The number of people waiting more than 12 hours in Northern Ireland A&E departments is now 36 times higher than it was in 2009, FactCheck analysis can reveal.
Meanwhile the number of people waiting more than four hours to be seen, transferred or discharged has risen nearly four-fold.
Both of these are key metrics that Northern Ireland uses to measure its emergency care performance.
The health service has a target that 95 per cent of patients will be dealt with in less than four hours, and that no-one should ever wait 12 hours or more.
Our analysis of official data shows that in 2009, some 258 patients endured these extreme waits each month on average.
By 2023, that figure was 9,924. (The latest stats we have cover January to September last year.)
Things have undoubtedly worsened since Covid, but the poor performance of Northern Ireland’s emergency departments pre-dates the pandemic.
By 2019, four-hour waits were nearly three times higher than they had been in 2009, while 12-hour waits rose almost 14-fold over the same period.
What’s causing the long waits?
The number of patients attending A&E rose only 10 per cent between 2009 and 2023 – not enough to explain by itself the stratospheric rise in long and extremely long waits.
But the Northern Ireland Department of Health tells FactCheck that demand is being driven by the “acuity of patient conditions”. In other words, while the number of patients in A&E may not be that much higher than before, the severity and urgency of their symptoms means that more resources are needed to treat them.
The Department also points to social care capacity, “which impacts on hospital discharge rates and consequently on patient flow from [emergency departments]”. Put simply: if there’s no space in care homes, more patients will have to stay in hospital, meaning those arriving at A&E have to wait longer for a bed or for staff to attend to them.
And the Department alludes to an ongoing problem across many parts of Northern Ireland’s public sector: the political impasse in Stormont.
At the time of writing, Northern Ireland has been without a government for more than 700 days.
The Democratic Unionist Party (DUP) says it won’t take part in power sharing in the Northern Ireland executive until the UK government amends part of the post-Brexit deal with the EU.
The DUP is concerned that the Windsor Framework agreed by Rishi Sunak treats Northern Ireland differently to the rest of the UK and wants this to change.
Without agreement from all the parties involved in power sharing, the Northern Ireland Assembly cannot sit and the day-to-day business of government, like approving budgets for public services, is curtailed.
The Department of Health hinted at this in its response to FactCheck, describing how “budgetary pressures and budgetary uncertainty over a number of years” have “hampered” investment in “growing capacity” in the health service.
The Department told us as part of a longer statement that it is “acutely aware of the pressures within Emergency Departments. The situation is reflective of the current pressures across the entire health and social care system, with demand for care outweighing existing capacity.”
The spokesperson told us: “Staff in Emergency Departments make every effort to keep waiting times as short as possible. Patients are treated according to clinical priority with a focus on the most severe and life-threatening conditions.”