Waiting Lists in Hospitals – OMG

ELAINE EDWARDS of The Irish Times

Nearly 178,000 people are on outpatient waiting lists to be seen by a
consultant after referral by a GP, new figures published by the HSE
show.

Over 10,000 people referred before January 2011 remain on waiting
lists and some 316 people referred before that date have been waiting
over four years for an appointment.

It is the first time the HSE has published the figures compiled as
part of its Outpatient Data Quality Programme, which was introduced in
hospitals in January last year in order to capture standardised data
on consultant-delivered outpatient services.

The information is, however, as yet incomplete as a number of the
country’s biggest hospitals have yet to report their figures. The HSE
said the figure for the total number of patients waiting was likely to
rise once these were made available.

Among those hospitals not included on the list are University Hospital
Galway, Mid West Regional Hospital Limerick and St Vincent’s Hospital
in Dublin.

Thirty hospitals are compliant with the new reporting requirements on
waiting times, representing some 72 per cent of total outpatient
“footfall”.

Some 167,825 patients referred on or after January 1st 2011 are still
waiting for an appointment. Some 71 per cent of those (118,964) have
been waiting less than six months. St James’s Hospital in Dublin is
the only hospital reporting no patient waiting longer than six months.

Tony O’Brien, chief operating officer of the Special Delivery Unit of
the Department of Health, said the report had shone a light on a
problem that had existed for a very long time. He admitted, however,
that it was “undoubtedly only a partial picture” at present.

Speaking on RTÉ’s News at One, he said Minister for Health Dr James
Reilly would shortly set an outer limit for waiting times to ensure
that no patient would wait longer than 12 months to be seen.

With regard to the number of patients referred prior to January of
last year who were still waiting, Mr O’Brien said: “Clearly it’s
unacceptable. There’s no debate about that.”

Patients waiting more than four years would be the “first priority”,
Mr O’Brien said.

He said that once the urgent referrals were taken care of, every other
referral would be dealt with in chronological order “so that we don’t
see patients waiting for extraordinary lengths of time”.

New processes would include weekly monitoring of outpatient data. This
would ensure that such information wasn’t being published for the
first time in this form, but that it was coming out regularly and was
part of the core business of every hospital in the country.

For the first time, the number of referrals in each speciality each
month is now available. Of the 46,241 referrals by GPs in February
this year, some 51 per cent of them were in just five specialities.

There were 8,804 referrals for general surgery, 5232 for orthopaedics,
4,061 for ear, nose and throat consultations, 2,798 for ophthalmology
and 2,688 for general medicine.

Mr O’Brien said that previously, patients who had already been
identified by their GP as having specific needs had been put into a
“largely undifferentiated queue”.

The new reporting procedures would ensure that patients could be seen
quicker. In some cases, they may not need to go to a consultant but
rather to diagnostics or to a different health professional, he said.

A number of hospitals reported high percentages of non-attendance by
patients for outpatient appointments.

The highest of these included St John’s Hospital in Limerick, which
reported a 58.9 per cent non-attendance rate among new outpatients.

The Royal Victoria Eye and Ear Hospital reported 35.9 per cent
non-attendance, Connolly Hospital Blanchardstown had a rate of 22.8
per cent and St Luke’s Hospital in Kilkenny reported 18.2 per cent
no-shows.

The HSE acknowledged the new programme had made “considerable demands”
on acute hospitals with requirements for systems and business changes
“which have not been insignificant”.

“Most, if not all, of the IT systems needed to be adapted or upgraded
which has caused delays but the majority of the work is now complete.”

It also noted that the “sheer volume” of outpatient referrals and
appointments had added to the complexity of implementing the
programme.