General Report on the Health and Social Care Sector 2010-2011

06 December 2011

General Report on the Health and Social Care Sector 2011

The health and social care (HSC) sector in Northern Ireland spends more than £4 billion each year. Today Kieran Donnelly Comptroller and Auditor General (C&AG), issued a report which focuses on the results of the 2009-10 and 2010-11 financial audits of HSC bodies in Northern Ireland. It notes the following:

Financial Performance

  • All health bodies were able to “break even” with regards the budget set for both 2009-10 and 2010-11 with the exception of the Northern Trust which required additional funding for both years and the Belfast Trust which required additional funding for 2009-10.
  • Management costs in the health and social care sector in 2010-11 were £125 million. This is £17.9 million above the management costs incurred in 2006-07, the final year before the Review of Public Administration (RPA) reforms1 . Mr Donnelly would have expected greater savings in these costs as a result of the revised structure that followed the RPA reforms in 2008. The Department of Health, Social Services and Public Safety (the Department) disagrees.
  • Compliance with prompt payment targets continues to present a considerable challenge to health bodies.

Operational Performance – Access to Health

Performance against waiting time targets has declined considerably since March 2009. Key targets have not been achieved for inpatient treatment, outpatient appointments, diagnostic tests or emergency care during 2010-11. At the end of March 2011:

  • over 17,000 patients were waiting more than 13 weeks for inpatient treatment compared to over 3,000 at March 2010;
  • 32,000 patients were waiting longer than the target of nine weeks for a first outpatient appointment; and
  • 12,000 patients were waiting longer than nine weeks for a diagnostic service or more than 13 weeks for a day case endoscopy.

The number of patients waiting more than 12 hours in an emergency care department showed an improvement, with 850 waiting in 2010-11 compared to 1,239 twelve months earlier. The target is that no patient should wait for this period of time.

Other Issues

The report also draws attention to:

  • the C&AG’s report on the Belfast Trust’s 2010-11 accounts addressing unauthorised senior executive salary payments. It also comments on information and clinical governance issues arising within the Trust;
  • the C&AG’s 2010-11 reports on each of the five non-regional trusts in respect of weaknesses in procurement and contract management procedures. The trusts are addressing these weaknesses. With the potential regularity and litigation risks associated with poor contract management, added to the potential value for money rewards arising from improvement, these weaknesses must be addressed as a priority; and
  • the reduction in Single Tender Actions across the health and social care sector from £9.8 million in 2006-07 to £5.4 million in 2010-11. This is a welcome development.

Notes for editors

  1. The Comptroller and Auditor General is Head of the Northern Ireland Audit Office (the Audit Office). He, and the NIAO, are totally independent of Government. He certifies the accounts of Government Departments and a range of other public sector bodies. He has statutory authority to report to the Assembly on the economy, efficiency and effectiveness with which departments and public bodies use their resources. His reports are published as Assembly papers.
  2. The Comptroller and Auditor General's report, General Report on the Health and Social Care Sector by the Comptroller and Auditor General for Northern Ireland – 2010 & 2011 is available from the Stationery Office throughout the United Kingdom. The report is embargoed until 00.01 hrs on 6 December 2011.
  3. Background briefing can be obtained from the Audit Office by contacting Denver Lynn (028 9025 1063) or Anu Kane (028 9025 4301).


1The Department has advised that if the 2006-07 management costs were re-based to 2010-11 levels factoring in inflation, pay modernisation progression and a change in employee’s superannuation rate, there would be real terms savings on management costs of £17.3 million reducing these to £107.7 million. This rebased figure for 2010-11 is £0.6 million higher than the actual management costs recorded in 2006-07.