I propose to take Questions Nos. 1477 to 1480, inclusive, together.
The HSE has advised that the Physiotherapy Orthopaedic Triage Initiative has been in operation in Louth County Hospital since 2010. This is a nationally and internationally approved approach to managing Orthopaedic referrals to assist with management of waiting lists for Orthopaedic patients.
A staffing compliment of 0.8 wte Senior Physiotherapist was put in place to implement this initiative involving the triaging of appropriate patients to Physiotherapy for assessment and possibly further progression of treatment of their condition. The triage process is overseen by an Orthopaedic Consultant who assesses and grades all referrals in terms of Consultant or Physiotherapist triage.
A letter is then issued to the patient explaining the triage option informing them that a triage physiotherapy assessment may be of use as a treatment option. The outcome of the physiotherapy triage is discussed and reviewed by the Orthopaedic Consultant and Physiotherapist and physiotherapy treatment may be the proposed treatment option for the patient.
Other investigations such as Xray, CT and MRI scans or further diagnostic tests may also be considered and surgery may also be an option. In summary, the clinical decision regarding treatment options is always made by an Orthopaedic Consultant
The Orthopaedic Physiotherapy Triage Initiative is dedicated for Orthopaedic patients and it is planned to continue this service going forward. The Consultant Outpatient service is also available for referrals.
The criteria for referral to the Physiotherapy Orthopaedic Triage Initiative is a clinical decision made by the Orthopaedic Consultant. This Initiative may refer patients for intensive physio, an exercise programme, falls programme, 'back school', relaxation therapy or referral to primary care. Consultant-led service may involve surgery, injection therapy or oral medication. If required, patients referred to this initiative maintain their original place on the Consultant Orthopaedic waiting list which is managed by chronological booking.