Twenty-four children in NI waiting over a year for first cancer appointment

Over 17,000 children in Northern Ireland are waiting over a year for a first consultant appointment, according to a new report.

The Northern Ireland Commission for Children and Young People is behind the review.

Commissioner Koulla Yiasouma explained: “The report presents a concerning picture of the number and length of waits for services, this includes red flagged first consultant out-patient appointments which are either confirmed or suspected cancers where we found that 24 children were waiting over one year”.

The review examined the number of children and young people on waiting lists, and the length of time they wait to access first or review appointments with consultants, for treatment in hospitals, and for community-based services, it also assessed the impact that waiting has on children and young people and their families.

“While the impact of waiting on a red flag or urgent appointment is clear, we know that delayed access to any specialist support, whether that be for autism diagnosis or support, CAMHS, physiotherapy or speech and language, can and does have a profound impact on a child’s health outcomes, emotional and mental wellbeing, educational attainment, relationships with family and friends and quality of life more broadly,” Ms Yiasouma continued.

“The stress and pressure on parents and carers as advocates for their child, experiencing delays in accessing healthcare is significant. A clear message from them was that communication, co-ordination and emotional and practical support is inadequate and needs to be improved.

"These are the most basic expectations of these services and are particularly important when waiting times are as long as they are. Therefore, I have recommended an interim regional waiting list management process for child health services be established while overall reform is on-going.”

  • The review highlights that, one in five children and young people in NI are waiting for a first or review outpatient appointment with a consultant.

  • It also found that 17,194 children and young people were waiting over 1 year and 510 over 4 years for a first consultant out-patient appointment.

  • One in every 47 children in NI with conditions that require surgery or procedure are waiting for an in-patient or day case appointment. In April 2021, 62% (6092) were waiting over 1 year, and 197 over four years.

Koulla continued “While these hospital care statistics are shocking at least we get a clear picture. Worryingly, we have found a complete absence of regional monitoring or reporting of waiting times for community child health services which makes it impossible to get a clear understanding of the number of children waiting for these services.

"This review found that at least 26,818 (1 in 16) children in NI are waiting for a community-based health service and that figure is likely to be much higher given the limited data that was available.”

The review highlighted that there are three times more paediatric posts vacant for over three months in Northern Ireland compared to England, with workforce provision in rural areas a particular problem. The Commissioner concluded: “More Than A Number makes 17 recommendations, these include a full review of the child health system to ensure that health and social care reform is based on an up-to-date understanding of need across the system, takes account of existing plans for the reform of children’s health services but also identifies where the gaps are.

"I am also calling for improvements in the visibility of, and accountability for, children’s health within key departments by ensuring that key high level dedicated posts are in place to oversee commissioning, policy and service delivery. One of which is the appointment of a Deputy Chief Medical Officer for Child Health. “The commitments given by the current Health Minister to improve waiting lists and address the underlying issues which drive them is very welcome. It is important that the scope of the work is broad enough to cover all child health services. “Waiting times are one of the clearest indicators of a system under immense strain and unable to meet the needs of its population.

The commissioner committed to monitoring the implementation of the recommendations in this review and will publish a progress update report in Autumn 2022, before the end of her Term as Children’s Commissioner.

The review’s findings were put to the Health Minister at Stormont on Tuesday, he conceded that the majority of people in the region are being failed because of a hospital waiting lists crisis.

He said: "More needs to be done, we need more recurrent investment, we need support of our staff. We are now paying the price of 10 years of underfunding as well."

In a statement later he said the data in relation to paediatric red flags referred to in the NICCY report was correct as of April 2021 and based on September monitoring information there are no red flag paediatric patients waiting more than 52 weeks.