Northern Ireland’s hospitals recorded 570,282 finished consultant episodes in 2025/26, a 7.3% increase on the previous year, according to new statistics published by the Department of Health. However, the data excludes the entire Western Health and Social Care Trust due to ongoing transition issues with the new encompass electronic patient record system, raising questions about whether the figures truly reflect hospital activity across the region.
The Acute Episode-Based Activity Statistics, published on 1 October 2026, provide detailed analysis of hospital activity at specialty, diagnosis and procedure levels. The Western Trust’s exclusion is significant—it serves a large population across Derry/Londonderry, Fermanagh and Tyrone, meaning the reported figures cover only four of Northern Ireland’s five health trusts.
Day case surgery surges—but is it more patients or policy?
The statistics reveal a dramatic 72.0% increase in day case episodes over five years, rising from 116,522 in 2021/22 to 200,418 in 2025/26. Inpatient episodes grew more modestly at 11.4% over the same period, from 282,665 to 314,830.
This shift towards day surgery aligns with national policy priorities to reduce hospital stays and free up bed capacity. The Centre for Perioperative Care, alongside Getting it Right First Time and the British Association of Day Surgery, has championed expanding day surgery as “the answer to the waiting list crisis since the COVID-19 pandemic.” However, the 72% increase may reflect this deliberate policy shift rather than simply more patients receiving treatment.
The average length of an inpatient episode increased slightly from 3.4 days in 2021/22 to 3.6 days in 2025/26—suggesting that while more patients are being treated as day cases, those who do require admission are staying marginally longer.
Cancer diagnoses jump 24%—catch-up or crisis?
One of the most striking findings is a 24.3% increase in cancer and neoplasm diagnoses, rising from 63,134 FCEs in 2024/25 to 78,471 in 2025/26. This represents a 19.1% increase compared to 2021/22.
This surge demands careful interpretation. Cancer Research UK has documented that Northern Ireland’s cancer services were severely disrupted by COVID-19, with the charity’s January 2026 “No Time to Wait” report warning that, according to the charity’s research, “only around one in three patients begin treatment within 62 days.” The 24.3% increase likely reflects intensive efforts to clear the diagnostic backlog rather than a genuine spike in new cancer cases.
The charity notes that “for far too many people, the impact of a cancer diagnosis is compounded by unacceptably long waits to get the tests and treatments they need.” Whether this surge in recorded diagnoses translates to improved patient outcomes remains to be seen.
Respiratory illness and kidney disease dominate
Chronic kidney disease was the most frequently recorded primary diagnosis in 2025/26, accounting for 59,092 FCEs (10.4% of all episodes). Compensation for renal failure was also the most common main procedure, with 59,758 recorded.
This finding warrants medical context. Research from Trinity College Dublin indicates that chronic kidney disease is often a comorbidity—present alongside other conditions—rather than the primary reason for hospital admission. The high ranking may reflect improved recording practices or the growing burden of chronic disease among Northern Ireland’s ageing population.
Influenza and pneumonia FCEs surged 78.5% from 2021/22, rising from 11,296 to 20,168. This aligns with reports from late 2025 of an unusually severe and early flu season, with Dr Julie-Ann Maney at the Royal Belfast Hospital for Sick Children describing it as “the most severe influenza outbreak that I have experienced.” The increase likely reflects post-pandemic immunity gaps rather than system failure, though it placed significant pressure on emergency departments.
Hip procedures and heart disease
Hip procedures increased 36.3% from 2021/22, from 1,640 to 2,235 FCEs. Ischaemic heart disease episodes rose 10.2% over the same period, from 10,360 to 11,417.
These increases may reflect both population ageing and efforts to address elective surgery backlogs. The Northern Ireland Audit Office has previously noted that hospital admission activity remained 2.5% below pre-pandemic levels, suggesting ongoing recovery efforts.
Data quality concerns persist
The Department of Health acknowledges significant data limitations. The Western Trust’s transition to encompass on 8 May 2025 means its data is “still in development” and excluded from analysis. This creates a major gap in understanding true hospital activity, particularly for the Western Trust’s population across Derry/Londonderry, Fermanagh and Tyrone.
Additionally, the encompass system has changed how transfers between hospitals are recorded. Under the legacy system, transfers created new finished consultant episodes; under encompass, transfers within the same trust currently count as continuous admissions. This will only be corrected for episodes ending after 1 April 2026, meaning year-on-year comparisons are problematic.
The Department notes that “caution must be exercised when using these figures” and that they are considered “official statistics in development” rather than fully accredited statistics.
Questions for policymakers
- How significantly does the Western Trust exclusion skew our understanding of true hospital activity across Northern Ireland, and when will complete data be available?
- Does the 24.3% increase in cancer diagnoses represent successful backlog clearance, or are patients still facing dangerous delays as Cancer Research UK has warned?
- Is the 72% increase in day case surgery delivering genuine efficiency gains, or simply shifting costs and care burdens to patients and community services?
- How will the encompass system stabilisation improve data reliability for future planning and accountability?
- What proportion of the chronic kidney disease diagnoses represent genuine primary admissions versus improved recording of existing comorbidities?
The statistics are available alongside the Northern Ireland Hospital Statistics: Inpatient and Day Case Activity 2025/26 publication, which uses different methodologies based on admissions rather than consultant episodes. Readers seeking to understand hospital performance should consult both sources while remaining alert to their respective limitations.