The Department of Health today published the 2017/18 Inpatient, Day Case and Outpatient Hospital Statistics for Northern Ireland.
These Hospital Statistics publications outline (a) the number of inpatient and day case admissions and (b) the number of attendances at consultant led outpatient services in Northern Ireland during 2017/18, analysed by Health and Social Care (HSC) Trust, hospital and speciality.
Both publications are available online at:
Key Findings 2017/18
- During 2017/18 there were 608,578 inpatient and day case admissions to hospital in Northern Ireland. This was a decrease of 1.1% (6,693) on the number of admissions during 2016/17 and an increase of 0.1% (639) on the number admitted during 2013/14. Of the 608,578 admissions in 2017/18, 49.0% (298,401) were inpatient admissions and 51.0% (310,177) were day cases.
- The day case rate for acute services has increased from 77.8% in 2013/14 to 80.3% in 2017/18. The greatest increase occurred between 2014/15 and 2015/16 when the day case rate increased by 0.8 percentage points from 78.3% to 79.1%.
- In the period between 2013/14 and 2017/18, the average number of available beds throughout Northern Ireland decreased by 4.1% (249.3) from 6,151.5 to 5,902.2.
- Between 2016/17 and 2017/18 the greatest decrease in average available beds was evident in the Learning Disability programme of care, falling by 10.5 (7.8%) beds from 134.6 in 2016/17 to 124.1 in 2017/18.
- The occupancy rate in hospitals in Northern Ireland was 83.6% during 2017/18; this was an increase from 82.7% in 2013/14 and a decrease from 83.9% in 2016/17.
- Average length of stay in hospitals has shown an overall decrease from 6.1 days in 2013/14 to 6.0 days in 2017/18.
- Due to major changes between 2014/15 and 2015/16 regarding the outpatient activity figures (see notes to editors section), it is only possible to provide trend data on outpatient activity in HSC hospitals from 2015/16 onwards.
- During 2017/18, there were 1,456,651 attendances at consultant led outpatient services within HSC hospitals in Northern Ireland. This was an decrease of 51,084 attendances on the 1,507,735 seen during 2016/17.
- Some 32.0% (466,823) of patients seen during 2017/18 were new attendances, with the other 68.0% (989,828) being review attendances, resulting in a new to review ratio of 1:2.1.
- Patients missed a total of 128,407 appointments during 2017/18, giving a Did Not Attend (DNA) rate of 8.1.
- Patients cancelled 191,803 appointments during 2017/18, giving a Could Not Attend (CNA) rate of 11.6.
- Hospitals cancelled a total of 166,238 appointments during 2017/18, giving a hospital cancellation rate of 10.2.
- During 2017/18, 10,643 patients attended an appointment with an Independent Sector Provider, commissioned by the Health Service.
- When attendances at HSC Trusts and Independent Sector activity are combined, there were 1,467,294 consultant led attendances in Northern Ireland during 2017/18.
- During 2017/18, 116,292 patients were seen at an ICATS service in Northern Ireland. This was a decrease of 44 on the 116,336 seen during 2016/17.
- Some 42.3% (49,147) of patients seen during 2017/18 were new attendances, with the other 57.7% (67,145) being review attendances, resulting in a new to review ratio of 1:1.4.
- Patients missed a total of 10,944 ICATS appointments during 2017/18, giving a Did Not Attend (DNA) rate of 8.6, compared with a rate of 8.5 reported for 2016/17.
- Patients cancelled 16,157 appointments during 2017/18, giving a Could Not Attend (CNA) rate of 12.2, compared with a CNA rate of 11.8 reported for 2016/17.
- Hospitals cancelled 9,190 appointments during 2017/18, giving a hospital cancellation rate of 7.3, compared with a hospital cancellation rate of 6.9 reported during 2016/17.
Notes to editors:
- Publication of Northern Ireland Hospital Statistics: Inpatient and Outpatient Activity 2017/18
Hospital Information Branch (DoH) publish annual data relating to (i) Inpatient and Day Case Activity; (ii) Outpatient Activity; (iii) Emergency Care Activity and (iv) Mental Health and Learning Disability Activity
This statistical press release relates to the publication of the two National Statistics publications containing data relating to (i) Inpatient and Day Case Activity and (ii) Outpatient Activity. Data relating to Emergency Care Activity were published on 22 June 2018, with data on Mental Health and Learning Disability Activity due to be published on 5 September 2018.
- Limitations to the Consultant Led Outpatient Activity Data
Readers should note that there have been a number of important changes to the statistical monitoring return in the last three years.
At the beginning of 2014/15, the Quarterly Outpatient Activity Return (QOAR) return was revised so that ward attendances seen by a consultant are now reported separately and are no longer included in the new and review outpatient attendance figures, as in previous years.
Also, prior to 2015/16, virtual outpatient activity was included within the QOAR. During 2015/16, the HSCB developed regional guidance on the recording of virtual activity; this activity has been removed from the QOAR return and as such is not included within this publication. All terminology in this publication should therefore be taken to refer to face to face outpatient activity only.
From the beginning of 2015/16, HIB introduced a separate monitoring return to allow the monitoring of virtual outpatient activity. However due to data quality issues, we have not included it within this publication but plan to develop it for future publication.
Due to the major changes over the last two financial years, it has not been possible to provide trend data on outpatient activity in HSC hospitals during 2015/16 with previous years. HIB advise against making any comparisons across financial years.
- Data definitions
Inpatient and Day Case Activity
Inpatient admissions include both (a) patients admitted electively with the expectation that they will remain in hospital for at least one night, and (b) non-elective admissions (e.g. emergency admissions). A patient who is admitted with this intention but who leaves hospital for any reason without staying overnight is still counted as an inpatient. Day cases and regular attenders are not included.
A patient admitted electively during the course of a day with the intention of receiving care who does not require the use of a hospital bed overnight and who returns home as scheduled. If this original intention is not fulfilled and the patient stays overnight, such a patient should be counted as an inpatient. Regular attenders have been included in day case figures with the exception of the acute programme of care.
Average Available/Occupied Beds
The average number of available and occupied beds during the year in wards that are open overnight, measured at midnight. Hospitals may also have a number of beds in wards that are only open during the day. Beds reserved for day care admission or regular day admission are not included.
A patient who attends a clinic to see a consultant, a member of their team, or a locum for such a member.
Outpatient Did Not Attend – DNA
DNA refers to the number of patients with an appointment who did not attend and failed to give advance warning to the hospital. This includes patients who cancelled their outpatient appointment on the same day on which the appointment was scheduled. The DNA rate is calculated by taking the number of missed appointments (DNAs) as a rate of the sum of the total number of attendances and missed appointments.
Appointment cancelled by patient – CNA
A patient cancellation refers to an appointment that was intended to be held but was cancelled by the patient, with the patient contacting the hospital no later than the day before the appointment is scheduled and informing the hospital that they are unable to attend the scheduled appointment. The CNA rate is calculated by taking the number of patient cancellations (CNAs) as a rate of the sum of the total number of attendances and patient cancellations.
Appointment cancelled by the hospital
An appointment that was intended to be held, but which did not occur, due to circumstances within the hospital. Appointments may be cancelled by the hospital for a variety of reasons. These include, in order to reschedule the appointment to an alternative date and due to the unavailability of the consultant. The hospital cancellation rate is calculated by taking the number of appointments cancelled by hospitals as a rate of the sum of the total number of attendances and appointments cancelled by hospitals.
Note: The number of attendances does not equate to the number of individual patients seen, as it is possible for the same person to attend a consultant led outpatient service more than once during the year. This is the same when looking at missed and cancelled appointments, as it is possible for the same person to miss or cancel their appointment or have their appointment cancelled by the hospital more than once during the year.
Integrated Clinical Assessment and Treatment Services (ICATS)
ICATS is the term used for a range of outpatient services for patients, which are provided by integrated multi-disciplinary teams of health service professionals, including GPs with a special interest, specialist nurses and allied health professionals. They are provided in a variety of primary, community and secondary care settings and they include assessment, treatment, diagnostic and advisory services.
An ICATS Tier 2 appointment is a non consultant outpatient appointment. Following ICATS Triage, patients who have not been given either a discharge, advice only or referral incomplete outcome will proceed for either a (i) first outpatient appointment, (ii) a diagnostic test or (iii) an ICATS Tier 2 appointment. Following a first Tier 2 ICATS appointment there are a number of outcomes, including a review Tier 2 ICATS appointment or a referral for a first consultant led outpatient appointment.
ICATS Tier 2 appointments attended, those missed by patients (DNA), cancelled by patients (CNA) or cancelled by the hospital (Hospital Cancellations) are defined similarly to those for consultant led outpatient services. Reasons for cancellation of ICATS Tier 2 appointments are not currently collected by the Department.
- This information was collated by Hospital Information Branch, DoH.
Further information is available from:
Hospital Information Branch,
Department of Health
Annex 2, Castle Buildings,
Stormont, BT4 3SQ
Telephone: 028 90 522800
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