merrion street

Figures show reductions in all three categories
Total Patients Over 15 months Over 18 months
Category End Nov End Oct Change End Nov End Oct Change End Nov End Oct Change
IPDC 68824 69046 -222 3293 4969 -1676 1533 2161 -628
OPD 385507 396571 -11064 21282 31289 -10007 9618 13353 -3735
GI Endoscopy 16038 16891 -853 240 577 -337 108 116 -8

The latest NTPF figures, published on Monday 7 December, continue to show improvements across all categories. These figures cover all people waiting any length of time, ranging from a few weeks to a period of months. The combined total figures have fallen consistently since September.
For November, there are reductions in the total Inpatient / Day case (IPDC) waiting list, and in the numbers of patients waiting over 15 months and waiting over 18 months. It is very positive to see these reductions in all three key categories.
Similarly, there are reductions in the total number of people waiting for outpatient appointments, which has now fallen below 386,000 for the first time this year. Through facilitating additional clinics outside conventional working hours or by outsourcing where capacity is limited, the end of November sees a reduction of over 11,000 in the overall Outpatient waiting lists and of over 10,000 in the number of people waiting over 15 months for appointments. It is encouraging, to see that the number of people waiting over 18 months has also decreased by almost 4,000.
It is very welcome to see a reduction in numbers of patients awaiting routine GI endoscopy in all 3 categories. It should be noted that the NTPF has recently commenced a GI Endoscopy Initiative which aims to complete before the end of the year. The initiative will target those waiting over 12 months now or before the end of December 2015 for a routine endoscope. While these patients are largely confined to a smaller number of hospitals, the initiative aims to offer an external appointment to all patients waiting > 12 months. The HSE has in place a weekly monitoring system to ensure all patients referred for an urgent colonoscopy are seen within a 28 day target time. A policy of zero tolerance applies to any breaches.
For those patients waiting over 15 months (includes over 18 months) substantial progress has been made with Inpatients and Day cases reduced by 34% (-1,676) during November while Outpatients have reduced by 32% (-10,007).
In terms of those patients waiting over 18 months progress has been slightly slower. Inpatients and Daycases have reduced by 29% (-628) during November while Outpatients over 18 months have reduced by 28% (-3,735). Patients over 18 months are of highest chronological priority and the Department has requested the HSE to follow this up with hospitals as a matter of urgency. The HSE has directed all hospitals to prioritise these cases within the overall outsourcing programme.
The HSE is addressing the targets in relation to maximum waiting times with Hospital Groups as part of the regular performance and accountability process. The additional funding which has been provided by the Government in 2015 is being used to both maximise capacity across public and voluntary hospitals as well as outsourcing activity where the capacity is not available to meet patient needs within the maximum allowable waiting time. The application of fines is also aimed at incentivising improved performance in relation to the patients waiting longest.
The Department and the HSE recognise that there are personnel and structural challenges which impact on individual specialties and hospital sites. The impact of ED escalation policies, which require the cancellation of non-essential surgery in order to safely manage demand and capacity, may pose a further challenge which cannot be accurately predicted in advance. All of these factors mean that it is vital to effectively manage waiting lists so that those longest waiting are scheduled within the available capacity, once emergency and urgent cases have been dealt with.