Written answers

Tuesday, 9 October 2012

Photo of Gerald NashGerald Nash (Louth, Labour)
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To ask the Minister for Health if he will provide figures and details by consultant specialism on the number of missed outpatient appointments in each major acute hospital in the years 2009, 2010 and 2011; and if he will make a statement on the matter. [43143/12]

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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While acute hospitals currently have in place a variety of DNA (did not attend) policies, a new policy has been developed as part of the Special Delivery Unit (SDU) Outpatient Performance Improvement Programme. This Programme is being implemented nationally over the period 2012 to 2015 to improve the provision of Outpatient Services to patients in acute hospitals. The programme will be delivered in a phased manner and a series of Technical Guidance documents will issue to all hospitals covering amongst others (a) Governance and Accountability structures (b) the Management of Referrals (c) the Management of Waiting Lists, Booking and Scheduling (d) the Management and Delivery of Outpatient Clinics (e) the Management of DNAs (f) Clinical Outcome Management and (g) Discharging Patients from Outpatient Services. The first Technical Guidance Document issued on August 20th, 2012, with the key focus on putting governance and accountability structures in place, minimising risk and beginning the process of making robust the manner in which patient referrals are handled and triaged. This document also sets a requirement of a minimum of 6 weeks notification of leave for all outpatient staff.

With regard to the specific question regarding DNA numbers, Table 1 sets out a yearly sum of patients who missed scheduled appointments (did not attend) from 2008 to 2010, along with those who attended and total number of appointments booked (supplied by the HSE Business Intelligence Unit). The DNA rate is calculated by taking the number of missed appointments (DNAs) as a percentage of the total number of attendances and missed appointments combined. While hospitals returned activity, including DNA data across 2011, this data was not compiled / processed by BIU due to the roll out of the Outpatient Data Quality Programme.

Table 1. Outpatients - Attendances and DNAs 2008, 2009, 2010

Year
No of New Attendances
No of Return Attendances
No of Appointments Missed (DNA)
No of Return Appointments Missed (DNA)
All Appointments Booked
DNA as a % of all appointments booked
2008860,9102,428,007142,404414,2953,845,616
14.5
2009930,0142,489,691161,862428,7024,010,269
14.7
2010999,9782,583,312168,067429,0514,180,408
14.3

RAW DATA SOURCE: HSE BIU

In relation to the specific query of DNA's by consultant speciality I have asked the HSE to respond directly to the Deputy with this information when it becomes available.

Most importantly, however, is the effect of DNAs on outpatient waiting lists and wait times. In 2010, almost 600,000 appointments were missed by patients on hospital waiting lists. Current outpatient waiting lists do not exceed 400,000 patients. It is clear, therefore, that the already limited capacity for the system to attend to all patients on the waiting list in a timely manner is being impacted further by these missed (and therefore wasted) appointment slots which prevents this slot being utilised by another patient still waiting for his/her appointment.

I am determined to do all that is possible to minimise this waste and reduce waiting lists. If a patient finds they cannot attend the appointment they have been given I would appeal to all such patients to inform the clinic concerned as soon as they know they cannot attend.

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