Dáil Éireann Debate, Thursday - 10 October 2019
49. Deputy Anne Rabbitte asked the Minister for Health the 2019 targets in place for the outpatient waiting list in the Children’s Health Ireland Hospital Group; and if he will make a statement on the matter. [41209/19]
Amharc ar fhreagraImproving access to hospital appointments and procedures in a key commitment of Government. The HSE Management Data Report (MDR) reports on HSE activity against Key Performance Indicators as set out in the National Service Plan for 2019. Under the National Service Plan 2019, the target for all hospital groups, including Children’s Health Ireland (CHI), is for 80% of people to wait less than 52 weeks for a first Outpatient Department appointment.
The last published MDR figures are for June 2019 and report that 60% of patients waiting for a first Outpatient appointment at CHI hospitals are waiting 52 weeks or less. Furthermore, the NSP target for Outpatient Activity (including both new and return appointments) for CHI for 2019 is 145,766 appointments for the full year. The target to the end of June was 73,274 while actual activity to the end of June was recorded in the MDR as 55,528. In addition, the target for new:return appointments for CHI for 2019 is 1:2.3. As of the end of June, CHI reported a ratio of 1:2.4.
CHI has advised that it is committed to reducing waiting lists and supporting initiatives that ensure that children receive care appropriately and in a timely manner, and in 2019 a number of initiatives were put in place to address Outpatient Waiting Lists.
For example, the new paediatric outpatient and urgent care centre in CHI at Connolly opened on 31st July 2019. This new facility offers a range of services to children and their families in the local area as well as those in Dublin North city and county and the surrounding areas in Kildare and Meath. General Paediatric Clinics are held from 8am to 6pm Monday to Friday. CHI has advised that the opening of CHI at Connolly is having a positive impact on CHI OPD waiting lists. At the end of September 2019, there were 4,130 patients on CHI’s General Paediatric Outpatient waiting list, which is a 35% reduction when compared to the same period last year.
Furthermore, CHI at Connolly will provide a further 1,300 outpatient appointments between September and December 2019. CHI advise that they are currently in the process of expanding these clinics to provide a focus on the specific requirements for some patients including asthma, allergy, faltering growth and constipation. When fully operational, CHI at Connolly is expected to provide 17,000 outpatient appointments (General Paediatrics and Orthopaedic clinics) every year .
Management of referrals is a key enabler to reducing waiting lists, and in this regard CHI advise that they have initiated a referrals process whereby all referrals from the three children’s hospitals are managed centrally. The group is progressing its ICT requirements to have a single Patient Administration System across all CHI sites (the three children’s hospitals and CHI at Connolly).
The central referrals team, through administrative and clinical validation are ensuring that all appointment slots are used appropriately and that where appropriate, patients are removed from the waiting list, which is assisting in the waiting list reduction.
Another example of innovation in referral pathways is the TORC project (Triage of Referral Clinics). This is one of a number of virtual clinics currently being held across CHI and involves the active triage of referrals, the provision of advice and commencement of treatment for patients. As a result, patients may then either not have to attend an outpatient clinic appointment or can begin their pathway of care prior to attendance. CHI advise that this has been very successful in achieving a discharge rate of up to 30% of patients contacted. In addition, patients can begin their diagnostics prior to attending an appointment which ensures the best use of resources and reduction in follow-up attendances for patients and their families.
CHI is continuing with a number of other initiatives including moving Dermatology referrals towards a more centralised structure together with a virtual clinic model in this specialty.
CHI continues to engage with the National Treatment Purchase Fund (NTPF) to secure funding for initiatives in 2019 to address access to patients for specialties including ENT, Ophthalmology, General Paediatrics, Orthopaedics and Gastroenterology.
CHI advises that recruitment of additional consultants for CHI specialties with the longest OPD waiting times (Allergy, Dermatology, Radiology, Gastroenterology, Rheumatology, Orthopaedics & ENT) is also underway following CHI securing additional National Service Plan funding in 2019. In appointing these positions, the multidisciplinary teams are also reviewing their current work practices and identifying new ways of working to ensure appropriate management of waiting lists.
