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Health Minister’s Plan to Cut Waiting Times

Last week, Health Minister Michelle O’Neill published a document that describes the plan to transform the delivery of elective care services across Northern Ireland.

Elective care is any prearranged, non-emergency care, including planned operations, outpatient appointments and appointments that help diagnosis, such as scans, X-rays or biopsies.

The document, Elective Care Plan: Transformation and Reform of Elective Care Services, contains the plan to transform the delivery of elective care services through a process of modernisation and reform to ensure that sustained action is taken to address the root cause of excessive waiting times.

Current waiting times and performance for all elective services are outlined on page eight of the Elective Care Plan, which you can download at

It is hoped that implementation of the initiatives in this plan will ensure that, by March 2018, no one should wait more than 52 weeks for a first outpatient appointment and inpatient/day case treatment, and 26 weeks for a diagnostic appointment.

There are a number of actions and commitments in the plan that will help to improve current waiting times. These include exploring the opportunities for primary care to take forward some of the areas for transformation and innovation envisaged in this plan, the improved use of technology and undertaking a review of existing waiting lists.

It is recognised that additional resources will be required if the actions and commitments in this plan are to be realised.

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Brendan Clarke 26-Feb-2017 at 22:58 hrs

I suppose most of us have thought about what we could do if we had a substantial win in the Euro-millions but never thought of our ideas constituting a plan. Concentration should be on what can be done with available money without wasting resources on publishing papers about dreams. This only reinforces lack of confidence in the abilities of those running our health services.
When dealing with staff shortages staff shortages in our hospitals we need to be looking at how we cheat NHS staff in their pay increases and at why their earnings here do not match other areas of the UK.
We should be questioning need to have a Dept of Health, Public Health Authority and multiple Trusts to administer health for the relatively small population of Northern Ireland.
What is the ratio of NHS administrators to patients in Northern Ireland and more importantly is the ratio of NHS Directors to those people.
More and more is being moved to Primary Care but GPs do not appear to be seriously involved in the organisation and planning of these services but rather accept extra work for their nursing staff if the price is right without any regard to the ability of their staff to handle the volume of extra duties.


Mary Gordon 26-Feb-2017 at 19:01 hrs

A YEAR to wait for a first appointment! That is far far too long!!!


Carol McCullough 22-Feb-2017 at 20:41 hrs

I know that many people have very positive experience of the health service but users and health care workers alike are becoming more and more demoralised by continuing problems that cannot be resolved. Waiting lists is one of them. Waiting 52 weeks for a first outpatient appointment and inpatient/day case treatment, and 26 weeks for a diagnostics appointment, is still too long. The proposed waiting times, even if possible, will have a negative impact on person centred, holistic, care. Patients may be left suffering physically, socially and emotionally. Health may deteriorate without a diagnosis and timely management. Jobs may also be lost and there can be financial difficulties. Homes may be lost if there are problems keeping up mortgage payments. Marriages can suffer; whole families may be effected. Long waiting times push people into the benefits system. It also can be more difficult to prove that you are entitled to benefits if discovering the cause of mystery symptoms/ signs is prolonged. The collective impact results in damage to the economy. Regarding health care professionals, it is the GPs who face additional work resulting from patients and carers asking for repeat appointments. Who can fault users if patients are feeling very ill, or additional anxiety is caused, due to the length of time it takes to receive elective care. Secondary care clinicians are put under extra stress due to large workloads and trying to meet targets. People are more likely to be pushed through the system; dismissed and discharged. This will have a greater impact on those who have an ‘invisible illness’, transient symptoms/ signs, and/ or rare disease. These people are often not viewed as a priority because they do not look ill; results for routine tests may be normal; or there may be no initial tests available that a GP can carry out. These are also the people who are often sent in circles around the system because a diagnosis cannot be established or is missed. They wait extended periods on one appointment as a non-priority patient and when they meet a secondary care clinician discharged without the cause of symptoms/ signs being found. Following that they put up with problems without support until they die; or go back onto another waiting list as a non-priority patient.


Michael Martin 21-Feb-2017 at 17:57 hrs

Our waiting times for all procedures are much to long and it seems that this proposal is not going to reduce them greatly. No patent should have to wait more than seven days for an assessment by a consultant and no more than one month for a procedure and less if its a life threatening ailment or if the patent is suffering considerable pain. It is not acceptable to make the excuse of no money is available. Money can be found for MLAs expenses, heating schemes and payment to some questionable groups in the guise of development funds. It must be a priority of all those elected to have a fit for purpose NHS which we all can get proper care at the time of need and that all NHS staff are not put in such an impossible position as they find them themselves in now.


Allison Barron 21-Feb-2017 at 16:56 hrs


I seriously do not believe a word of this plan. Ms ONiell will say and do anything in order to get election votes, she has been pushed on this subject by reporters for a very long time and I suspect she is saying what she thinks the voters wish to hear her say.
I do not think that 52 weeks of a wait for a first outpatient appointment is acceptable, it should be more like 3 months. After all a lot can happen in a year and 26 weeks for a diagnostic appointment is even worse.I totally agree with the comments of Susan Boyce.


Doreen Patton 21-Feb-2017 at 16:30 hrs

It is great to see that the Health Minister intends improving waiting times within our NHS. A large part of any plan outlines details of how, where and when this plan will operate and most important how much it will cost the public purse. If there had not been so many cuts and reduction of beds the waiting lists would not have got into the state they are in. Many people are now being forced to use private care for first assessment and then jumping the queue into the NHS system and the result is the waiting list getting longer. Bring all the NHS consultants who are doing private work back into the system and cut the lists. We have more consultants now than ever so why are the patients not being seen. The BCH outpatients department
used to be crowded with patients now it is dead and deserted, why?


Tom Sullivan 21-Feb-2017 at 09:56 hrs

The document states that

"We will improve direct access between primary and secondary care."

How does that fit with the decision taken by the Health & Social Care Board last week not to proceed with direct access to physiotherapy in Northern Ireland.

Direct access is a system of access that facilitates patients with a musculoskeletal condition to refer themselves directly to a physiotherapist without seeing a GP first. The known benefits include,

To Patients:
•Access to expert musculoskeletal (MSK) assessment, diagnosis and treatment
•Prevention of short term problem becoming a long term condition
•Improved patient experience
•A shorter and more streamlined pathway
•Opportunity to gain lifestyle/physical activity advice
•Quicker support to aid patients’ return to work.

To GPs:
•Freed up time through reallocating appointments for patients with MSK problems
•Reduced prescription costs
•Freed up administration time

An evaluation of the direct access physiotherapy pilot, which has been operating in the South Eastern Trust since June 2015 demonstrated high levels of service user satisfaction, patient empowerment and better clinical outcomes. In addition, given the current crisis facing general practice in Northern Ireland direct access physiotherapy has the potential to significantly free up GP time and reduce waiting lists.

However, this will now not happen as a result of the decision taken by the Health & Social Care Board. This decision is contrary to the redesign and transformation of health care services agenda and the most up to date research evidence.


Susan Boyce 21-Feb-2017 at 08:43 hrs

Whilst the document addresses many issues and very prominent issues it still is dependent on significant additional funding.

Surely the minister knows the budget IS NOT. A bottomless pit.

The real problems within primary care are not addressed i.e. Waste of current time and monies within hospitals being addressed and employees being held to account.

The waiting times suggested are still not good enough given we have paid for this care all our working lives. Waiting 26-52 weeks for many is to little to late.

Engagement with the public is to say the least sporadic and those of us needing care are not listened to.

Health care needs total reformation and less job protection in the mix.