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Leading surgeons warn national health service in Northern Ireland is failing

20 Oct 2017

The Royal College of Surgeons (RCS) has today warned the health service in Northern Ireland is failing patients waiting for planned treatment and that the current political instability is undermining efforts to reduce unacceptably long waits. Overall patient waiting times from referral to treatment in Northern Ireland are far longer than anywhere else in the UK.  There were 64,074 patients waiting longer than a year for an outpatient appointment and 11,261 were waiting longer than a year for inpatient or daycase treatment as of 30 June 2017. In comparison, the number of patients waiting more than a year for treatment in England was 1,544 patients in June 2017.

The RCS say the state of the health service underlines the need for a rapid restoration of the Northern Ireland Assembly and for the additional funds agreed by Westminster in the DUP/ Conservative confidence and supply agreement, which were to be targeted at waiting time pressures and support for the implementation of recently agreed health service reforms in Northern Ireland, to be urgently brought forward.  

As waiting times in Northern Ireland are measured differently to the rest of the UK (1), with outpatient and inpatients waits reported separately, the RCS is concerned published performance data masks the actual length of waits from referral, with an unacceptable number of patients potentially waiting more than 2 years for treatment from their initial referral.

In a new briefing paper on waiting times in Northern Ireland, the RCS says lengthy waiting times characterise almost all surgical specialties, although in some specialties, such as Trauma and Orthopaedics, and General Surgery, the problems are more severe. Surgeons are worried that this escalating problem is causing significant risk to patients and may result in increased disease and preventable deaths.

Commenting on the long waits patients are facing, Susan Hill, Vice President of the Royal College of Surgeons, said:

“The waits patients are having to endure for treatment in Northern Ireland are frankly shocking and suggest the health service is failing. The latest performance data shows more than a third of Trauma & Orthopaedics patients and fifth of General Surgery patients are now being forced to wait over a year for treatment, and that’s after they’ve waited to see a specialist, meaning individuals will be waiting significantly longer than the data reflects.

“The political instability of the last 9 months offers little prospect of immediate relief for anxious patients. It was announced last week that £40M of monitoring rounds monies would be released to ease service pressures and deliver some of the proposed reforms. If the health service in Northern Ireland is to avoid catastrophe it is vital the Northern Ireland Assembly returns and this funding, as well as the extra funding agreed by Westminster in the DUP/Conservative confidence and supply agreement is brought forward, through whatever channels are available, coupled with funding to support the implementation of the agreed health reforms. The health service, and more importantly patients, cannot wait any longer.

The Northern Ireland health service target for outpatient appointments is 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.

This target is being significantly missed with no realistic likelihood that the gap will be closed by March 2018. As of 30 June 2017, 71.6% of patients waited longer than 9 weeks for an outpatient appointment. Worse still, 64,074 patients waited longer than 52 weeks for an outpatient appointment – just under a quarter of the outpatient waiting list.

The RCS’s briefing paper suggests that rising demand as a result of an ageing population, insufficient numbers of doctors, nurses and other health professionals, growing demand in emergency care, a reduction in the use of the independent sector and an inability to implement reforms, coupled with political instability, are the key factors contributing to Northern Ireland’s struggling health service.

Susan Hill added:

“One in six people are currently on a waiting list for treatment in Northern Ireland. With no agreed budget for health and no minister, it is easy to see how waiting times have been allowed to deteriorate over every quarter in the last year. Health and Social Care staff are working extremely hard to deliver high standards of care, however with smaller budgets, and the need to make efficiencies, they are fighting an almost impossible battle. Action is needed immediately to address these wholly unacceptable waiting times.”



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. 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.

3. For more information, please contact the RCS Press Office on: 020 7869 6052/6047; or email:


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