Publication of NI Hospital Statistics: Inpatient and Outpatient Activity 2015/16

The Department of Health today published the 2015/16 Inpatient, Day Case and Outpatient Hospital Statistics for the north of 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 during 2015/16, analysed by HSC Trust, hospital and specialty. 

Both publications are available online.

• Outpatient activity
• Inpatient and Day Case activity

Key Findings 2015/16

Inpatient Activity

• during 2015/16 there were 607,858 inpatient and day case admissions to hospital in the north of Ireland.  This was an increase of 0.3% (1,714) on the number of admissions during 2014/15 and an increase of 1.6% (9,630) on the number admitted during 2011/12. Of the 607,858 admissions in 2015/16, 50.4% (306,366) were patients admitted as inpatient admissions with the other 49.6% (301,492) day cases
• the day case rate for acute services has increased from 77.1% in 2011/12 to 79.1% in 2015/16.  The greatest increase occurred between 2011/12 and 2012/13 when the day case rate increased by 2.0 percentage points from 77.1% to 79.1%
• in the period between 2011/12 and 2015/16, the average number of available beds throughout the north decreased by 8.5% (147) from 6,034 to 5,887
• between 2014/15 and 2015/16 the greatest decrease in average available beds was evident in the Elderly Care programme of care, falling by 57 (6.1%) beds from 928 in 2014/15 to 872 in 2015/16
• the occupancy rate in hospitals was 83.7% during 2015/16; this was an increase from 83.2% in 2014/15 and was an increase from 83.6% in 2011/12
• average length of stay in hospitals has fallen consistently each year from 6.7 days in 2011/12 to 5.9 days in 2015/16

Outpatient Activity

• due to major changes over the last two financial years in what is included within the outpatient activity figures (see notes to editors section), it has not been possible to provide trend data on outpatient activity in HSC hospitals during 2015/16 with previous years
• during 2015/16, 1,519,297 patients were seen at consultant led outpatient services within HSC hospital
• some 31.9% (484,806) of patients seen during 2015/16 were new attendances, with the other 68.1% (1,034,491) being review attendances, resulting in a new to review ratio of 1:2.1
• patients missed a total of 136,899 appointments during 2015/16, giving a Did Not Attend (DNA) rate of 8.3
• patients cancelled 190,294 appointments during 2015/16, giving a Could Not Attend (CNA) rate of 11.1
• hospitals cancelled a total of 153,498 appointments during 2015/16, giving a hospital cancellation rate of 9.2
• during 2015/16, 37,057 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 1,556,354 consultant led attendances during 2015/16

ICATS Activity

• during 2015/16, 107,957 patients were seen at an ICATS service.  This was an increase of 0.5% (550) on the 107,957 seen during 2014/15
• some 43.5% (47,006) of patients seen during 2015/16 were new attendances, with the other 56.5% (60,951) being review attendances, resulting in a new to review ratio of 1:1.3
• patients missed a total of 9,803 ICATS appointments during 2015/16, giving a Did Not Attend (DNA) rate of 8.3, the same rate reported for 2014/15
• patients cancelled 14,142 appointments during 2015/16, giving a Could Not Attend (CNA) rate of 11.6, compared with a CNA rate of 12.2 reported for 2014/15
• hospitals cancelled 8,998 appointments during 2015/16, giving a hospital cancellation rate of 7.7, compared with a hospital cancellation rate of 8.4 reported during 2014/15

Notes to editors: 

1. Publication of NI Hospital Statistics: Inpatient and Outpatient Activity 2015/16

• 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 24th June 2016, with data on Mental Health and Learning Disability Activity due to be published on 1st September 2016 

2. Limitations to the Consultant Led Outpatient Activity Data

• readers should note that there have been a number of important changes to this return in the last two years
• at the beginning of 2014/15, the 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

3. Data definitions

Inpatient and Day Case Activity

Inpatient Admission

• 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

Day Case

• 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

Outpatient Activity

Outpatient

• 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

ICATS Appointment

• 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

4. 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

E-mail:  statistics@health-ni.gov.uk

5. Media inquires about this press release contact DoH Press Office on 028 9052 0567. Out of office hours please contact the Duty Press Officer via pager number 076 9971 5440 and your call will be returned. Follow us on Twitter @healthdpt

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