Reducing waiting time for patients for hospital operations and procedures is a key priority for Government. Last year saw considerable improvement in the number of patients waiting for procedures. As a result of increased activity and the ongoing collaboration between the HSE and the National Treatment Purchase Fund (NTPF), the number of patients waiting for an Inpatient or Day case procedure fell to 70,204 in December 2018, from a peak of 86,100 in July 2017. This represents a reduction of over 18% in the overall number of patients waiting for a procedure. The number of patients waiting more than 3 months fell by more than 17,700, or 31% in the same period .
The impact is particularly notable when one considers the improvements to the Waiting Lists for those particular specialties which were the focus of the Inpatient/Daycase Action Plan in 2018. These include the numbers waiting over 3 months for a Cataract procedure which fell by 55% from July 2017 to the end of December 2018; the numbers waiting 3 months for a tonsillectomy fell by 65% in the same period; and angiograms fell by 50%.
Budget 2019 announced that the Government had further increased investment in tackling waiting lists, with funding to the NTPF increasing from €55 million in 2018 to €75 million in 2019. The joint Department of Health, HSE, and NTPF Scheduled Care Access Plan 2019 was published on 11th March. Under the Plan, the HSE, in line with the National Service Plan, will deliver 1.155 million elective inpatient and day case discharges at a value of €1.4 billion in 2019. The Scheduled Care Access Plan includes:
- detailed plans from the NTPF to fund 25,000 IPDC treatments; 5,000 Gastro Intestinal Scopes and 40,000 first outpatient appointments.
- Projections by year end to reduce the overall number of patients on the Inpatient/Day Case waiting list (excluding GI scopes) from just over 70,200 in Dec 2018 to under 60,000;
- Within this overall reduction the number of patients waiting longer than 3 months will reduce from 40,200 at the end of 2018 to 31,000;
- It is also projected that for ten identified high volume procedures, including tonsillectomies, all clinically suitable patients waiting more than 6 months will be offered treatment in 2019. These 10 procedures account for over a third of the active inpatient day case waiting list and represent 60% of NTPF planned activity in 2019.
A key element of the Scheduled Access 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.
The plan also includes a target that the number of patients waiting for a first Outpatient appointment will fall from over 516,000 at the end of 2018 to under 509,000 by the end of 2019. This target takes into account the more than 800,000 new patients who will be added to the Outpatient waiting list in 2019; a figure that is based on trends for the previous two years.
While the meeting of short-term targets is always welcome, more can be achieved and, in this regard, the HSE, Department of Health and NTPF, under the Access Plan, will work together 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 data requested by the Deputy is outlined in the documents attached.