Waiting list validation is key to faster treatment for long-waiting public patients

This year the NTPF expects to remove over 126,000 patients from waiting lists who no longer require an appointment

The issue of waiting lists for public hospital appointments and treatment has been a significant recognised challenge in Irish healthcare for decades. Long waiting times negatively affect patients’ outcomes, adversely impacting their health, causing pain or disability difficulties in daily life.

Sustainably reducing hospital waiting times has been prioritised through the strategic multi-agency Waiting List Action Plan (WLAP) approach, with improved outcomes for patients achieved over recent years, providing timelier access to care and moving closer to Sláintecare targets.

Improving the quality and management of our public hospital waiting lists is a key intervention in the strategy to reduce waiting times through the WLAP. Alongside the National Treatment Purchase Fund’s (NTPF) audit and quality assurance programmes, and data completeness quality programmes, the administrative validation of waiting lists is an invaluable tool to achieving more accurate waiting lists and ultimately ensuring faster treatment for the longest waiting patients.

Following a pilot programme across the University Limerick Hospital Group, the NTPF’s validation function commenced its work seven years ago. Working closely with the HSE, regional health authorities and individual hospitals, the NTPF coordinates a national administrative validation process for patients on outpatient, inpatient or day case waiting lists.

Patients on waiting lists for long periods of time are contacted in writing to confirm if they are ready, willing, and available to access care, or if they wish to be removed. The goal is not to reduce numbers on waiting lists, but to make the best mutually agreed decision for the patient.

Several safeguards to protect patients with high clinical and/or social needs are built into the system. Requests for removal are reviewed by hospital staff and clinical guidance is sought where appropriate before removing a patient from the list. If a patient requests to be removed or fails to respond to multiple requests and is subsequently removed, they can be reinstated at the request of their GP.

Last year over 855,000 patients were engaged to confirm they still required access to care, resulting in the removal of over 130,000 patients from waiting lists who no longer required an appointment.  Since 2018, over 3.1 million such letters have been issued to patients.

While patient-level information on reasons for no longer requiring treatment is not recorded, several causes can be considered. For example, the patient’s condition may have changed thus no longer requiring an appointment, or the patient may have sought treatment elsewhere.

By maintaining hospital-patient communication throughout the patient’s pathway to care journey and ensuring patient records are up to date, do-not-attends and patient cancellation rates have reduced. Most importantly, more accurate waiting list data reflecting the true demand for hospital services is achieved.

Accurate waiting lists enable the system to operate more efficiently and effectively, ensuring a better use of resources. Procedures and appointments are offered sooner to those who require them.

Better information helps inform decision-making concerning patient treatment – policymakers can allocate resources and implement targeted interventions to address waiting list issues. Hospitals can identify areas for improvement within their facilities and optimise service delivery. Patients can gain insights into waiting lists and make informed choices about their healthcare needs.

This year the NTPF’s validation function will issue over 850,000 validation letters, and expects to remove over 126,000 patients from waiting lists who no longer require an appointment. This work will play a key role in sustainably reducing the amount of time people are waiting for care, improving outcomes for patients, and providing them with a better experience of our health service.

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