Concerns Over NHS Waiting Lists In Northern Ireland

There is growing concern about the level of waiting lists in the health service.

There is growing concern about the level of waiting lists in the health service.

Concerns are growing rapidly amid news that waiting lists have increased during the coronavirus pandemic with worries regarding plans post-Covid-19.

With many hospital departments closing following government plans to tackle the Covid-19 crisis, the Department of Health has commented on potential plans to tackle the escalating waiting lists.

The burning question is, considering the impact of Covid-19 what will the Department do to tackle growing waiting lists ?

Health Minister Robin Swann.

Health Minister Robin Swann said: “No one has been in any doubt that performance in this area has been under intense pressure for some time, although steps were being taken to build capacity whilst implementing new innovative ways of working.

“The onslaught of Coronavirus is something that we could never have contemplated when we started the transformation of health and social care, and the truth is that today’s statistics only cover the position to the end of March, so simply provide an early indication of the full impact of the virus on waiting times. 

“I need to be very honest and signal that the figures for the next quarter, when published, will make even more depressing reading.

“But, just as there was no doubt about scale of the challenge before Coronavirus, equally no one can be in any doubt that a quick fix is simply not realistic. 

“Successfully attacking these waiting times will take time and money, and can only be achieved if additional long term funding is made available – such funding must be over and above that needed to run existing services.  I have been very clear on this point since taking up post.

“Even with significant additional investment, the task of putting this right will be immensely challenging.  For the foreseeable future, we will have to plan around the continuing threat posed by Covid-19. This will severely constrain the capacity of our hospitals to scale up activity – social distancing in hospitals means reduced numbers in waiting rooms and on theatre lists.

“We have started the process of re-building our health and social care system – and it is essential that our emphasis is ‘re-building’ rather than ‘restoring’. 

“The truth is that our health service will never be the same again – the challenge for us is to make that reality an opportunity rather than a threat. The way we use services will have to change and innovations like virtual clinics will increasingly become the norm. 

“For those who think or call for a return to where we were at the start of January, I simply say we cannot go there. The system was broken and struggling then so simply returning to the same place would be a disservice not just to those who are waiting but to all those who have worked so hard in the last few weeks.

“We must capture the lessons and innovation from our response to Coronavirus, and seek to build on the ingenuity and flexibility of the wonderful workforce across Health and Social Care. 

“As I have said before, it was only their dedication and commitment that held the service together before this epidemic struck and, given what we have asked of them though the recent weeks and how they have responded, we simply cannot ask any more of them.  We must change.

“Opportunities exist to transform services for the better but we need to be realistic about what is achievable in the short term.”

In clarifying if the Health Service will turn to the private sector to clear the back log, the Minister added: “There is no quick fix for addressing waiting times… it is a complex issue that requires both time and additional long term funding.

“The independent sector has been used in the first quarter of this year to support red flag and urgent cases. Discussions are ongoing on how to maximise elective activity in the remainder of 2020/21 within the ongoing constraints associated with COVID-19.”

Asked whether the health service would consider video conferencing for consultation and follow up appointments to help reduce the waiting lists, the Department of Health indicated: “We are currently reviewing how we move forward, and the Minister will be saying more about that in the near future.”

With waiting lists now a ticking time bomb, it is easy to see this issue becoming more and more apparent over the coming weeks and months. With a potential second wave of Covid-19 potentially lurking in the shadows, it won’t be an easy fix to address waiting times.

However it is essential that all political parties and representatives work closely with the health service and trusts to ensure that this issue is tackled head on.

The Department of Health today published the quarterly Northern Ireland Waiting Times Statistics, relating to the position at 31 March 2020.

The Waiting Times Statistics releases show detailed information on the number of people waiting for a first consultant-led outpatient appointment, a diagnostic test and inpatient or day case treatment at hospitals in Northern Ireland.

Key facts and figures for NI Waiting Times at end of March 2020

Waiting Times for a First Outpatient Appointment

  • The 2019/20 Ministerial target relating to outpatient waiting times states that by March 2020, at least 50% of patients should wait no longer than nine weeks for a first outpatient appointment, with no patient waiting longer than 52 weeks.
  • A total of 307,066 patients were waiting for a first consultant-led outpatient appointment, 0.7% (2,049) more than at 31 December 2019 (305,017) and 6.3% (18,312) more than at 31 March 2019 (288,754).
  • An additional 1,503 patients were waiting for their first consultant-led outpatient appointment at a Regional Assessment and Surgical Centre for cataract treatment.
  • Almost four fifths (79.1%, 242,864) of patients were waiting more than nine weeks for a first consultant-led outpatient appointment, compared with 78.4% (239,130) at 31 December 2019 and 74.0% (213,708) at 31 March 2019.
  • Almost two fifths 38.1% (117,066) of patients were waiting more than 52 weeks for a first consultant-led outpatient appointment, compared with 36.7% (111,963) at 31 December 2019, and 33.9% (97,851) at 31 March 2019.
  • During the quarter ending March 2020, there were 105,321 attendances for a first outpatient appointment, a decrease of 10.2% (11,906) on the number seen during the quarter ending December 2019 (117,227), and 13.9% (16,992) less than during the quarter ending March 2019 (122,313).

Waiting Times for Inpatient and Day Case Admission

  • The 2019/20 Ministerial target, for inpatient and day case waiting times, states that by March 2020, 55% of patients should wait no longer than 13 weeks for inpatient or day case treatment, with no patient waiting longer than 52 weeks.
  • A total of 93,641 patients were waiting to be admitted to hospitals in Northern Ireland, 3.5% (3,127) more than at 31 December 2019 (90,514), and 7.1% (6,191) more than at 31 March 2019 (87,450).
  • An additional 3,294 patients were waiting for treatment at a Regional Assessment and Surgical Centre (RASC); 932 patients were waiting to be admitted to a Varicose Veins RASC, with a further 2,362 patients waiting to be admitted to a Cataracts RASC.
  • Over two thirds (71.4%, 66,872) of patients were waiting more than 13 weeks for either inpatient or day case admission, compared with 68.7% (62,163) at 31st December 2019 and 65.0% (56,871) at 31 March 2019.
  • Almost a third (32.8%, 30,696) of patients were waiting more than 52 weeks for either an inpatient or day case admission, compared with 29.9% (27,090) at at 31 December 2019, and 25.6% (22,350) at 31 March 2019.
  • During the quarter ending December 2019, 17,549 patients received inpatient and day case treatment, 59.4% (25,677) fewer than during the quarter ending December 2019 (43,226) and 65.2% (32,914) fewer than during the quarter ending March 2019 (50,463).

Waiting Times for a Diagnostic Service

  • The draft 2019/20 Ministerial target for diagnostic waiting times states that, by March 2020, 75% of patients should wait no longer than nine weeks for a diagnostic test, with no patient waiting longer than 26 weeks.
  • A total of 131,040 patients were waiting for a diagnostic service, 7.2% (10,234) more than at 31 December 2019 (141,274) and 0.5% (637) more than at 31 March 2019 (130,403).
  • More than half (55.1%, 72,248) of patients were waiting longer than nine weeks for a diagnostic test, compared with 57.5% (81,286) at 31 December 2019 and 49.4% (64,387) at 31 March 2019.
  • Over a quarter (27.3%, 35,784) of patients were waiting more than 26 weeks for a diagnostic test, compared with 30.4% (42,895) at 31 December 2019 and 21.7% (28,321) at 31 March 2019.

Diagnostic Reporting Turnaround Times

  • The draft 2019/20 Ministerial target for diagnostic reporting times states that, by March 2020, all urgent diagnostic tests should be reported on within two days of the test being undertaken.
  • A total of 408,012 diagnostic tests were reported on and dispatched to the referring clinician at hospitals in Northern Ireland during the quarter ending March 2020, 3.5% (14,971) fewer than the quarter ending December 2019 (422,983), and 1.3% (5,208) fewer than the quarter ending March 2019 (413,220).
  • Of the 62,970 urgent diagnostic tests reported on, 85.4% (53,797) were reported on within two days. 
  • The Western HSC Trust reported the highest proportion of urgent tests within two days (94.0%), with the other HSC Trusts reporting between 77.1% and 88.0% of urgent tests within two days. 

All publications are available on the Department’s website at: 

https://www.health-ni.gov.uk/topics/dhssps-statistics-and-research/hospital-waiting-times-statistics.