'350,000 on outpatient lists'

The Department of Health has estimated that as many as 350,000 people could now be on waiting lists for a  hospital outpatient appointment.

The Department's Special Delivery Unit (SDU), at a media briefing today, admitted that tackling this huge 'waiting list to get on a waiting list' would be a significant challenge, as once these patients are seen, many of them will require treatment from already hard-pressed hospital services.

The SDU is tasked with reducing treatment waiting lists and ED trolley waits.

The SDU said it is currently monitoring and verifying these outpatient lists and latest estimates indicated that between 325,000 and 350,000 could be on hospital outpatient lists at the moment. Previous figures provided for outpatient waiting lists given by the HSE in recent months gave lower numbers, as they did not include data from all hospitals.

According to Senior Adviser to the SDU, Dr Martin Connor, as part of the initiative to deal with these lists, the SDU would target longest outpatient waiters first and try to get them seen more quickly within the hospital system.

Patients would be given greater choice in terms of the timing of their appointment and the hospital in which they saw a consultant, the briefing was told.

The SDU is attempting to use spare capacity within the hospital system to tackle both treatment and outpatient lists. It claims that many outpatient waits can be cleared using existing capacity within the system more efficiently.

The current streamlining of outpatient lists is also aimed at tackling the large number of patients who do not turn up for appointments. According to the SDU, factoring out these patients would help reduce numbers on lists, as would eliminating the number of patients who may be on more than one outpatient list.

However, the Unit says it is unlikely to be able to set specific maximum waiting time targets for outpatient consultations until September or October. Some patients are waiting as long as 4-6 years for an outpatient appointment at present.

It was not clear from the media briefing as to whether hospitals will have adequate resources to deal with reducing such massive numbers on outpatient lists to manageable proportions.

An added problem too, is that dealing with outpatient waiters in large numbers may only serve to add considerably to already high treatment waiting lists, thereby negating recent progress made on these lists.

Figures produced at the briefing showed that converting 25% of outpatient waiters into inpatient waiters would mean 87,500 would require hospital care. Officials admitted that while not all these patients would require operations, this would still pose major challenges to the system, although a structured programme was currently under way to deal with outpatient lists.

The SDU is also aiming, with the HSE, to streamline the referral process from GPs to hospitals, which is currently regarded as fragmented and inefficient.

The briefing was also told told that since the SDU became fully operational last September, 3,500 patients were on treatment waiting lists for more than 12 months, but this had reduced to 203 at the end of May.

This is the lowest recorded level of 12 month-plus waiters for a number of years, and the SDU said it was now optimistic that it could eliminate nine-month plus waits for hospital treatment.

The numbers waiting over nine months for hospital treatment had been reduced from 7,000 to 3,193 since last September, the briefing was told.

The total number on treatment waiting lists in all waiting time categories, however, is still high, although it has has dropped from 60,030 to 58,626 between September last and the end of May.

On trolley waits, the average number of patients on trolleys per day was 340 last year and had been reduced to 260 at the end of May.

However, health officials at the briefing admitted that there were still severe ED bottlenecks in some hospitals, particularly in Dublin and Drogheda.

Dr Connor told journalists that while there had been major progress with trolley waits, 'we are not there yet'. He said some hospitals were still struggling with ED pressure.

The SDU said it intended to deal with the issue of over 700 beds in acute hospitals being taken up by 'delayed discharge' patients, which meant there were fewer beds available for those who needed to be admitted through EDs.

Hospitals say a shortage of alternative community facilities for delayed discharge patients means they cannot free up enough beds for acute patients who need them.

However, Tony O'Brien, Chief Operating Officer of the SDU, said by the end of the year, delayed discharges should no longer be a significant factor in hospitals.

This year, the SDU, working with the National Treatment Purchase Fund (NTPF), will spend €5.5 million of NTPF funds on improving outpatient performance, while €40 million will be spent this year on reducing treatment waiting lists, and a further €10.5 million is to be spent on reducing ED trolley waits.

A total of €70 million in NTPF funding is being allocated this year to the SDU waiting list/trolley wait initiative. In addition, around €1.8 million is being spent up to the end of 2014 on outside experts and consultants working with the SDU.

Added to this are the Department of Health's salary costs for SDU staff.

[Posted: Thu 21/06/2012]