Seanad debates

Wednesday, 7 February 2018

Commencement Matters

Hospital Appointments Administration

10:30 am

Photo of Jim DalyJim Daly (Cork South West, Fine Gael) | Oireachtas source

I thank the Senator for raising this issue which, as he said, was referred to at the committee meeting earlier. When one thinks about it, it is an incredible statistic. As many as 2,000 people a day are not turning up for their appointments, at a time when we have chronic waiting lists. Clearly, there is a serious issue to be addressed. I, therefore, genuinely welcome the opportunity to answer the Senator's question. It is welcome that it has been raised in the House.

Providing patients with access to clinicians in a timely manner is a key priority. Reducing the number of "did not attends", DNAs, is essential to ensure available appointments are utilised fully to see and treat patients.Outpatient activity has increased year on year. However, the gap between referrals and appointment activity continues to widen. Waiting list data at the end of December 2017 showed an outpatient waiting list of 500,800. The HSE has advised that last year 479,000 outpatients did not attend their outpatient appointment. By way of example, according to the National Children's Hospital, Temple Street, one in eight outpatient appointments is missed. That means that valuable appointment slots are not being availed of, which is leading to longer waiting times for all patients.

In the light of such stark figures, it is clear that technological and e-health solutions have an important role to play in helping to resolve some of the most pressing and practical issues affecting health services. A Programme for a Partnership Government seeks to drive improvements in the management of health services by mandating the HSE "to engage strategic partners to help with the planning, financing and roll out of a 21st century IT health infrastructure, working towards the universal use of data to improve integrated care and outcomes across primary and secondary care". Potential solutions to the problem of "did not attends", DNAs, are being considered in the context of recommendations from the National Treatment Purchase Fund, NTPF, and the Sláintecare report on access management and e-health.

In regard to ICT supports for managing DNAs, the office of the chief information officer of the HSE has outlined a number of possible technology solutions to assist in improving the efficiency of the current arrangements. A waiting list validation service has been proposed to focus specifically on DNAs. The proposal is to validate waiting lists using SMS reminder messages, which will speed up the validation process and increase efficiency. It is to remind patients of their upcoming hospital appointments via text message. This solution has the potential to reduce the number of patients who do not show up for appointments and, most importantly, reallocate the appointment slots to other patients.

Currently, 31 hospitals use text message based solutions to manage DNAs. The HSE and the NTPF are working to develop a standardised national approach and enable a reminder service that can process patient replies for hospitals that currently do not have solutions in place. Further phases of the programme would see the standardised approach and solution being deployed nationally. The Department is examining funding mechanisms for this proposal.

Overall, outpatient waiting lists remain a significant challenge to be addressed in 2018. A number of steps, including the commencement of a national waiting list validation project by the HSE, are being taken to ensure the lists are accurate and these efforts are to intensify in the coming months. In order to help patients to access timely appointments, I encourage all patients to let their hospital know as soon as possible if they cannot attend scheduled appointments. That simple action on the part of individuals could free up almost 500,000 additional slots in outpatient departments which could have clear benefits in the context of overall waiting lists.

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