Written answers

Wednesday, 3 May 2017

Department of Health

Hospital Appointments Administration

Photo of Brendan GriffinBrendan Griffin (Kerry, Fine Gael)
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24. To ask the Minister for Health the measures he is taking to reduce the number of persons not presenting for outpatient appointments in the public health system; the annual cost of DNA's nationally; the number of no shows per annum nationally; if he will consider a deposit system to ensure persons that no longer need an appointment would inform the service provider; the methodology used to ensure that deceased persons are removed from waiting lists; and if he will make a statement on the matter. [20449/17]

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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In order to ensure that outpatient services are used to best effect, it is important that the HSE progresses initiatives to reduce the number of people not presenting for outpatient appointments. Consequently, the HSE is investing in digital and technological systems to ensure that patients are appropriately reminded.

One of the solutions eHealth Ireland has proposed is to provide a standardised national patient reminder service using SMS or email. This solution has the potential to reduce the number of people who do not show up for appointments and reallocate those appointment slots to other patients. This standardised national text reminder service project has already been initiated.

In addition, under the new Outpatient Reform Programme, the hospital system will be moving to advanced booking systems which will allow patients two choices of appointment time. This process has been shown internationally to dramatically reduce patient failure to attend.

A waiting list validation service has also been proposed. The proposal is to validate waiting lists using SMS reminder messages which will quicken the validation process and increase efficiency. A pilot is to be initiated shortly for both inpatient and outpatient services.

These initiatives are being progressed in conjunction with the HSE's Outpatient Waiting List Action Plan 2017 which will be communicated shortly.

The cost of patients who "Did Not Attend" (DNA) is difficult to ascertain. In order to ensure that outpatient clinics, and the time of clinical staff, are used to best effect, hospitals usually schedule a greater number of patients so that the clinic is fully utilised in the event that some patients fail to attend. There is an administrative cost associated with DNAs, which is approximately €25 per patient visit. According to the latest HSE data, current ‘Did Not Attend’ rates are at approximately 13%. This translates into a cost of approximately €12 million.

With respect to a deposit system, I am not sure it would be effective having regard to the administrative overheads involved and the requirement for a legislative basis for charges.

With regard to deceased persons, during routine validation of waiting lists by hospitals, deceased patients are removed from waiting lists. The waiting list validation service mentioned above will also assist in relation to this issue in the future.

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