Increase in endoscopy referrals proving challenging for Hospital Group

The Ireland East Hospital Group (IEHG) Operational Plan 2019 has outlined the difficulties it is experiencing in managing the increase in referrals for endoscopy.

While priority 1/urgent referrals are seen within the four-week time frame, there are ongoing problems in treating category 2/‘non-urgent’ and surveillance referrals within the 13-week target. Managing the latter referrals in line with national targets has become “particularly challenging due to the limited capacity, volume of referrals and the complexity of procedures being performed”.

According to the operational plan, which was recently published by the HSE, the model 4 hospitals in the Group are experiencing increasing referrals for complex inpatient and tertiary care therapeutic procedures, such as ERCP (endoscopic retrograde cholangiopancreatography), endoscopic ultrasound (EUS), EMR/complex polyps, enteric stenting, and gastrointestinal (GI) bleeds. These referrals are received both from within IEHG and from other Hospital Groups, predominantly in the west of Ireland. IEHG is one of the largest providers of endoscopy to the national BowelScreen programme, with three participating hospitals.

“Some of these units continue to experience capacity challenges to accommodate BowelScreen referrals in line with service level agreements,” according to the document.

“We will continue to engage with the National Screening Service to manage their capacity requirements, however, the anticipated demand for screening cannot be accommodated without the opening of the fifth endoscopy room in St Vincent’s University Hospital.”

In the interim, the operational plan states the IEHG will avail of National Treatment Purchase Fund (NTPF) funding to run additional lists or refer long-waiting ‘routine’ patients to external hospitals. “All hospitals will be supported in their application for JAG accreditation,” according to the report. “Monitoring of standards and performance will be closely managed in conjunction with the clinical lead for endoscopy services.”

The HSE’s performance report for the first quarter of the year showed that the target for BowelScreen faecal immune-chemical tests (FIT) was not met, with a total deficit of 8,793 screenings.