Years before hip and knee services benefit, board says
The Health and Social Services Board said it could take three to five years before the public feels the benefit of recent investment in orthopaedic services.
According to figures obtained by the BBC, the numbers waiting in the Belfast Health Trust for knee and hip operations has risen dramatically.
The numbers have increased by almost 100% in the past two years.
The board's commissioning director Dean Sullivan said more surgeons are needed.
Under the NHS constitution in England it is a legal right for people to wait no longer than 18 weeks for an operation.
In Northern Ireland however that figure is 36 weeks.
"By the end of this September no patient, other than in exceptional circumstances, should be waiting longer than 36 weeks for their treatment," Mr Sullivan said.
"By next March that should reduce further to 30 weeks."
"In this year alone we've invested over £3.5m in the Belfast Trust to increase the number of consultants they have and the number of surgical procedures undertaken.
"But it will take time to put this investment on the ground and in the interim period we will continue to have to rely on other providers, be they from the independent sector or from elsewhere."'Unacceptable'
The Department of Health told the BBC that long waiting times for appointments were "unacceptable".
In a statement, a spokesperson for the department said: "That's why the minister (Edwin Poots) has set targets that people should be seen within acceptable time scales.
"For patients waiting for an outpatient appointment, he expects that at least 50% of patients wait no longer than nine weeks, with no-one waiting for longer than 21 weeks, increasing to 60% by March 2013."
To help address backlogs in elective care waiting times, the department has allocated an additional £10m.
"The £10m would target specialities which are particularly at risk of falling short of the 2012/13 outpatient and inpatient waiting times targets - which include orthopaedics."
Within the Belfast Trust, there are currently more than 1,527 people waiting for knee and hip replacements - in 2012 there were 797.
Sue Ramsey, who chairs Stormont's health committee, said: "The questions that the trust need to answer is why has this occurred and what is the strategy to reduce this list.
"This is a problem that the Department must take very seriously and I would ask what pressure will they be placing on the Belfast Trust to see that this excessive waiting list is addressed with urgency."Obesity
While a lack of resources in the NHS is mainly to blame for the increasing waiting times, other issues include an ageing population and a sharp rise in the number of people in Northern Ireland who are obese.
People who are overweight are placing massive pressure on their joints. Where possible, consultants prefer patients to lose as much weight as possible before they carry out a hip replacement.
It is a similar story in England.
Last year the president of the British Orthopaedic Association (BOA) told the BBC that surgeons were becoming increasingly frustrated that hip and knee replacements were being targeted as a way of finding savings.'Increased demand'
The BBC understands that other factors which are contributing to the waiting problem is a lack of consultant orthopaedic surgeons and a lack of theatres.
While there are approximately 36 surgeons, the feeling among some members of staff is a lack of planning has meant there are not enough surgeons to meet demand.
Maeve Hully, the chief executive of the Patient & Client Council, said the increase in waiting times for operations was affecting patients' quality of life.
She told BBC Radio Ulster: "You have people who are in a lot of pain and the other thing of course is, if you wait two years for surgery then you're going to be two years down the line, your recovery might be slower and your quality of life in the time that you've been waiting has deteriorated."
In a statement, a spokesman for the Health and Social Care (HSC) Board said: "We understand and very much sympathise with the frustration of some patients who have faced longer waiting times and who may be in pain."
He added the board was "working actively to deal with increased demand for orthopaedic surgery".
The spokesman said that HSC Board was "hopeful that patients in Northern Ireland will wait no longer than 36 weeks for surgery by the end of September of this year".