Reporting of Quarterly ICATS Activity Information
Reporting of Quarterly ICATS Activity Information
Version 1 (March 2026)
1 Background
The Quarterly ICATS Activity Return (QIAR), the present methodology for the collection of ICATS activity, was introduced in 2010.
On 9 November 2023 the South Eastern Health and Social Care (HSC) Trust launched ‘encompass’ - a new electronic patient record system. The system also went live in Belfast Trust on 6 June 2024, Northern Trust on 7 November 2024 and Southern and Western Trusts on 8 May 2025.
The QIAR relates to total face-to-face and virtual ICATS outpatient activity at each Health and Social Care Trusts in Northern Ireland. This includes ICATS attendances, patient cancellations of ICATS appointments (CNA), ICATS appointments which the patient did not attend (DNA) and hospital cancellations of ICATS appointments.
The return is populated by activity data extracted from an encompass report developed by the Department and HSC Trusts.
2 Definitions
ICATS SERVICES - Integrated Clinical Assessment and Treatment Services (ICATS) are outpatient services provided by multi-disciplinary teams of health service professionals, including GPs with a special interest, specialist nurses and allied health professionals. They are provided in a variety of primary, community and secondary care settings.
ICATS APPOINTMENTS - An ICATS appointment provides assessment, treatment and advisory services in a variety of primary, community and secondary care settings. An appointment at ICATS is known as a Tier 2 appointment. These are non-consultant-led services. Following ICATS Triage, patients who have not been given either a discharge, advice only or referral incomplete outcome will proceed for either a (i) first outpatient appointment, (ii) a diagnostic test or (iii) an ICATS Tier 2 appointment. Following a first Tier 2 ICATS appointment there are a number of possible outcomes, including a review Tier 2 ICATS appointment or a referral for a first consultant-led outpatient appointment.
ICATS NEW ATTENDANCES - A new ICATS attendance is the first of a series or the only attendance at an ICATS with a consultant or their representative following an ICATS referral.
ICATS NEW ATTENDANCE SEEN - This is the number of patients who attended a new ICATS appointment.
ICATS NEW ATTENDANCES DID NOT ATTEND (DNA’d) - This is the number of patients who did not attend, and failed to give advance warning to the hospital, for a new ICATS appointment. This includes patients who cancelled their new ICATS appointment on the same day on which the appointment was scheduled. These should not be confused with those who could not attend and who did warn the hospital in advance (before the day on which the appointment was scheduled).
ICATS NEW ATTENDANCE COULD NOT ATTEND (CNA’d) - This is the number of patients who did not attend, and gave advance warning to the hospital, for a new ICATS appointment before the day of the scheduled appointment. These should not be confused with those who either did not attend without prior warning or those who could not attend and informed the hospital on the day on which the appointment was scheduled. This does not include new appointments cancelled as a result of the hospital being notified of the patient’s death.
ICATS REVIEW ATTENDANCES - A review ICATS attendance is an attendance at an ICATS following; a new ICATS attendance, a previous ICATS review attendance. Essentially review ICATS appointments are all ICATS appointments that are not a first appointment.
ICATS REVIEW ATTENDANCE SEEN - This is the number of patients who attended a review ICATS appointment.
ICATS REVIEW ATTENDANCES DID NOT ATTEND (DNA’d) - This is the number of patients who did not attend, and failed to give advance warning to the hospital, for a review ICATS appointment. This includes patients who cancelled a review ICATS appointment on the same day on which the appointment was scheduled. These should not be confused with those who could not attend and who did warn the hospital in advance (before the day on which the appointment was scheduled).
ICATS REVIEW ATTENDANCE COULD NOT ATTEND (CNA’d) - This is the number of patients who did not attend, and gave advance warning to the hospital, for a review ICATS appointment before the day of the scheduled appointment. These should not be confused with those who either did not attend without prior warning or those who could not attend and informed the hospital on the day on which the appointment was scheduled. This does not include review appointments cancelled as a result of the hospital being notified of the patient’s death.
ICATS NEW OUTPATIENT APPOINTMENTS CANCELLED BY HOSPITAL - This is the number of new ICATS appointments that have been cancelled by the provider Health and Social Care Trust. Such cancellations do not include those cancelled by the patient (Could Not Attend), appointments the patient did not attend without giving prior notice (DNA) and new appointments cancelled by the hospital as a result of the patient’s death.
ICATS REVIEW OUTPATIENT APPOINTMENTS CANCELLED BY HOSPITAL - This is the number of review ICATS appointments that have been cancelled by the provider Health and Social Care Trust. Such cancellations do not include those cancelled by the patient (Could Not Attend), appointments the patient did not attend without giving prior notice (DNA) and review appointments cancelled by the hospital as a result of the patient’s death.
ICATS PRIVATE PATIENT ATTENDANCES - A private patient is one who has opted to have treatment outside the Health Service and has undertaken to pay for all expenses incurred, including treatment and accommodation costs. Private patient attendances relate to private patients who attend an ICATS appointment at a facility provided by a Health and Social Care Trust. These should not be confused with independent sector attendances, which relate to attendances at a private sector healthcare company that is contracted by HSC Trusts in the provision of healthcare or in the support in the provision of healthcare. Any cost of these independent sector attendances is paid by the Health Service and not the patient.
PATIENT DIED - This is an appointment which has been cancelled due to the hospital being notified of the patient’s death. Cancellations due to the death of a patient are not included within the figures for either Patient Cancellations (CNA) or hospital cancellations.
ICATS VIRTUAL ACTIVITY - A virtual appointment is a planned contact by a Healthcare Professional responsible for the care of a patient for the purposes of clinical consultation, advice and treatment planning. It may take the form of a telephone contact, video-link intervention, an email or a letter.
Virtual contact taking place at an ICATS should be included in the QIAR return as long as it replaces what would have been a face-to-face attendance at an ICATS clinic and that it directly supports the diagnosis and care planning of a patient/client. It is not intended to facilitate the recording of every contact/phone call.
3 Collection of Data
OUTPATIENT ACTIVITY
• All activity at ICATS is counted as an ICATS attendance and should
be included on the return.
• All activity performed by health professionals employed by the
Health and Social Care Trusts in at ICATS in Northern Ireland should be
recorded. This includes activity performed as part of ‘in-house’ waiting
list initiatives and private patient consultations.
• Activity will be reported by specialty. Prior to encompass the
specialty related to the specialty of the consultant that performed the
activity and was derived from the consultant’s contract of employment.
On encompass the specialty is based on the Department specialty mapped
to Treatment Function Code. Therefore, specialties do not match those
previously reported.
• Activity should be reported irrespective of the location at which
the service is delivered but should be attributed to the Trust that
holds the contract for the health professional that provided the
service.
PERIPHERAL OUTPATIENT SERVICES
For the majority of specialties, a patient’s ICATS attendance will reflect the HSC Trust to which they have been referred and the location where they attended the appointment. However, not all ICATS are provided at each of the five HSC Trusts in Northern Ireland. In such circumstances patients from one HSC Trust may attend an appointment for a service provided at another HSC Trust, or, in other cases, a Trust may provide a visiting ‘outreach’ service at another HSC Trust. In addition, within an HSC Trust, health professionals may hold services at various locations within their own Trust.
These ‘peripheral’ ICATS services can therefore be:
• regional specialties which are organised centrally but hold ICATS
appointments throughout the five Trusts, or
• health professionals from any specialty from one HSC Trust that
provide a ‘visiting’ outreach service at another HSC Trust.
• health professionals from any specialty who may hold services at
various locations within their own Trust.
Data on ICATS patients attending peripheral services should be recorded and returned by the HSC Trust which holds the contract for providing the service. With regional specialties this is likely to be the organising Trust.
4 Reporting of Data
ICATS ACTIVITY
The number of attendances for a new (first) ICATS appointment should be reported in Column B.1 of the return. These include private patient attendances, which are also recorded separately.
The number of patients who did not attend a new ICATS appointment and failed to give advance warning to the hospital (DNA’d) should be recorded in Column C.1 of the return. Patients who could not attend a new ICATS appointment and informed the hospital on the day of the appointment (CNA on the day) should also be reported in Column C.1 of the return.
The number of patients who could not attend a new ICATS appointment and informed the hospital before the day of the appointment (CNA’d), should be reported in Column D.1 of the return. This does not include new appointments cancelled as a result of the hospital being notified of the patient’s death.
The number of attendances for a review ICATS appointment should be reported in Column E.1 of the return. These include private patient attendances, which are also recorded separately.
The number of patients who did not attend a review ICATS appointment and failed to give advance warning to the hospital (DNA’d) should be recorded in Column F.1 of the return. Patients who could not attend a review outpatient appointment and informed the hospital on the day of the appointment (CNA on the day) should also be reported in Column F.1 of the return.
The number of patients who could not attend a review ICATS appointment and informed the hospital before the day of the appointment (CNA’d), should be reported in Column G.1 of the return. This does not include review appointments cancelled as a result of the hospital being notified of the patient’s death.
The number of ICATS appointments as a result of a patient attending a ward for examination or treatment by a consultant should be reported in Column H.1. New and review appointments should be combined.
The number of new ICATS appointments cancelled by the hospital should be reported in Column I.1 of the return.
The number of review ICATS appointments cancelled by the hospital should be reported in Column J.1 of the return.
The total number of appointments cancelled as the result of the patient’s death, both new and review, should be reported in Column K.1 of the return.
Attendances by private patients are included within the main body of the return but are also separately reported in Column L.1 of the return. The total number of private patient attendances, both new and review, should be reported in Column L.1.
SCHEDULE
HAIB issue a timetable each quarter instructing HSC Trusts to run the encompass report on a particular date. This is usually three weeks after the end of each quarter, allowing HSC Trust administrative staff sufficient time to ensure their ICATS data are recorded correctly on encompass. The timetable also includes the date by which HSC Trusts must submit their QIAR return to HAIB each quarter. Sufficient time is given to allow HSC Trusts to run their report, collect data not recorded on encompass, and then populate the QIAR return.
5 Data Validation
Each quarter, following receipt of the QIAR return from each HSC Trust, HAIB validate the data by comparing figures at Trust and at specialty level for the current quarter and against each of the four quarters of the previous year. Any irregularities are queried with HSC Trusts.
The validation queries are compiled for each of the five HSC Trusts. Trusts are required to provide an explanation for all queries within a week, as well as to confirm figures or provide amendments where necessary.
At the end of each financial year the last quarter’s data is sent out for validation, along with any outstanding queries for the previous quarters of that year and presented to HSC Trusts for final sign-off. Trusts are given two weeks to respond to this.
6 Data Use
Data submitted by HSC Trusts to the DoH on the QIAR are Accredited Official Statistics. Accredited Official Statistics are produced to high professional standards set out in the UK Statistics Authority Code of Practice for Official Statistics. They are required to comply with the Code’s core Principles namely Trustworthiness, Quality and Value, including Release Practices.
Following final sign off from HSC Trusts, data on new and review ICATS attendances, did not attends and cancellations, is then published in the annual Hospital Statistics: Outpatient Activity Statistics report. The most recent publication, together with previous editions, can be found at the following link:
(https://www.health-ni.gov.uk/articles/outpatient-activity)
ICATS activity data split by financial year, HSC Trust and specialty are also published in Microsoft Excel format at the above link.
ICATS activity data are also used in:
• Ministerial answers to both Written and Oral Assembly questions;
• Departmental responses to correspondences received from the NI
Assembly Health Committee, Public Accounts Committee, Northern Ireland
Audit Office and other stakeholder bodies such as the Patient Client
Council;
• Ministerial briefing material;
• Health compendium publications, and
• Responses to data requests from HSC, politicians, journalists,
voluntary / charitable organisations and members of the general public.
7 Contact Details
This document will be reviewed and updated periodically. Frequently asked questions can be found in Appendix 1.
If you have any issues relating to the contents of the document or
the collection of outpatient activity information in general please
contact:
Hospital Activity Information Branch
DoH
Annex 2, Castle Buildings
Stormont
Tel: 028 90522521
E-mail: Statistics@health-ni.gov.uk
APPENDIX 1: Frequently Asked Questions
What are the main sources of referral for a first ICATS appointment?
The majority of referrals for a first ICATS appointment will be made by a General Practitioner, however, referrals may also be received from a range of other sources.
Should virtual activity be reported on this return?
Yes. This return should include both face-to-face and virtual ICATS activity.
Can a face to face attendance occur after a virtual attendance, and, if so, how should this be recorded?
Following a new virtual ICATS attendance, it may be decided that a patient needs a face-to-face ICATS appointment. In this case a patient will be booked in for a review face-to-face attendance.
Where should private patient attendances be recorded?
Private patient attendances relate to patients who pay a fee and attend an assessment with a Health and Social Care professional at a Health and Social Care facility. They are included within the main ICATS activity figures (where they should be separated into new and review attendances) and also listed in the Private Patient attendances column. Data in this column relate to total attendances and are not split by appointment type. These columns should therefore not be added together.
Does the patient have to attend a face to face consultation at a hospital in order for the attendance to be reported on the return?
Not necessarily. The face-to-face consultation may take place at a location outside of a hospital.
For activity performed outside of a hospital, the attendance should be attributed to the Trust that holds the contract for the health professional that provided the service.
Should Waiting List Initiative (WLI) activity be included within this return?
Yes. ‘Waiting List Initiatives’ or ‘Waiting List Reduction’ ICATS activity should be recorded as one would the routinely provided or core ICATS activity.