Figures at the end of December 2013 indicate that the total number of patients awaiting Outpatient appointments has reduced by 25% from 399,951 to 300,752. Of these, 295,815 are waiting less than 12 months, a level of 98.4% compliance with the Government target.
- Numbers waiting 12-24 months have reduced by 94%, from 67,529 down to 3,990
- Numbers waiting 24-36 months have reduced by 97%, from 23,726 down to 706
- Numbers waiting 36-48 months have reduced by 97%, from 7,802 down to 197
- Numbers waiting 48+ months have reduced by 99%, from 7,795 down to 44.
A key part of the management of scheduled care, and in particular outpatient waiting lists, is addressing the loss of 16% of the total potential outpatient capacity due to patients not attending scheduled outpatient appointments (often referred to as the ‘Do Not Attend’ or ‘DNA’ rate). Through the introduction of validation of current waiting lists, revised control processes in respect of patients who fail to attend booked appointments, using texts and/or letters to prompt patients about forthcoming appointments, facilitating patient choice in the arrangement of appointments and the use of electronic referral systems, it is intended to reduce the ‘DNA’ rate to 10% in 2014.
As regards Inpatient / Day Case care, the total number of adults waiting more than eight months for an inpatient or day-case procedure at 31 December 2013 was 68. This, compared with a figure of 2752 at the end of 2012, is a comparative reduction of 97.7%. If compared with the figure of 7,645 identified in August 2011, the comparative reduction exceeds 99%. Of a total of 1,731 children awaiting inpatient / day case surgery, over 91% are waiting less than 20 weeks, with approximately 170 children in breach of the target as at 31 December 2013. Those who have exceeded the target are predominantly awaiting spinal surgery in Crumlin or ENT evaluation in Temple St. It is anticipated that the appointment of a new Consultant and supporting team in Crumlin will increase the capacity for spinal surgery by 50 – 75 cases annually, which will facilitate the achievement of the 20 week target; in terms of ENT, the current shortfall is to be addressed through a combination of outsourcing across a number of appropriate sites and securing additional consultant capacity.
In respect of GI Endoscopy, over 99% of patients waiting for routine endoscopy procedures are waiting less than 13 weeks. As at 31 December 2013, 73 patients were waiting over 3 months, thereby exceeding the 13 week target: plans have been drawn up to ensure that no patient is waiting more than 13 weeks in 2014. This will be achieved by opening additional endoscopy units, focusing on more robust levels of control of the GI Endoscopy programme and the use of periodic outsourcing where necessary, to increase capacity within the system. All of these measures will enable the HSE to regain and maintain compliance with the 13 week target.
The HSE Service plan includes a specific €30 million fund to address hospital service pressures and every effort will be used to deploy this fund as effectively as possible to achieve and surpass service plan activity targets. In order to ensure that patients who require emergency, acute or elective care can access that care, the HSE is also seeking to maximise the discharge options available to patients who no longer require such care by opening additional sub-acute beds, where such capacity is available and providing additional home care supports so that as many older people as possible can be supported at home. These measures will help to expedite the discharge of patients whilst ensuring they continue to receive the care appropriate to their needs, thus reducing delayed discharges further, easing ED trolley waits and reducing the risk of cancellation of elective procedures.