Written answers

Tuesday, 15 October 2019

Department of Health

Hospital Waiting Lists Data

Photo of Louise O'ReillyLouise O'Reilly (Dublin Fingal, Sinn Fein)
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335. To ask the Minister for Health the number of children on waiting lists for a first outpatient appointment across all specialties by hospital and length of time waiting in tabular form. [41675/19]

Photo of Louise O'ReillyLouise O'Reilly (Dublin Fingal, Sinn Fein)
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338. To ask the Minister for Health when the recommendations made by the Ombudsman for Children will be implemented in respect off the establishment of child specific wait lists and target outpatient waits for children. [41678/19]

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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I propose to take Questions Nos. 335 and 338 together.

The National Treatment Purchase Fund (NTPF) currently collects and collates information in respect of the Inpatient, Day Case, and Outpatient (OP) Waiting Lists. The monthly waiting list figures are published on the NTPF website, and a breakdown of the Inpatient/Day Case waiting list by Adult & Child Analysis is published by hospital.

Outpatient waiting list information has been collected and published by the NTPF since 2013. The data represents those waiting for a first appointment at a consultant-led Outpatient clinic. The Outpatient Waiting List report shows the total number of patients waiting, across the various time bands, for a first appointment at a consultant-led Outpatient clinic. The analysis by Adult and Child is not currently published for the outpatient waiting list in a pdf format, however a breakdown by specialty by hospital/ hospital group/and by age profile is available on the NTPF website in an open source format. The NTPF has advised my Department that they are working towards publishing the outpatients waiting list by Adult & Child Analysis in a pdf format in the coming months.

The HSE Management Data Report (MDR) reports on HSE activity against Key Performance Indicators as set out in the National Service Plan for 2019. Under the National Service Plan 2019, the target for all hospital groups is for 80% of people, including children, to wait less than 52 weeks for a first Outpatient Department appointment.

The last published MDR figures are for June 2019 and report that 68.9% of patients waiting for a first Outpatient appointment across all hospitals are waiting 52 weeks or less, while 60% of patients waiting for a first Outpatient appointment at CHI hospitals are waiting 52 weeks or less.

CHI has advised that it is committed to reducing waiting lists and supporting initiatives that ensure that children receive care appropriately and in a timely manner, and in 2019 a number of initiatives were put in place to address Outpatient Waiting Lists.

For example, the new paediatric outpatient and urgent care centre in CHI at Connolly opened on 31stJuly 2019. This new facility offers a range of services to children and their families in the local area as well as those in Dublin North city and county and the surrounding areas in Kildare and Meath. General Paediatric Clinics are held from 8am to 6pm Monday to Friday. CHI has advised that the opening of CHI at Connolly is having a positive impact on CHI OPD waiting lists. At the end of September 2019, there were 4,130 patients on CHI’s General Paediatric Outpatient waiting list, which is a 35% reduction when compared to the same period last year.

Furthermore, CHI at Connolly will provide a further 1,300 outpatient appointments between September and December 2019. CHI advise that they are currently in the process of expanding these clinics to provide a focus on the specific requirements for some patients including asthma, allergy, faltering growth and constipation. When fully operational, CHI at Connolly is expected to provide 17,000 outpatient appointments (General Paediatrics and Orthopaedic clinics) every year .

Management of referrals is a key enabler to reducing waiting lists, and in this regard CHI advise that they have initiated a referrals process whereby all referrals from the three children’s hospitals are managed centrally. The group is progressing its ICT requirements to have a single Patient Administration System across all CHI sites (the three children’s hospitals and CHI at Connolly).

The central referrals team, through administrative and clinical validation are ensuring that all appointment slots are used appropriately and that where appropriate, patients who do not need hospital care, are removed from the waiting list, which is assisting in the waiting list reduction.

Another example of innovation in referral pathways is the TORC project (Triage of Referral Clinics). This is one of a number of virtual clinics currently being held across CHI and involves the active triage of referrals, the provision of advice and commencement of treatment for patients. As a result, patients may then either not have to attend an outpatient clinic appointment or can begin their pathway of care prior to attendance. CHI advise that this has been very successful in achieving a discharge rate of up to 30% of patients contacted. In addition, patients can begin their diagnostics prior to attending an appointment which ensures the best use of resources and reduction in follow-up attendances for patients and their families.

CHI is continuing with a number of other initiatives including moving Dermatology referrals towards a more centralised structure together with a virtual clinic model in this specialty.

CHI continues to engage with the National Treatment Purchase Fund (NTPF) to secure funding for initiatives in 2019 to address access to patients for specialties including ENT, Ophthalmology, General Paediatrics, Orthopaedics and Gastroenterology.

CHI advises that recruitment of additional consultants for CHI specialties with the longest OPD waiting times (Allergy, Dermatology, Radiology, Gastroenterology, Rheumatology, Orthopaedics & ENT) is also underway following CHI securing additional National Service Plan funding in 2019. In appointing these positions, the multidisciplinary teams are also reviewing their current work practices and identifying new ways of working to ensure appropriate management of waiting lists.

In relation to the question raised by the deputy regarding the number of children on waiting lists for a first outpatient appointment across all specialties, the attached spreadsheet, provided by the HSE BIU, shows the breakdown by hospital in tabular form.

">OPD Waiting list

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