THE HEALTH SERVICE needs to run more ‘blitz clinics’ to get through patients, according to Health Minister Stephen Donnelly, who says that hospital waiting lists will fall again in 2024.
Speaking to The Journal in an interview, the minister said more patients have to be seen out-of-hours for that to be achieved, stating that the opening of new surgical hubs will also help.
Surgeons at a London hospital called Guy’s and St Thomas’ NHS Foundation Trust are performing an entire week’s operations in a single day as part of new initiative to help tackle the record waiting lists in the NHS.
The London Times reported recently that the hospital had already slashed its own elective backlog in certain specialities by running monthly HIT (High Intensity Theatre) lists at weekends.
Under the model, two operating theatres run side by side and as soon as one procedure is finished the next patient is already under anaesthetic and ready to be wheeled in.
Kariem El-Boghdadly, the consultant anaesthetist who designed the programme with his colleague Imran Ahmad, compared it to a Formula One pit stop.
When asked if the Irish system could use such innovation to clear its backlog of patients sitting on waiting lists, Donnelly said there is some good innovation taking place in Irish hospitals which are similar, such as weekend clinics and “blitz clinics”.
The minister said he has assessing if more “high intensity blitz clinics” can happen “across the board”, with a particular focus on the outpatient waiting list.
“80% to 90% of our waiting list is outpatients,” said Donnelly, stating:
“When I engage at a hospital level and say, ‘folks, you’ve got a lot more doctors than you had, so I want to see that much more patient activity’. Sometimes they’ll say, ‘oh well we don’t have the outpatient clinic room’.
‘Well, are you using it on a Saturday? I ask. ‘Are you using it at eight o’clock on a Friday?’ And the answer typically is no, we’re not.
“My view is, that’s what we have to do now, folks. The new public only contracts, which is going really well. We’re at about 1,300 and growing, like it’s good. With that contract, we’re paying a lot more money to be able to say, ‘look, I need you to run clinics on a Thursday evening or on a Saturday morning. This is the new world and you’re being paid a lot more money to do it’.
The minister said the health service has to use its resources to the fullest extent possible and the new consultant contract is part of that.
Under the new contract, consultants can be asked to work 8am to 10pm Monday to Friday and 8am to 6pm Saturday as part of their core 37-hour week.
The Department of Health has said that having an extended consultant presence on duty results in reduced emergency admissions, more rapid and appropriate decision-making, shorter lengths of stay, better patient flow and improved outcomes for patients.
The contract offers basic pay of €217,325 to €261,051 on a six-point scale, with additional remuneration for on-call duties and overtime.
Surgical hubs are going to start opening up shortly to deal with day cases, said the minister, who predicted that the inpatient list will fall because theatres will be freed up in hospitals “for more complex work”.
Donnelly said he is telling the HSE that in 2024, waiting lists have to fall again, to make it a trend of three years in a row.
“We can’t have hundreds of thousands of people waiting,” he said.
The Waiting List Action Plan launched earlier this year focused on a 10% reduction, with HSE boss Bernard Gloster stating that it was a more “hands on approach” with tackling the long waiting lists.
“So last year, the waiting list fell for the first time since 2015. That was important. And it was it was hard won by a lot of good people working in the health service,” said the minister.
“This year, they’re going to fall again, we’re waiting on the final numbers from the National Treatment Purchase Fund (NTPF) which we will get in first week of January.
“But we know they’re going to fall again, that’s in spite of a massive increase in patient referrals onto the list,” said Donnelly.
The targeted 10% decrease in the number of patients being taken off the list is “going to be exceeded by a lot”, he added.
“What we have achieved this year is a second year of reduction in waiting lists, while in many countries around us, they’re going up. So the focus then for next year is let’s make it three years in a row. We just need to keep going with that,” said the health minister.
Despite the health budget being under the spotlight for all the wrong reasons, the minister maintains that things can be achieved in the health service next year.
Before Christmas, Cabinet approved the revised estimates vote, which will see €92 million more funding for health. This will include funding for new drugs in 2024. That’s in addition to €100 million allocated as part of the budget.
“That’s a decent amount of new development funding,” he said.
After the budget, it was expected that many programmes would not be getting any additional funding for 2024, so will this money change things?
“I don’t want to give anybody any any false hope,” said Donnelly.
There will be a €30 million budget for new medicines for next year and €10 million of savings being targeted, said the minister.
“That’s more cancer drugs and lots more chronic disease drugs, rare disease drugs as well, which is going to be really important,” he said.
Donnelly said despite the recruitment freeze in some areas, more consultants are being hired.
When asked if he is optimistic that things can still achieved in the health service, despite the criticisms that not enough money has been allocated, the minister said:
“Things can definitely be achieved. I mean, we’ve now got nearly €200 million in new development funding. That’s good. We’re going to hire in excess of 2,500 more staff.
The minister said the health service is moving back to “pre-Covid budgets”, stating “this is what more normal healthcare looks like”.
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