Surgeons in Northern Ireland hail post-Covid elective efforts but say progress in reducing the backlog remains challenging

Surgeons in Northern Ireland have commented on annual hospital statistics released today that show progress has been made, but that more needs to be done to get back to pre-pandemic levels. 

The new figures reflect inpatient, day case and outpatient activity for 2021-22 and show the health service has made significant progress in recovering from the impact of the pandemic.  Overall, there were 510,834 inpatient and day case admissions to hospital in NI. This was an increase of 19.4% (83,102) on the number of admissions during 2020/21 but a decrease of 16.1% (97,704) on the number admitted during 2017/18. 

In 2021/22, there were 83,269 theatre cases across all HSC Trust hospitals; this was an increase of 39.3% (23,507) compared with 59,762 theatre cases in 2020/21.

At the beginning of the pandemic, all planned surgery in Northern Ireland stopped and throughout subsequent Covid-19 waves, surgical activity suffered from a stop-start approach.

The impact on planned operations was clear with theatre case figures showing a drop of 46%[1] during 2020/21 with outpatient activities experiencing a similar decrease of 50%[2].

Currently NI waiting times show 358,807 patients are waiting for a first outpatient appointment with a consultant and over 122,000 are waiting for surgery or treatment. The longest waiters are those in General Surgery 27,068; Trauma and Orthopaedic Surgery 25,742; ENT 13,640 and Urology 10,146. Over 41% [51,001 patients] have been waiting more than 104 weeks.

Responding to the report, Mr Gary Spence, a member of the Northern Ireland Board of The Royal College of Surgeons of England, said:

“Against the backdrop of the worst waiting time figures in the UK, the new figures demonstrate that Northern Ireland hospitals are recovering, with activity rates that are better than the previous year. However, it’s crystal clear we are not back to pre-pandemic levels yet. We need to continue to increase access to planned surgery. Unfortunately however, with continuing spikes in Covid-19 infection, staff illness and low staff morale, getting planned services to recover fully is going to take some time.  Unfortunately, it is our patients who are still suffering.

“Significant work has been carried out by surgeons and their teams to reduce waiting lists in the most difficult of circumstances. There are still big challenges ahead. As people return to using our health service, demand is only getting stronger.”

According to Chief Medical Officer, Sir Michael McBride, this winter is going to be challenging again for the health service with his prediction of another Covid-19 surge and higher flu activity circulating at the same time. Unfortunately this could impact hospital admissions.

Mr Spence added:

“There can be no doubt about the pressure facing our hospitals and health service staff. It is the summer, yet we are facing pressures normally seen in winter.

“Coping with year-round pressures of this level is not sustainable and we are seeing an impact right across all our surgical teams.

“We are pleased that surgical hubs have been created at Lagan Valley and Omagh hospitals - where more planned surgery can happen with reduced disruption due to competing emergency workloads. 

“We also need more staff.  Surgical trainees are a key part of the solution, and should be involved in every operation. If we do not support trainees to progress, they may abandon their training or decide to pursue their careers elsewhere, away from NI.  That would be a tragedy, and we cannot allow it to happen.”

[1] Hospital Statistics: Inpatient and Day Case Activity Statistics 2020/21 https://www.health-ni.gov.uk/sites/default/files/publications/health/hs-inpatient-day-case-stats-20-21_0.pdf

[2] Hospital Statistics: Outpatient activity 2020/21 https://www.health-ni.gov.uk/sites/default/files/publications/health/hs-outpatient-stats-20-21_0.pdf

Notes to editors

1.The statistics from the Department of Health can be accessed here: https://www.health-ni.gov.uk/articles/outpatient-activity and here: https://www.health-ni.gov.uk/articles/inpatient-and-day-case-activity They also show:

• In 2021/22, there were 83,269 theatre cases across all HSC Trust hospitals; this was an increase of 39.3% (23,507) compared with 59,762 theatre cases in 2020/21. Of the 83,269 theatre cases 61.6% were Elective and 38.4% were Emergency.
• Independent Sector: In 2021/22 there were 20,039 admissions for an inpatient or day case procedure –an increase of 11,474 (134.0%) compared with 2020/21.
• Outpatients: During 2021/22, there were 1,009,034 face-to-face attendances at consultant-led outpatient services, an increase of 46.3% from 2020/21 (689,898).
• During 2021/22, the highest number of theatre cases was recorded under General Surgery with 20.7%, followed by Trauma & Orthopaedic Surgery 14.6%, and Urology 13.2%.

2.The Royal College of Surgeons of England (RCS England) is a professional membership organisation and registered charity. The College provides world-class education, assessment and development to more than 28,000 surgeons, dental professionals and members of the wider surgical and dental care teams, at all stages of their career. The College sets professional standards, facilitates research and champions the best outcomes for patients – with a vision to see excellent surgical care for everyone.

3.For more information, please contact the Press Office:

Telephone: 020 7869 6052/6055

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