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, Ben Simpson & Siobhán Morgan
Contact:

Reporting Date: 31 March 2023
Publication Date: 25 May 2023
Date of Next Publication: 31 August 2023

Coverage: Northern Ireland
Frequency: Quarterly

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 have been published in CSV format in order to aid secondary analysis. These data are available at: https://www.health-ni.gov.uk/publications/northern-ireland-waiting-time-statistics-outpatient-waiting-times-march-2023

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.

Statistics on patients waiting for an appointment at Day Case Procedure Centres are now included in the main waiting list statistics rather than being reported separately as in previous releases. Time series presented in this report have been backdated to reflect this change. The total number of patients waiting each quarter remains unchanged and statistics on patients waiting specifically at Day Case Procedure Centres are still available in the accompanying CSV files.

Key Figures

First Consultant Led Outpatient Appointment Waiting Times

  • A total of 401,201 patients were waiting for a first consultant led outpatient appointment at hospitals in Northern Ireland, 1.6% (6,398) less than last quarter (394,803), and 7.3% (27,147) more than the same quarter last year (374,054).
  • 51.2% of patients were waiting for an appointment under the General Surgery, ENT, Ophthalmology, Gynaecology or Dermatology specialties.
  • The median waiting time was 53.1 weeks and the 95th percentile waiting times was 244.0 weeks.
  • 81.3% (326,241) of patients were waiting more than nine weeks for a first consultant led outpatient appointment, compared with 83.8% (330,723) the previous quarter and 82.7% (309,165) at the end of the same quarter last year.
  • 49.2% (197,345) of patients were waiting more than 52 weeks for a first consultant led outpatient appointment compared with 50% (197,402) last quarter and 52% (194,645) at the end of the same quarter last year.

Outpatient Waiting List

As at 31 March 2023, there were 401,201 patients waiting for a first consultant led outpatient appointment at hospitals in Northern Ireland.

The number of patients waiting has increased by 1.6% (6,398) from 31 December 2022 and increased by 7.3% (27,147) from 31 March 2022.

Patients can be waiting for more than one first outpatient appointment. The figure of 401,201 patients waiting refers to the number of patient pathways and is the total number of first appointments being waited on. This relates to approximately 332,000 individual patients.

Figure 1: Patients Waiting for a First Consultant Led Outpatient Appointment

30 June 2008 to 31 March 2023

This line chart shows that the number of patients waiting has risen steadily from 99,774 on 31 March 2013 to 401,201 on 31 March 2023.

Waiting List by Specialty

At 31 March 2023, the largest waiting lists were for General Surgery (53,527 patients) and ENT (41,357 patients).

General Surgery, ENT, Ophthalmology, Gynaecology, Dermatology, Paediatrics and T & O Surgery specialties all had more than 20,000 patients on their waiting lists.

Since 31 March 2022 the Gynaecology waiting list showed the largest growth (6,626 additional patients) and Neurology showed the largest reduction (1,873 fewer patients).

Of specialties with at least 5,000 patients waiting, the greatest proportionate growth was in the Gynaecology specialty, which grew by 21.7% (6,626 patients). The greatest proportionate reduction was in the Neurology specialty, with 9.1% (1,873) fewer patients.

Figure 2: Patients Waiting for a first consultant led outpatient appointment by Specialty

31 March 2023 compared with 31 March 2022

The bar chart above shows the number of patients waiting for an appointment in each specialty at 31 March 2023, with markers comparing numbers at 31 March 2022. Only specialties with at least 5,000 patients waiting are shown.

Median and 95th Percentile Waiting Times

Information required to produce this analysis is not available prior to 30 June 2020.

Paedaetrics, Genito-Urinary Medicine, Learning Disabilty and Old Age Psychiatry specialties are excluded from this analysis due to limited data availability.

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 March 2023, the median waiting time for a first outpatient appointment was 53.1 weeks and the 95th percentile was 244 weeks (approximately 4 years and 34 weeks).

Figure 3: Median and 95th Percentile Waiting Times

30 June 2020 to 31 March 2023

This line chart shows that the median waiting time has increased from 45.1 weeks at 30 June 2020 to a peak of 65.7 weeks at 30 June 2021 then decreased to 53.1 weeks at 31 March 2023.

Waiting Times by Specialty

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 March 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 March 2023. The longest median waiting time was 127.3 weeks in the Oral Surgery specialty.

General Medicine, Neurology, Rheumatology, Oral Surgery, Ophthalmology, Plastic Surgery, Dermatology, Gastroenterology, ENT and General Surgery specialties all had median waiting times over 1 year.

At least one in twenty (5%) patients waiting for General Medicine, Neurology, Rheumatology and Oral Surgery had been waiting over 5 years.

Performance against Targets

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 March 2023

The line and stacked bar charts above illustrate the number and proportion of patients waiting less than 9 weeks at the end of each quarter between 30 June 2016 and 31 March 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 35.2% (79,426 of 225,593 patients) at 30 June 2016.

As at 31 March 2023, 18.7% of patients were waiting less than 9 weeks, an increase from 17.3% at 31 March 2022 and a decrease from 26.5% at 31 March 2018.

Figure 6: Patients Waiting Over 52 Week Target

30 June 2016 to 31 March 2023

The line and stacked bar charts above illustrate the number and proportion of patients waiting over 52 weeks between 30 June 2016 and 31 March 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 56.8% (197,257 of 347,518 patients) at 31 March 2021.

At 31 March 2023, 49.2% of patients were waiting longer than 52 weeks, a decrease from 52% at 31 March 2022 and an increase from 30.9% in 31 March 2018.

Performance by HSC Trust

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 March 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

Outpatient Attendance data are fully validated once per year and, as such, provisional figures presented in this section do not hold National Statistics status.

Between January and 31 March 2023, there were 122,010 attendances at first outpatient appointments, of which 5.1% (6,282) were at independent sector providers commissioned by HSC Trusts and the remaining 94.9% (115,728) at HSC Trust hospitals.

Figure 8: Number of First Outpatient Attendances Commissioned by HSC Trusts

30 June 2008 to 31 March 2023

The bar chart above indicates the number of patients who attended first outpatient appointments in each quarter between June 2008 and March 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 levels seen before this.

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
Waiting time for a first outpatient appointment begins on the date the HSC Trust receives a referral to a consultant led service and ends on the date a patient attends their first outpatient appointment.

Patients who cannot attend or miss their appointment have their waiting time adjusted to commence on 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 outpatient services may not be provided at a patient’s local HSC Trust and instead are provided as centralised services for Northern Ireland.

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 inpatient and day case admission 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 in CSV format to aid secondary analysis, at the following link: https://www.health-ni.gov.uk/publications/northern-ireland-waiting-time-statistics-outpatient-waiting-times-march-2023



ICATS waiting times
Statistics on Integrated Clinical Assessment and Treatment Services (ICATS) waiting times are published in CSV format, available here: https://www.health-ni.gov.uk/publications/northern-ireland-waiting-time-statistics-outpatient-waiting-times-march-2023
ICATS statistics are in addition to the consultant-led outpatient statistics presented in this report.


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
National Statistics Logo
The United Kingdom Statistics Authority has designated 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. National Statistics status means that official statistics meet the highest standards of trustworthiness, quality and public value. The statistics underwent a full assessment against the Code of Practice in 2011 and designation was awarded in June 2013. Since the assessment by the Office for Statistics Regulation, we have continued to comply with the Code of Practice for Statistics. 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 designated as National 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 National Statistics designation to include Day Case Procedure Centre waiting times statistics. Further information on the Code of Practice for Statistics is available at: https://code.statisticsauthority.gov.uk


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