Health Minister Mike Nesbitt has announced that £80 million will be ring-fenced for waiting list and elective care capacity building during the 2026/27 financial year, as the Executive seeks to maintain momentum in tackling Northern Ireland’s record hospital backlogs. The funding commitment, confirmed during a visit to Belfast’s Mater Hospital Elective Overnight Stay Centre, comes as latest statistics show modest reductions in waiting lists but reveal that no health trust is currently meeting official treatment time targets.
The Funding Commitment
The £80 million allocation will support continued action to reduce the longest and most critical waiting times across Health and Social Care (HSC) trusts. Minister Nesbitt made the announcement at the Mater Hospital’s Elective Overnight Stay Centre (EOSC), a facility that has treated more than 8,000 patients since opening in November 2022 and has played a key role in eliminating waits of more than four years for specific procedures.
The funding forms part of the Executive’s Programme for Government commitment to cut health red flag and critical waiting lists, and sits within the broader £165 million annual provision for waiting lists and elective care outlined in the Draft Budget 2026-29. Details of how the money will be allocated across specific services and trusts will be confirmed in the coming weeks.
Progress on the Ground
The Mater EOSC has contributed to the elimination of waits exceeding four years for laparoscopic cholecystectomy (gallbladder removal), colonoscopy and tonsillectomy, alongside significant reductions in hernia surgery waiting lists. The centre handles intermediate complexity surgery requiring overnight stays, freeing capacity at other hospital sites for more complex cases.
Health Minister Mike Nesbitt said:
“Reducing waiting times and improving access to care are among my sharpest areas of focus as Health Minister and central to the Executive’s Programme for Government commitment to do what matters most for people across Northern Ireland.
This investment is a continuation of the Executive’s previous commitment to expand elective care capacity and deliver sustained improvements for patients. By working together as one system, we are increasing activity, improving productivity and reducing unacceptable waits for care.
Real progress is being made. Waiting lists in time critical and red flag areas are falling, capacity is increasing and staff across our health and social care system are delivering for patients every day in exceptionally challenging circumstances. But we know there is much more to do, and sustained investment alongside reform will be essential if we are to maintain momentum.”
The Minister also praised the specific contribution of the Mater facility:
“The Mater Hospital is an excellent example of innovation, teamwork and determination helping to improve outcomes for patients. Staff here at the Mater, alongside colleagues right across the health and social care system, have shown real energy, ambition and commitment in helping reduce waiting times. Their work demonstrates what can be achieved when we work together as one system for all the people of Northern Ireland.”
Tara Clinton, Interim Director of Anaesthetics, Critical Care, Theatres and Sterile Services at Belfast Health and Social Care Trust, said:
“The Mater’s Elective Overnight Stay Centre represents a significant development in elective care delivery for Belfast Trust and has made an important contribution to reducing long waits for surgery.
Working in partnership with clinical and theatre teams, the centre has supported delivery against Elective Care Framework priorities and Programme for Government waiting list targets, while helping release capacity for more complex patients across the wider hospital system.
We are grateful to all staff whose continued professionalism, commitment and innovation are helping improve access to care for patients.”
The Scale of the Challenge
Despite these advances, official statistics published by the Department of Health for December 2025 illustrate the enormous scale of the backlog:
- 527,062 patients were waiting for a first consultant-led outpatient appointment, down 2.8% (15,389) from September 2025, with a median wait of 63.7 weeks
- 84,329 patients were waiting for inpatient or day case admission, down 8.0% (7,316) from September 2025, with a median wait of 30.1 weeks
- 220,999 patients were waiting for a diagnostic test, down 2.9% (6,673) from September 2025
Crucially, no HSC Trust met the draft waiting time targets at December 2025. For outpatients, the target states 50% should be seen within nine weeks and no one should wait longer than 52 weeks; however, 87.1% were waiting more than nine weeks and 55.3% were waiting more than a year. The figures are based on the new Encompass electronic patient record system and are classified as “official statistics in development,” meaning caution is advised when comparing with historical data.
Critical Context and Concerns
While elective care centres are reducing extreme long waits, significant concerns remain about urgent pathways. Recent reports indicate that some patients with red flag cancer referrals—who should be seen within 14 days—are facing waits of seven to nine weeks, with hundreds breaching the target. This suggests that capacity increases in elective centres have not yet resolved bottlenecks in urgent diagnostic and assessment pathways, potentially harming vulnerable patients awaiting cancer diagnosis.
The funding announcement arrives against a backdrop of severe financial pressure. The Northern Ireland Fiscal Council has warned of “unprecedented” constraints, with the 2026-27 budget potentially seeing lower cash-terms allocations than the previous year once stabilisation funding ends. The £80 million ring-fence must be viewed alongside the £495 million total earmarked for waiting lists over three years in the Draft Budget, but questions persist about whether these sums can match the scale of a backlog where over half a million people await outpatient appointments.
Additionally, the continued rollout of the Encompass IT system has caused data reporting disruptions in some trusts, particularly affecting CAMHS (Child and Adolescent Mental Health Services) statistics and potentially masking the true extent of waits in certain specialties.
Questions for Stakeholders
- How will the £80 million be distributed between clearing backlogs in specific specialties versus expanding permanent capacity, and will it address workforce shortages or solely fund additional activity?
- Given that red flag cancer patients are currently waiting up to nine weeks against a 14-day target, what specific measures will ensure urgent diagnostic capacity keeps pace with elective improvements?
- With data quality concerns surrounding the Encompass system transition, how will the Department ensure accurate public reporting of waiting list reductions while the system stabilises?
- Does this funding represent the full allocation for waiting lists in 2026/27, or is it drawn from the broader £165 million annual provision outlined in the Draft Budget—and how will the Minister prevent these ring-fenced funds from being diverted to cover in-year financial pressures?
- What mechanisms are in place to ensure that reducing the longest waits (four years plus) does not come at the expense of patients in the “middle tier” who may see their waits extend beyond 52 weeks?
What Happens Next
The Department of Health will confirm detailed allocation of the £80 million across HSC services in the coming weeks. The Minister has previously indicated that sustained investment of approximately £135 million annually over five years would be required to bring waiting lists to acceptable levels. While the Mater EOSC and similar facilities at Daisy Hill and South West Acute Hospital demonstrate that concentrated capacity can deliver results, the challenge remains scaling these successes across all five trusts while simultaneously addressing urgent cancer pathways and diagnostic reporting delays.
Patients can check current average waiting times by trust and specialty via the My Waiting Times NI portal, though they should note that individual wait times may vary significantly from published averages and that data continues to be refined following the Encompass rollout.