Work in Progress - Elective Care Waiting Lists

Work in progress

We are currently undertaking work in order to produce this publication. Details of when we aim to publish the finalised report are indicated below.

`Elective care’ is care that is planned in advance rather than unscheduled treatment. Usually following referral from a General Practitioner (GP), it involves specialist assessment and potentially subsequent care mainly delivered in hospitals. The Department of Health (DoH) reports patient waiting times across the local Health and Social Care (HSC) Trusts for a first outpatient appointment, and subsequent hospital admission and diagnostic tests. DoH also has three specific cancer care waiting time standards. 

Lengthy waits means patients’ conditions can significantly worsen, potentially leading to more complex and expensive treatment, and detriment to patients’ mental health and financial wellbeing. However, the number of people on HSC waiting lists and length of waiting times have both risen very sharply since 2013-14, and the Department has not achieved any of its formal targets in any year since then.

Waiting times in NI are by far the longest in the UK, and this has been significantly driven by a widening gap between rising population demand for care and the HSC capacity available to meet this. Other factors include HSC funding and workforce deficits, growing unscheduled care pressures, and slow progress in transforming and modernising HSC services. Covid-19 pressures saw waiting times rise even further in 2020 and 2021. The Department and Trusts now face huge challenges, with significantly enhanced funding and better planning required to rectify the situation. A DoH Framework published in June 2021 aims to clear the patient backlog and maintain waiting times at `acceptable’ standards by March 2026, but over £700 million of additional funding is required to implement this.  

 

This review is assessing:

  • performance against elective and cancer care waiting time targets since 2013-14, and across individual HSC Trusts and care specialisms since 2017-18, and where possible, comparison with the rest of the UK.
  • why local waiting times have deteriorated so badly.
  • the effectiveness of previous and current initiatives to reduce waiting times.
  • key challenges, and what more needs to be done if waiting times are to be substantially reduced.

We aim to publish in Summer 2023.