Waiting Lists to be reduced

All public hospitals are being instructed to ensure they have no patients waiting more than 12 months by the end of the year. The Minister for Health Dr James Reilly has also announced changes in the role of the National Treatment Purchase Fund (NTPF), which will take place with immediate effect (Irish Medical Times)

These changes are another stage in the implementation of the Government’s health reform agenda and follow on from the establishment of the Special Delivery Unit, the Minister said.

Besides the waiting list instruction, there are two other main three changes involved. The NTPF will target particular backlogs rather than routinely accept referrals of patients waiting over three months. The requirement that the NTPF purchase 90 per cent of treatments in the private sector is being ended.

“When I announced the setting up of the SDU, I said that the role of the NTPF would be changed to support the mission of the new Unit. The SDU led by Dr Martin Connor is already putting systems in place to track, monitor and manage patient flows through the hospital system.  I intend that the resources of the NTPF, and by that I mean not just financial resources but also its data systems and highly-trained and experienced staff, will now be fully aligned with the SDU,” the Minister said.

The NTPF is entering a transition phase. It will continue to fund patient treatments but will be shifting its focus to target waiting lists more strategically, to deliver more treatments for the funds provided and to incentivise hospitals to manage their lists proactively in the interests of patients.

The SDU is carrying out a detailed analysis of the management of elective and non-elective care. However, it is already clear that individual hospitals can do more to reduce maximum waiting times for their patients.

“It is  unacceptable that hospitals leave some patients on waiting lists for very long periods of time, safe in the knowledge that the NTPF will eventually pick up the tab. I will no longer tolerate this attitude to patients – hospitals need to become accountable for the listing decisions of their surgeons. As part of the changes I am announcing today, I am requiring all hospitals to ensure that they have no patient listed as waiting over 12 months for treatment by the end of the year. Where they fail to do so, the NTPF will source the necessary treatments and the hospitals’ budgets will be reduced by a corresponding amount in 2012,” the Minister said.

“I want a system where the patient and taxpayer get the greatest return on scarce resources consistent with quality and safety. The NTPF will purchase treatments wherever it gets the best value in either the public or the private sector. I want the NTPF to drive a hard bargain on behalf of patients without regard to the location of the treatment,” the Minister said.

The SDU will be introducing a more focused strategy to target treatments for patients. This will require new data systems, a new accountability framework and a sustained focus by clinical and management leaders in hospitals to reduce the lists from their present level and prevent them building up again. As part of these changes, the Minister has decided that for the remainder of this year, the NTPF will no longer routinely accept referrals for those patients waiting over three months, as at present. It will still provide treatments for patients but will target specific backlogs.

Follow-up treatments for existing patients will be provided, as is the normal practice.

The NTPF and the SDU are already working in close collaboration, the Minister said. The NTPF capability will be a core part of the SDU’s performance management role in holding public hospitals to account. The changes being announced today lay the foundation for this transformation and introduce the concept of rigorously-enforced maximum waiting times.

These maximum waits will be systematically reduced in the coming months and years to “deliver the goal of eliminating excessive waiting lists from the Ireland health economy,” the Minister said.