Emergency department waiting times in Northern Ireland have deteriorated further during the first quarter of 2026, with new official figures showing that more than one in six patients now waits longer than 12 hours for treatment, admission or discharge. The statistics, published today by the Department of Health, reveal that performance against the four-hour target has slipped to its lowest quarterly level in years, while median waiting times for patients requiring hospital admission have stretched to over 14 hours at major facilities.
The latest data covers the three months from January to March 2026 and captures the period immediately following the full rollout of the new Encompass digital patient record system across all five Health and Social Care Trusts. While the department notes that the statistics remain “meaningful,” they carry a caution that data quality issues related to the Encompass transition—particularly in the Southern Trust—may affect some figures.
Key Statistics at a Glance
The bulletin paints a stark picture of sustained pressure across Northern Ireland’s emergency care system:
- In March 2026 alone, 72,086 patients attended emergency departments—an increase of 837 (1.2%) compared with March 2025
- During the quarter ending 31 March 2026, just 40.2% of patients spent less than four hours in an emergency department, down from 43.6% during the same period in 2025
- The number of patients waiting over 12 hours increased to 12,549 in March 2026, representing 17.4% of all attendances—up from 10,977 in March 2025
- For patients who required admission, the median time spent in a Type 1 emergency department was 14 hours and 22 minutes—54 minutes longer than in March 2025
- Those discharged home faced a median wait of 5 hours and 20 minutes, up 32 minutes from the previous year
Significant Regional Variations
The data reveals striking disparities between hospitals. Altnagelvin Area reported the longest median waiting time for patients requiring admission, at 21 hours and 28 minutes in March 2026. By contrast, the Royal Belfast Hospital for Sick Children (RBHSC) recorded the shortest median admission wait at 6 hours and 16 minutes.
The Phone First service, designed to divert non-urgent cases away from busy emergency departments, received 16,563 calls in March 2026. However, nearly two-thirds (64.9%) of callers were still directed to attend an emergency department, suggesting that demand for urgent care remains high despite alternative pathways.
Digital Transformation and Data Quality Concerns
The statistics are the first to cover the period after the Encompass patient record system went live across all trusts in May 2025. The department acknowledges that “data quality issues have been identified in encompass data” within the Southern Health and Social Care Trust, meaning the number of valid triage and treatment instances recorded is “lower than usual.” A data validation exercise is ongoing.
This follows earlier disruption in September 2025, when approximately 1,600 appointments were cancelled across the Southern Trust due to IT infrastructure issues related to the new system. While the department maintains that Encompass will eventually offer “better quality data to improve services,” the transition period appears to be creating additional administrative burdens for staff already managing rising demand.
The Human Cost of Extended Waits
Today’s figures arrive against a backdrop of mounting concern about patient safety. A report published earlier this year by the Royal College of Emergency Medicine (RCEM) estimated that 1,032 excess deaths in 2025 were associated with waits of 12 or more hours in emergency departments. The body noted that while this represents a slight reduction from 1,122 in 2024, the mortality figure has more than doubled over five years—from just 461 in 2020.
Responding to these concerns in the Northern Ireland Assembly on 20 April 2026, Health Minister Mike Nesbitt acknowledged that “the level of preventable harm remains unacceptably high.” He outlined plans to implement “Release to Rescue” guidance from 27 April 2026, which aims to ensure no ambulance wait exceeds two hours for handover at an emergency department.
“The crux of the issue is at the ‘back door’ of the hospital, not that we have too many people coming to A&E,” Mr Nesbitt told MLAs. “Too many patients are stuck occupying beds when they are medically fit to be discharged. We are looking at a long-term solution, because you cannot flick a switch and fix it.”
The Minister also highlighted efforts to improve hospital flow through expanded hospital-at-home services, same-day emergency care, and strengthened “Hear and Treat” pathways within the Ambulance Service.
Omissions and Unanswered Questions
While the statistical bulletin provides granular detail on waiting times, it offers limited insight into causation. The department attributes some deterioration to the “winter surge” and higher demand, yet the RCEM has previously noted that attendance numbers have “barely changed” while long waits have “skyrocketed”—suggesting systemic capacity issues rather than demand spikes are driving the crisis.
Notably absent from today’s release is any specific analysis of delayed discharges (patients medically fit for discharge but awaiting community care packages), which both the Minister and emergency medicine specialists identify as the primary bottleneck. The bulletin also does not quantify how many patients left before treatment was complete due to excessive waits, though it notes 6.7% left without completing treatment in March.
Critical Questions for Policymakers
- Given that Altnagelvin consistently reports the longest waits in Northern Ireland, what specific interventions are being targeted at the Western Trust to address capacity and flow issues?
- With the Encompass system now fully implemented but still generating data quality concerns, when can trusts expect the system to deliver the promised efficiencies rather than administrative complications?
- How will the Department of Health measure the success of the “Release to Rescue” policy in reducing mortality risks, and will this data be published transparently?
- What concrete timelines exist for expanding community care capacity to address the “back door” blockages that are keeping admitted patients in emergency departments for a median of 14 hours?
- Given that 40% of Phone First callers are still being sent to emergency departments, is the service sufficiently resourced to provide genuine alternatives to ED attendance?
The next quarterly statistics, covering April to June 2026, will provide the first indication of whether the “Release to Rescue” guidance and spring operational changes are having any measurable impact on waiting times. For the thousands of patients currently facing 12-hour waits in noisy, overcrowded departments, those figures cannot come soon enough.
The full statistical bulletin and additional guidance on interpreting the data are available on the Emergency Care Waiting Times Website. For information on how these statistics compare with other UK jurisdictions, see the ONS comparability report.