I am conscious that waiting times are often unacceptably long and of the burden that this places on patients and their families. Many areas in our health service currently lack sufficient capacity to meet the ever-increasing demand for services and the needs of patients, resulting in unacceptably long waiting times for hospital appointments and procedures.
In this regard, the Government is committed to improving waiting times for scheduled care in acute hospitals. The joint Department of Health/HSE/National Treatment Purchase Fund (NTPF) Scheduled Care Access Plan 2019 was published in March and sets out measures to improve care for patients waiting for scheduled care in 2019 by reducing waiting times for inpatient/day case treatment and outpatient appointments.
A key element of the Plan is the stabilisation of the Outpatient Waiting List. Under the Plan the HSE, in line with the National Service Plan, will aim to deliver 3.3 million outpatient appointments, of which approximately 1 million will be first appointments. For its part the NTPF will aim to deliver 40,000 first Outpatient appointments.
The Access Plan sets out the activity levels for the NTPF, who will supply additionality to HSE activity, in order to reduce waiting times experienced by patients for a hospital appointment, operation or procedure.
The Access Plan ensures an appropriate balance between high volume activities and offering treatment to complex long waiting patients. The NTPF is working with public hospitals to seek NTPF-funded solutions for very long waiting patients, either in the private sector or in public hospitals where there is available capacity.
In addition, my Department is working with the HSE and NTPF, under the Access Plan, with the objective of developing medium-long term improvement initiatives for patient access to hospital procedures. This will include moving care to more appropriate settings and providing care at the lowest level of complexity such as providing ophthalmology in the community; maximising the use of Advanced Nurse Practitioner led clinics; and physiotherapists to manage orthopaedic clinics.
The HSE has advised that the Galway University Hospital chronic pain service is a tertiary referral service and is delivered across both University Hospital Galway and Merlin Park University Hospital. The service consists of 6 clinics per month, where new and review patients are seen, and patients may also have trigger point injections performed at these clinics. All appointments are followed up by the Registered Advanced Nurse Practitioner (RANP) to avoid routine review clinic appointments.
In addition, there are 2 interventional pain management sessions carried out in the Surgical Day ward per week (8 per month). One session (6 patients) is radiology guided procedures and 1 session (6 patients) is non-radiology guided. This list consists of 12 patients per week and in-patients may also be added.
There are also scheduled interventional pain lists (6 per month) in Merlin Park. Four sessions are radiology guided and 2 sessions are non-radiology guided. These lists consist of 6 patients per session. In total 14 intervention sessions a month are carried out between UHG and MP.
The Registered Advanced Nurse Practitioner offers a telephone follow up service for all patients following intervention to avoid repeat Outpatient Department appointments for routine follow ups. A number of in-patients are reviewed on a consultation basis also. The pain clinic has the support of 6 psychology sessions a month. Group sessions are conducted 3 times a year.
The HSE advise that all patients are called in order of clinical priority and/or in chronological order and additional clinics to support the waiting lists are currently being discussed.