Immediately following my appointment as Minister for Health I established the Special Delivery Unit as set out in the Programme for Government. Its aim is to unblock access to acute services by improving the flow of patients through the system. As set out in Future Health, a key goal is to deliver faster more equitable access to hospital services.
With regard to waiting times for procedures, the target maximum wait times for inpatient and daycase treatment,as set out in the HSE Service Plan 2013, are:
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Children awaiting an inpatient or daycase procedure
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20 weeks
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Routine endoscopy procedure (all)
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13 weeks
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Adults awaiting an inpatient or daycase procedure
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8 months
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In July 2011, when the Special Delivery Unit was set up a total of 6,277 patients were waiting more than nine months for inpatient or daycase treatment. By December last year, there were 86 adults waiting over nine months for inpatient or daycase treatment, a 98% decrease on the previous year and 89 children waiting longer than 20 weeks, a decrease of 95% on the previous year. 36 patients were waiting over 13 weeks for routine endoscopy, a 99% decrease on the previous year.
Maintaining the progress made to date and achieving the 2013 targets will be extremely challenging. The achievement to the end of 2012 has been followed, as expected, by bounceback in the figures at the start of 2013. The early months of the year have brought severe pressures on Emergency Departments which impact on waiting times - the extended winter seasonal pressures, older age profile, sicker patients etc. are all having a knock-on effect on scheduled care. However, latest available data shows that as of 2 May 2013, 88% of adults on the list were waiting less than eight months (5,392 waiting longer), 80% of children waiting were waiting less than 20 weeks (716 waiting longer), and 90% of those awaiting a GI endoscopy were waiting less than 13 weeks (917 waiting longer).
With regard to patients waiting to see a consultant, in 2012 the National Treatment Purchase Fund (NTPF) initiated a national project to compile, for the first time, an Outpatient Waiting List database based on patient-level information from individual hospitals. Collaborating with individual hospitals, the SDU together with the NTPF and the HSE have developed the OP waiting list minimum dataset that allows for this data to be submitted to the NTPF from hospitals on a weekly basis. Clear data on the OPD waiting list is now being reported for the first time, and is published on www.ntpf.ie . The waiting list for outpatients is updated monthly. For 2013, a maximum waiting time target has been set of 12 months for a first time consultant-led outpatient appointment and this is reflected in the HSE Service Plan. The total number of people waiting on the out-patient waiting list as at 3 May 2013 is 376,751. This is a reduction of 7,881 in comparison with the NTPF published figures to March 2013. The data also shows that of the total number of people waiting, 199,513 (52.6%) are waiting less than 6 months and 278,666 (almost 74%) are waiting less than 12 months.
All hospitals have been engaged in the process of validating outpatient waiting lists, which is anticipated to be complete by mid-May 2013. Reforming the delivery of outpatient services is being addressed through the Outpatient (OP) Service Performance Improvement Programme. This is a national programme, encompassing the HSE, SDU, the NTPF and all hospitals providing outpatient services, being implemented between 2012 and 2015. The overall aim of the programme is to ensure timely, appropriate access to OP services so that the most appropriate member of the clinical team sees the right patient at the right time. Key elements of this large programme of reform will include on-going validation of waiting lists, the systematic and standardised management of referrals from primary care, a reduction in unacceptably high “do not attend” rates and appropriate discharging from OP services when clinically appropriate to do so.
Neither my Department nor the HSE has a function in relation to the gathering of waiting list data for the private hospital sector. Therefore, a comparison between public and private waiting lists is not available. However, I can assure the Deputy that my Department will continue to focus its resources on reducing waiting lists in line with the Government’s commitment to deliver rapid and equitable access to health services.
