Waiting list success for NTPF

Gary Culliton on the NTPF’s announcement that a number of common procedures on the waiting list can now be done within two to five months.
National Treatment Purchase Fund (NTPF) Chief Executive Pat O’Byrne can now point to a number of waiting-list achievements. Of the 20 most common procedures, 19 can now be done within two to five months (it used to be two to five years). Eight of the top ten procedures for children can be done within two to five months.

There are now 21,470 people in Ireland waiting over three months for surgery, but most people either have a scheduled date for treatment or they are treated within three months, the NTPF claims. Half of those on waiting lists for more than 12 months are waiting for treatment at just five hospitals and most are day cases. These hospitals are Letterkenny (385), Sligo (272), Tallaght (180), Tullamore (161) and Cork University (158). Many of the problems are administrative: the NTPF says that the resources are available and the capacity is in the system to deal with the problem of those day cases waiting more than 12 months.
Average waiting times have fallen from two to five years in 2002, to two to five months now. The NTPF hopes to treat 37,000 patients this year and it has now treated roughly one in 39 of the population.
The 29,000 people reported to be on waiting lists for surgical procedures in 2002 did not include day cases or scopes. The population of Ireland then was 3.9 million. Thus in 2002, the numbers waiting over three months, per thousand of population, amounted to 7.4. If the scopes or day cases were added in, however, that figure went up to nine or ten per thousand of population. In 2008, surgical waiting lists that now include scopes and day cases amount to 21,470, or 4.3 per thousand of population (the population now is 4.36 million).
h4. Common procedures
Since it began four years ago, the NTPF has facilitated over 110,000 patients. Waiting lists have reduced for inpatients from two to five years in 2002, to two to five months now. Most NTPF activity is in ophthalmology (19 per cent of the workload), in general surgery (16 per cent) and in ENT (12.5 per cent). Orthopaedics (nine per cent) comes in fourth place.
As in most hospital systems around the world, the most common procedures which the NTPF funds are cataracts, tonsils and adenoids (for both children and adults) and joint replacements, such as hip and knee.
Over 32,500 patients who availed of NTPF funding were treated in 2007, according to the Fund’s annual report for last year. A total of 10,500 of these were outpatient consultations and the surgeries which resulted from them.
Average waiting times are now two to five months for the most common surgical procedures for adults and children. Operations are provided in all the surgical specialties. The NTPF has arranged 22,500 outpatient appointments.
h4. Waiting for surgery
Of the waiting lists in the country at the moment, 58 per cent are day cases and 42 per cent are overnights or inpatients. At the moment, there are just over 16,000 patients on the Patient Treatment Register (PTR) waiting for surgery – over 8,000 for day surgery and 7,500 for inpatient surgery. The median wait times on the register are updated on a monthly basis. There are 5,000 medical cases on waiting lists: day cases account for 3,700 cases and inpatients account for 1,500.
The number of hospitals involved in the PTR last year rose from 36 to 43 hospitals around the country. The remaining hospital, which has not yet provided waiting list figures, is expected to do so soon and that will complete the project. The PTR report allows GPs and patients to check and compare waiting times between the different hospitals.
The PTR is showing that of the 21,000 people waiting for procedures at the moment, one fifth are waiting for scopes. About 1,000 patients are waiting for cataract procedures (3,500 of these procedures were provided using the NTPF last year). There are 800 children and adults waiting for tonsil or adenoid procedures, or both. The NTPF provided 1,400 of those operations last year.
h4. Increased ratio
Approximately 750 patients are awaiting joint replacements: hip, knees etc. The NTPF paid for 1,100 such procedures last year and it will achieve similar volumes in 2008. The Fund’s lo-call line has to date received 62,000 enquiries. In 2007, the NTPF received nearly 20,000 lo-call enquiries. A total of 99 per cent of NTPF patients are treated in Ireland, an increase on the ratio of some years ago.
In 2002, there were about 10,000 people waiting over 12 months. In May 2007, there were 5,500. In January 2008, the figure was 3,687. At the moment, there are 2,155 people waiting more than a year. “As far as the NTPF is concerned, that’s too many,” said Mr O’Byrne. “We would like to work with hospitals to get past this hurdle of those waiting more than a year.” About 54 per cent of those waiting more than 12 months are in just five hospitals. Once this issue is dealt with, the NTPF’s next target will be to focus on those waiting more than nine months.