Billy Timmins (Wicklow, Fine Gael)
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To ask the Minister for Health the measures that have been taken to tackle the number of patients on trolleys in St Vincent's University Hospital, Dublin; the impact of these measures; and if he will make a statement on the matter. [14312/13]

James Reilly (Dublin North, Fine Gael)
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Immediately following my appointment, I set out to address the issues which have been causing unacceptable delays in patients being treated in our hospitals. I established the Special Delivery Unit, (SDU), as set out in the Programme for Government. The SDU is working to unblock access to acute services by improving the flow of patients through the system. Since its establishment there has been significant improvements in the waiting times for unscheduled care against a background of reduced funding for health, reconfiguration of services and a challenging socio-economic climate.

Hospitals across the country have experienced a surge in presentations to Emergency Departments, as would be expected in the winter months, resulting in high demand for admissions and a consequent rise in trolley waits. Recent outbreaks of influenza have created additional logistical difficulties in relation to the admission, movement and discharge of patients in some hospitals. Those hospitals have released media messages advising non-attendance and restrictions on visiting. The SDU continues to monitor Emergency Department activity closely, engaging with key hospitals via teleconference and on-site meetings, collaborating in putting in place a range of measures to assist with patient flow and reviewing the available data for trends in relation to the reported levels of high activity.

Despite these pressures the year on year improvements continue nationally. Numbers recorded on trolleys at the end of 2012 showed a marked improvement of 23.6% less than 2011 which equates to 20,386 less people. From 1st January to 15th March, there has been a total of 15,220 patients on trolleys: this is a reduction of 2,258 patients or 12.9% on the equivalent period last year. Priority now is to reduce long waiters (over 9 hours) as we move to a six hour patient journey target. The SDU and the Patient Safety & Quality Directorate in HSE are in communication to agree a mechanism of capturing and responding in instances where a hospital reports one or more patients breaching the targets.

In relation to St. Vincent’s University Hospital, it is the largest hospital in Dublin South East region dealing with all trauma and serious cases and providing support for such patients presenting to St. Michael’s Hospital, Dun Laoghaire and St. Columcille’s Hospital. The hospital has advised that over the past few weeks the number of patients requiring admission has averaged between a low of 10 to a high of 30. The hospital is working closely with the SDU and the Acute Medicine Programme in order to enhance patient care pathways and patient flow.

The hospitals discharge process has been reviewed in detail and additional emphasis has been placed on the early identification of potential discharges. All members of the multi-disciplinary team have been engaged in this process. All consultants and their teams are required to identify potential “weekend discharges” for review by the consultant on call. Consultants and their teams are also required to prepare a list of “next day discharges” on a daily basis with a view to effecting discharges by 11.00am the following day. The hospital has also introduced the following initiatives in relation to dealing with Emergency Department pressures:

- Introduction of an Acute Medicine Unit (AMU)

- Acute Assessment Unit (AAU)

- Clinical Decision Unit (CDU)

- Chest Pain Evaluation Unit (CPEU)

- Rapid access triage (Doctor/Nurse triaging patients)

- Specialty Specific targets for Length of Stay

The hospital is also in daily consultation with their community based colleagues to ensure that all necessary supports are in place to facilitate discharge from the acute setting, to facilities more appropriate to the patients needs.

It is envisaged that these developments will lead to shorter lengths of stay in acute hospital care which will in turn improve waiting times and patient experience in the Emergency Department.

Tony McLoughlin (Sligo-North Leitrim, Fine Gael)
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To ask the Minister for Health the measures that have been taken to tackle in-patient and day case waiting lists in Sligo General Hospital; the impact of these measures; and if he will make a statement on the matter. [14301/13]

James Reilly (Dublin North, Fine Gael)
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43 patients were waiting over a year for an inpatient or day case procedure in Sligo Regional Hospital at the end of February 2011. Now, 6 patients are waiting this length of time. This waiting list has been reduced by 86%. 168 patients were waiting over 9 months for an inpatient or day case procedure in Sligo Regional Hospital at the end of February 2011. Now, 94 patients are waiting this length of time. This waiting list has been reduced by 44%. This improvement in waiting list numbers is mirrored throughout the country. There are 35 hospitals with data available for both the end of February 2013 and the end of February 2011. 1,925 patients were waiting longer than a year for an inpatient or day case procedure in these hospitals at the end of February 2011. 396 patients were waiting this length of time at the end of February 2013. This waiting list has been reduced by 79%. 4,992 patients were waiting longer than nine months for an inpatient or day case procedure in these hospitals at the end of February 2011. 2,136 patients were waiting this length of time at the end of February 2013. This waiting list has been reduced by 57%. 10,844 patients were waiting longer than six months for an inpatient or day case procedure in these hospitals at the end of February 2011. 8,649 were waiting this length of time at the end of February 2013. This waiting list has been reduced by 20%. Since the end of February 2011, waiting lists longer than a year for inpatient and day case procedures have been eliminated in 15 hospitals and waiting lists longer than 9 months for these procedures have been eliminated in 9 hospitals

I am determined that the progress made in 2012 be maintained and improved upon. For 2013, the target is that no adult should be waiting longer than 8 months for inpatient or daycase treatment. It is important to recognise that the progress made in 2012 does not mean the problem is solved, and 2013 will of course be extremely challenging. For example, winter pressures in Emergency Departments have impacted on scheduled care waiting times. However, in the coming months, as winter pressures ease, the SDU will work towards re-balancing scheduled care to maintain the improvements seen in 2012 and to achieve the new 2013 target.

Sligo Regional Hospital achieved the national adult waiting list targets of 9 months for inpatient and daycase surgery and 13 weeks for scopes by the end of December 2012. Whilst the seasonal challenges of winter have temporarily increased numbers, with 94 patients currently waiting over 9 months, the hospital continues to progress towards regaining compliance with the targets. .