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Galway and Roscommon University Hospital Group tackles the Outpatient Waiting List

One of the priorities for the Galway and Roscommon University Hospital Group (Galway University Hospitals, Portiuncula Hospital Ballinasloe and Roscommon Hospital) in 2013 is to address the outpatient waiting list and to meet the Department of Health’s Special Delivery Unit (SDU) target that no patient should wait longer than 12 months; this target has to be met by the end of November.
Tony Canavan, Chief Operating Officer for the Group described the progress being made. He said, “This is a major challenge for us as the outpatient waiting list has grown incrementally over a number of years. This year we are embarking on a major project which will involve a total change in the way that we manage the outpatient service from the way we assign appointments to the delivery of the actual service. This project will involve hospital staff and also GPs and indeed patients themselves. When we achieve the target we will have reduced the wait to under one year which is an ambitious challenge given that this time last year there were a small number of patients waiting up to seven years for an appointment; by the end of this month we should no longer have any patients waiting longer than four years.
“We are tackling the outpatient waiting list in the same way we approached the long inpatient waiting list last year. It involves four steps: waiting list validation, improved reporting and focus, more effective use of resources across all of the hospitals in the Group, patient education and engagement as well as increasing capacity. We successfully met the SDU target set for inpatients last September and we continued to meet the waiting list target for the remainder of the year. We know that this approach works and are applying it now to the outpatient waiting list also.
“In January 2012 there were 45,000 patients on outpatient waiting lists across the Group. Our first step was to validate the list to make sure that everyone on the list still needed an appointment. There are many reasons why people may no longer need to be on the list for example they may have been referred to more than one hospital and have received treatment already, their symptoms may have resolved or they may have moved away.
“With support from the SDU we set up a dedicated communication centre in Merlin Park at the end of 2012. We then contacted over 20,000 patients from across the Group who were added to the waiting list prior to 2012. We wrote to all the patients asking them to telephone us to confirm if they still required an appointment. If after two weeks we had no response, we sent a second letter. If there was still no response after a further two weeks we contacted the patient’s GP.
“As a result of this validation exercise 2,600 patients (13%) asked to be removed from the waiting list and a further 6,000 patients (30%) were removed when we received no response from the patient or from their GP.
“There are now 37,845 patients on the outpatient waiting list for the Group and 31,057 of these patients must be treated by November 2013 in order to meet the SDU targets.
“We have plans in place to give appointments to all these patients and the appointments will be given to those waiting longest first. We have milestones in place for the remainder of the year to keep us on track for the November deadline set by the SDU target. We are increasing our capacity in order to be able to see so many patients by having longer clinic sessions and by running additional clinics.
“I would like to acknowledge the cooperation from our patients and their GPs during the validation process. We are working hard to provide appointments on dates that suit patients which in turn will mean that we should have fewer “no shows” which put an unnecessary burden on the hospital. In 2012 we had 286,966 attendances at our outpatient clinics across the Group and we had approximately 23,000 instances where patients did not attend their appointment or notify us in advance. We hope that with improved communication we will be able to reduce this number significantly and provide improved access to our outpatient clinics.”