NTPF to use private hospitals for longest waiters

Health Minister Simon Harris said the National Treatment Purchase Fund is to use private acute hospitals to provide treatment for patients waiting longest on inpatient and daycase waiting lists, writes Maureen Browne.

Simon Harris T.D.
Simon Harris T.D.

This month, the NTPF issued tender documents to all private hospitals that have expressed an interest in providing treatment.

The initial focus of the plan will be on day cases and will focus on key specialties with high numbers of long-waiting patients, including in ophthalmology, general surgery, dental, urology and vascular surgery.
The Department said that only cases deemed clinically suitable for treatment in private hospitals would be referred to these hospitals for treatment.

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The Minister said that in tandem with this initiative, in order to ensure that all long-waiters experienced improved waiting times, he has also asked the HSE to develop new Waiting List Action Plans for 2017, in respect of both the Inpatient/Daycase Waiting List and the Outpatient Waiting List.

“The focus of these plans will be on ensuring that no patient is waiting more than 15 months on either list by the end of October 2017,” he said.

Mr. Harris said the NTPF estimated that around 3,000 patients waiting 18 months or more for daycase procedures would be treated, with the aim that no patient would be waiting more than 18 months for daycase treatment by June 30, 2017.

“The NTPF tell me that that there has been good engagement with all the major private hospitals and these hospitals are ready to play a significant role in this Initiative. Patients will be matched to the most appropriate pathway of care based on their individual procedure and the relevant hospital involved.”

Figures released by the NTPF this month showed over 3,000 patients on these waiting lists for over 18 months. Over 1,700 of these were children.

He has also asked the HSE to develop new Waiting List Action Plans for 2017, in respect of both the Inpatient/Daycase Waiting List and the Outpatient Waiting List.

Mr. Harris said that every year there were over 3.2 million outpatient attendances in our hospitals, 94,000 patients had elective inpatient procedures and 1 million had a planned day case procedure.

Since 2000 the number of daycase discharges carried out had effectively quadrupled for the over 65 age group and almost doubled for patients under 65. The outpatient lists were also increasing with an average weekly increase of 1,200 this year.

Mr. Harris said that in addition, during 2016, the NTPF rolled out the Endoscopy Waiting List Initiative to arrange for the provision of endoscopy procedures to patients waiting over 12 months. The Minister said that by the end of December, over 5,500 people had come off the waiting list and the NTPF managed to clear over 99% of the people waiting the longest.

He said he would like to take this opportunity to acknowledge the considerable work carried out in hospitals to deliver on the HSE’s Waiting List Action Plan 2016.

“I appreciate that it was challenging for hospitals and Hospital Groups in maintaining a focus on driving down waiting times for patients, while at the same time managing the growing demand for emergency care during the latter months of 2016. However, let’s not forget that through your efforts over 11,000 patients who had been waiting a long time came off the inpatient/daycase waiting list.

The NTPF has also launched its Inpatient, Day Case Planned Procedure Protocol for Waiting List Management.

The Department said this protocol will provide guidance to hospitals and hospital groups to ensure that there is a consistent and standardised approach to the management and scheduling of patients on the inpatient / daycase waiting lists. The Protocol is a result of collaboration between the NTPF and staff working in the HSE, in Hospital Groups and at hospital level.

Minister for Health, Simon Harris, has welcomed confirmation this month that the HSE had achieved its target of reducing by 50% the number of patients waiting 18 months or more for inpatient or daycase procedures.

The Minister has also stated that he wants the HSE to ensure that no patient will be waiting more than 15 months on either list by the end of October 2017.

This followed the publication by the NTPF of the latest waiting list data for December 2016.

Mr. Harris said: “It is really welcome that the HSE has achieved the target set in its Waiting List Action Plan and reduced by half the number of patients waiting longer than 18 months for inpatient treatment or day case procedures. The NTPF figures show that the overall inpatient/daycase waiting list and the outpatient waiting lists have both decreased since last month.

“This is real progress for those who have been waiting longest for procedures in our hospitals. Since I approved the HSE Waiting List Action Plan last August, 11,519 patients have come off the inpatient/daycase waiting list, leading to no more than 1,800 waiting over 18 months for treatment. The actual number of people waiting for procedures at the end of December was 1,738. There is no patient waiting over 36 months.

“The figures show that the HSE’s Waiting List Action Plan has significantly reduced the number of patients who have been waiting longest for an inpatient or daycase procedure. At the end of July the number of patients waiting over 18 months constituted 4.5% of the total Inpatient/daycase waiting List, whereas at the end of December this has reduced to 2%.  This is the culmination of five months of very intensive work by HSE management and hospitals.

“I am particularly pleased to hear that, in order to achieve this result, the HSE took advantage of opportunities to utilise public hospital capacity to best effect, and many hospitals within and across hospital groups collaborated to ensure the resources could be maximised and patients seen in a more timely fashion.

“The NTPF Endoscopy Initiative for 2016 has also been extremely successful with only 11 patients still waiting for the procedure for over 12 months at the end of the December, down from around 5,700 in June. This represents a very welcome 99.4% reduction in the number of patients waiting over 12 months for a routine endoscopy.

“It is important that our monthly reports on waiting lists are seen in the context of a considerable increase in demand for acute hospital services in recent years. Taking elective daycase procedures as an example, our hospitals are now carrying out four times more procedures in patients aged 65 years and over, and twice as many in the under 65 age group since 2000. This year alone we have seen a 4% increase in inpatient and day-case activity over 2015.

“There is no doubt that there are still 1,700 too many patients waiting 18 months or more for their inpatient/daycase procedure. However, I am determined that waiting list initiatives during 2017, which will be implemented collaboratively by the NTPF and HSE, will ensure that our longest-waiting patients receive the care that they need.

“Detailed work is already underway between the NTPF, HSE and my Department on coordinated waiting list initiatives this year supported by funding of €20 million. In December, I granted approval to the NTPF for the first €5 million of this spending for an initiative focused on daycase procedures, which account for 70% of the inpatient/daycase waiting list. The NTPF anticipates that 2,500 of the longest waiting daycase patients can be treated under this initiative with the aim that no patient would be waiting over 18 months for a day case procedure by June of next year.

“I have also requested that the HSE submit new Waiting List Action Plans for 2017 in respect of both the inpatient/daycase waiting list and the outpatient waiting list shortly. The focus of these Plans will be on ensuring that no patient is waiting more than 15 months on either list by the end of October 2017.

“During 2017 my Department will continue to work with the HSE and the NTPF to ensure the best use of public hospital capacity and the private hospital system to meet the needs of patients waiting for inpatient, daycase and outpatient services.

“Finally, I would like to take this opportunity to acknowledge the considerable work which has been ongoing in hospitals since August to deliver on the HSE’s Waiting List Action Plan 2016. I appreciate that it has been challenging for hospitals and Hospital Groups in maintaining a focus on driving down waiting times for patients on the Inpatient daycase waiting list, while at the same time managing the growing demand for emergency care.”