2023
Other waiting times publications
Statistics on waiting times for inpatients, diagnostic services, 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
National Statistics
Accredited official statistics are called National Statistics in the Statistics and Registration Service Act 2007. The United Kingdom Statistics Authority has accredited these statistics as National Statistics, in accordance with the Statistics and Registration Service Act 2007 and signifying compliance with the Code of Practice for Statistics.
Our statistical practice is regulated by the Office for Statistics Regulation (OSR).
OSR sets the standards of trustworthiness, quality and value in the Code of Practice for Statistics that all producers of official statistics should adhere to.
You are welcome to contact us directly with any comments about how we meet these standards.
Alternatively, you can contact OSR by emailing regulation@statistics.gov.uk or via the OSR website Office for Statistics Regulation (https://osr.statisticsauthority.gov.uk).
It is the Department of Health’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.
In November 2021, the Office for Statistics Regulation conducted a compliance check on these statistics and confirmed that they should continue to be labelled as ‘accredited official statistics’. Further details can be found at: https://osr.statisticsauthority.gov.uk/correspondence/mark-pont-to-eugene-mooney-Northern-ireland-ni-outpatient-waiting-time-statistics/
In May 2022, the Office for Statistics Regulation extended the accredited official statistics to include Day Case Procedure Centre waiting times statistics.
Since the assessments by the Office for Statistics Regulation, we have continued to comply with the Code of Practice for Statistics.
Further information on the Code of Practice for Statistics is available at: https://osr.statisticsauthority.gov.uk/accredited-official-statistics/.
Accessibility contact
Please contact Hospital Information Branch for assistance with accessibility requirements or alternative formats. Email: statistics@health-ni.gov.uk
Copyright
This publication is Crown copyright and may be reproduced free of charge in any format or medium. Any material used must be acknowledged, and the title of the publication specified.