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Royal College of Surgeons warns thousands are waiting over two years for treatment in Northern Ireland

06 Apr 2018

An unacceptable number of patients are waiting longer than two years for treatment in Northern Ireland, the Royal College of Surgeons (RCS) has warned today. Some patients have waited at least four years from first referral to treatment, and the number of patients waiting over two years is much higher than in England. 

The Royal College of Surgeons says that funds released March under the DUP-Conservative supply and confidence arrangements, to tackle unacceptably long waiting lists in Northern Ireland, should be directed so that the most urgent cases and longest waiters are prioritised. 

According to data obtained by the Royal College of Surgeons, 3,072 patients waited over two years for treatment. There were also 11,914 patients waiting between one year and two years for inpatient or day case treatment as of 31 December 2017.  There were 4,137 patients waiting for trauma and orthopaedic surgery and 2,026 waiting for general surgery.

A further 2,501 patients waited between two and three years for surgery. This has increased by more than 500 since last September alone. There were 571 patients waiting at least three years for treatment. The total number waiting one year or more in England is  around 1,800, despite the population being much higher.

Miss Susan Hill, Vice President of the Royal College of Surgeons, said:
“Waiting times data for Northern Ireland makes for very grim reading. Far too many patients are being left waiting unacceptably long for treatment. The latest figures show that things have worsened since the data published in September 2017. It is also important to remember Northern Ireland waiting times do not measure the full patient journey from when they are referred by a GP. It is little wonder waiting times have been allowed to deteriorate to this very sorry state when there is no health minister and no agreed health budget. 

“Long waits for surgery can be traumatising for patients and their families. In some cases, patients will be in extreme pain or immobile, possibly unable to work or carry out daily tasks. A patient’s condition can also deteriorate the longer they are made to wait for treatment, meaning the eventual outcomes are not as good as they could have been.

“The ongoing political impasse risks the wellbeing of patients across Northern Ireland. We encourage all political stakeholders to work together to implement the waiting times initiatives as soon as possible and to urgently prioritise the system changes recommended in the most recent transformation proposals.”

While England measures waiting times from referral to treatment, Northern Ireland measures waits for two stages of treatment: referral to first outpatient appointment and then outpatient to inpatient treatment1. In this context the long outpatient to inpatient treatment waiting times are even worse.

A number of factors are responsible for the figures, including an ageing population, a shortage of suitable doctors and nurses, increased demand for emergency care and a reduction in use of the independent sector. However, the current political impasse – which has resulted in the Northern Ireland Assembly being suspended since June 2017 and direct rule imposed from Westminster – is blamed for much of the problem.

The Northern Ireland health service target for outpatient appointments was for half of patients not to wait longer than 9 weeks for a first outpatient appointment, with no patient waiting longer than 52 weeks by March 2018. 

Notes to editors

1. How are waiting times in Northern Ireland are measured differently to the rest of the UK? 

England, Wales, and Scotland measure waiting times from when a patient is referred for treatment (referral to treatment waiting times). However, Northern Ireland instead measures two stages of treatment: referral to first outpatient appointment and then outpatient to inpatient treatment. This document focuses on inpatient waits but it is important to stress that outpatient waiting times are themselves very long meaning the overall patient time from referral to treatment is far longer than anywhere else in the UK. It is very likely that an unacceptable number of patients will be waiting more than 2 years for treatment from initial referral.

2. Full Data provided to the Royal College of Surgeons by the Northern Ireland Executive’s Department of Health:

Total patients waiting for inpatient/day case treatment at 31st December 2017: 

>1 year <2 years = 11,914 (Trauma & Orthopaedics: 4,137; General Surgery: 2,026; Urology: 975; ENT: 1,489; Plastic Surgery: 449)
>2 years <3 years = 2,501 (Trauma & Orthopaedics: 984 T&O; General Surgery: 518; Urology: 232; ENT: 230; Plastic Surgery: 118)
>3 years <4 years = 481 
> 4 years = 90 (General Surgery: 71)

Compared to total patients waiting for inpatient/ day case treatment at 30th September 2017: 

>1 year <2 years = 10,689 (Trauma & Orthopaedics: 3,822; General Surgery: 1,865; Urology: 917; ENT: 1,376; Plastic Surgery: 374)
>2 years <3 years = 2,045 (Trauma & Orthopaedics: 765; General Surgery: 470: Urology: 232; ENT: 205; Plastic Surgery: 104 Plastics)
>3 years <4 years = 390 
> 4 years = 55 (General Surgery: 42)

3. Northern Ireland Department of Health announces £30m to tackle hospital waiting lists:
4. The Royal College of Surgeons warned in a briefing paper in October 2017 that the national health service in Ireland is failing: 

5. The Royal College of Surgeons of England is a professional membership organisation and registered charity, which exists to advance surgical standards and improve patient care.

6. For more information, please contact the RCS Press Office on: 020 7869 6052/6047/6229; or email:; out of hours media enquiries: 07966 486832

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