Professor David Keegan:

Looking back, as part of the initial work, Ms Michelle Ford, with whom Dr. Rogers works in CHO 9, and I tried to explore how we could work a long waiting list initiative. The National Treatment Purchase Fund, NTPF, had originally worked on surgical waiting lists and then switched its attention to outpatient waiting lists, where we saw our greatest need. We collaborated with the NTPF and CHO 9 to create a new model clinic for long waiters. We had just started to deploy that prior to the Covid crisis hitting and the structure was such that we were able to keep it going. That is how we were able to reduce the number of long waiters by 80% and reduce the total wait list by 3,000 over that period. That gave us a model to refer to in discussions with our colleagues. I pay tribute to a number of people in this regard. I had discussions with my colleague, Ms Ryan, chief of operations at Temple Street hospital, about how we would integrate paediatric care, which is the key need in the CHOs. I spoke to Mr. Mullaniff of the NCBI about how we integrate the patient organisations, specifically the rehabilitation aspect, which was a gap in previous models. Professor Patrick Broe, the clinical director of the RCSI Hospitals Group, showed early interest in this. We also engaged with Mr. Des O'Flynn, who was originally in CHO 9 and then in CHO 8, and Ms Josephine Collins in CHO 1. We had a model to put in front of them.

When it comes to the broader coalition of IT experts and health pricing officers, when one can stand up in a room and offer a purpose pyramid that is patient-focused and patient-centred, it was remarkable, encouraging and enlightening to see how people will move with us and give of their time to these design events. They want to see this work. We are looking for support centrally in order to keep the momentum with the team. It is about personal relationships, conversations and meetings. The EVSA events are quite energising. We had the event in Ratoath GAA club last year and everybody enjoyed it and knew we were doing good work. The monthly VACO meetings are keeping that momentum going for us.