Flawed reporting in waiting times for hospital treatment

The official waiting times which patients face to secure hospital treatment are being inaccurately reported at both local and national level, a major new audit report given to the Minister for Health Simon Harris has found.

A series of audits carried out by the National Treatment Purchase Fund (NTPF) concluded that hospitals were not fully complying with official protocols governing the management of out-patient, in-patient, day-case and planned-procedure waiting lists.

An overall summary of the audits provided to the Minister suggested patients in some cases faced delays of nearly 50 working days in being added to out-patient waiting lists in certain hospitals, and 28 working days in being added to in-patient and day-case waiting lists.

The audits concluded that, based on the problems uncovered in various hospitals in complying with official protocols, “there was inaccurate reporting of patient wait times at both local and national level”.

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Fianna Fáil described the audit findings as "truly shocking".

The party's health spokesman Stephen Donnelly also strongly criticised the timing of the publication of the audits – on the day of local and European elections, and when the British prime minister had just resigned – as "an act of staggering cynicism on the part of the Minister".

The NTPF carried out audits of nine major hospitals for the new report to the Minister: Letterkenny University Hospital, Midland Regional Hospital Tullamore, Royal Victoria Eye and Ear Hospital, Sligo University Hospital, St James’s Hospital, St Vincent’s University Hospital, University Hospital Galway, University Hospital Limerick and University Hospital Waterford.

It said the audit team “could not give full assurance that waiting-list management practices or the quality and accuracy of the data returned were in line with national minimum data set guidance and national waiting-list management protocols”.

‘Unfit system ’

The NTPF said that all hospitals audited had accepted their individual findings and had agreed to implement the recommendations it had proposed.

One of the hospitals which faced particular criticism was University Hospital Galway.

The NTPF said: “Based on the results of the random sample analysis the audit cannot provide assurance that the overall waiting list and planned procedure patient pathways are managed within national protocols.”

“From a waiting-list perspective the audit team found evidence of inconsistencies around the recording and transcription of clinical priority, and also the incorrect listing of some patients.”

The hospital said it accepted the findings but made a number of observations.

"While the report makes reference to inadequacies of the Galway University Hospital 'Clinicom Patient Administration System', the impact of reliance on such an old, unfit-for-purpose system cannot be overstated. The system has been modified to cater for requirements for which it was never designed. The Saolta Group is proceeding to progress the replacement of our patient administration system across the group as a key priority and is the number one priority in our ICT strategy."

Mr Harris said the NTPF audits provided “limited assurance that hospital waiting lists are being managed in line with national protocols and recommended corrective actions be put in place”.

“The national protocols are intended to ensure there is a consistent and standardised approach to the management and scheduling of patients on hospital waiting lists.”

Mr Donnelly said it was “ very disturbing that what are already absolutely appalling figures for outpatient waiting times may be even worse than we anticipated”.

“Remember that there are almost 170,000 outpatients waiting over a year. It could well be that they also had to wait over two months to be listed as waiting.”