Professor Orla Hardiman:

There is also a capacity issue in the hospitals. For the purpose of social distancing, there is a requirement to reduce the number of people in the waiting rooms. Therefore, that has an impact on the number of people being seen. For example, in Cork University Hospital, the entire neurology services had to be moved to a different part of the hospital with much reduce capacity. Most of the hospitals have a capacity problem within outpatient services. Even if we wanted to see more patients, many of the hospitals do not have the capacity to enable that. Some hospitals are looking at renting space elsewhere. For example, Beaumont Hospital has rented space in Northside Shopping Centre. The hospitals are attempting to improve that situation. It has been a big issue. The Covid pandemic and the requirements for social distancing has significantly exacerbated that.

It is also the case, if we start looking at the high volume referrals, for example migraine, and build a pathway, which we have done for the scheduled care programme, that this identifies what we might call the pain points or the points where there are blockages in access. These include community diagnostics, which is now triaged through telephone consultations with a specialist nurse, and then reducing the number of returns by engaging with the Migraine Association of Ireland and developing self-care groups with psychology. They can all significantly impact on the waiting list because we reduce the number of people returning and increase the scope for new patients. We are making inroads on that and we are using migraine as an exemplar to build that pathway.