The patient treatment register

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1 The patient treatment register Item Type Report Authors National Treatment Purchase Fund Publisher National Treatment Purchase Fund Download date 18/09/ :35:28 Link to Item Find this and similar works at -

2 The Patient Treatment Register THE NATIONAL TREATMENT PURCHASE FUND has developed a Patient Treatment Register (PTR) which is a national database of patients on in-patient and day-case public hospital waiting lists. The register provides an accessible website link for patients, GPs and hospitals. After three months, patients on the Patient Treatment Register awaiting a surgical procedure will receive a personalised advice letter and information card from the NTPF. This card will allow patients to access surgery faster. The PTR will be rolled out nationally in The following hospitals are participating in Phase 1 which is the subject of this report. The Mater Misericordiae Hospital, Dublin St. Vincent's Hospital, Dublin Tallaght Hospital, Dublin Beaumont Hospital, Dublin Connolly Hospital, Blanchardstown St. James's Hospital, Dublin St. John s Hospital, Limerick

3 TABLE OF Contents Introduction page 3-6 Glossary of Terms page 8 Table 1 Patient waiting times for most common surgical procedures by volume page 9 Table 2 Analysis of patient status on surgical waiting lists - August 2005 page 10 Table 3 Total number and percentage of patients waiting for surgical procedures in time categories page 11 Table 4a Patient wait times and volumes for surgical procedures page Table 4b Patient wait times and volumes for medical cases page Acknowledgements page 16

4 Introduction In May 2004 the NATIONAL TREATMENT PURCHASE FUND was given responsibility for the collation and management of the national waiting list data for hospital treatment. On reviewing the historical system of collecting data, the NTPF found that there was variation in the recording, definitions and reporting of patient data. The old system was based on a collection of statistics by specialty which was not linked to individual patient names or details. Therefore, it was impossible to determine the accuracy of the information or the status of patients on the list. In a significant new development, the NTPF has moved away from the old system to create a new national waiting list system, a Patient Treatment Register with information based on named patients. The development of the Patient Treatment Register has been achieved in close collaboration with hospitals and required significant technical and operational development. It is being phased in nationally, with Phase 1 now complete and live. It includes the major Dublin Hospitals (The Mater Misericordiae Hospital, Tallaght Hospital, Beaumont Hospital, St. James's Hospital, St. Vincent's Hospital and Connolly Hospital, Blanchardstown) together with St. John s Hospital, Limerick. Under the prior waiting list system these hospitals accounted for approximately 40% of the total number of patients waiting nationally. Data on this new national system, The Patient Treatment Register, will be published bi-annually and will provide, for the first time, validated national and hospital information of patients waiting for in-patient and day-case treatments. The new Patient Treatment Register provides for the first time: An accessible website link for patients, with detailed information on the top surgical procedures; A GP website link on waiting times for all procedures in individual hospitals in order to assist the referral process; A separate link for each hospital with detailed information on procedures and patient status; Patient Treatment Register card and personalised advice letter sent directly to patients so that they themselves can opt for treatment under the NTPF; A complete and accurate picture of hospital waiting lists in Ireland. Report on the Patient Treatment Register page 3

5 Introduction continued WEBSITE The new website link enables patients and GPs to access information on waiting times for surgical procedures in each hospital covered in Phase 1. In 2006, they will be able to see the waiting times for all hospitals around the country. This is the first online system on waiting times nationally, and will facilitate referral decisions by GPs and patients. Once a public patient has been put on a public in-patient or day-case waiting list by their hospital consultant, their name will be placed on the Patient Treatment Register by that hospital. For the first time GPs and patients have updated information at their hands which can help get patients treated faster. GPs and patients will be able to use the Patient Treatment Register and the information on the average waiting times for surgery at a particular hospital for a particular procedure, when making their decision on referral. Each hospital also has a separate log-in facility, which is password protected, so that they can access information on each procedure in their hospital. This will give the hospital the patient status on their own waiting list. Access to the new PTR website is through PATIENT TREATMENT REGISTER CARD Once the patient is referred for treatment by the consultant, they will be placed on the Patient Treatment Register by their hospital. After three months, patients on the Patient Treatment Register still awaiting a surgical procedure will receive a personal advice letter and information card from the NTPF. This information will allow patients to choose if they wish to have their treatment sooner in another hospital or continue to wait in their original hospital. In some specialised cases, treatment may be best provided in a patient s own hospital. The patient needs to contact the NTPF lo-call line following the receipt of their letter to arrange their treatment. The Patient Treatment Register will empower patients with more choice and more information. page 4

6 VALIDATED WAITING LIST STATISTICS The new Patient Treatment Register now clearly sets out waiting lists using uniform definitions under categories which were not captured in the old waiting list system. The Register highlights the number of patients actively waiting for treatment; those who, for whatever reason, are not now available for their procedure; those who are suspended; and those who have a scheduled date for treatment. This detailed information gives an up-to-date, accurate reflection of the position in each public hospital which has not been available to date. This Report is divided into four separate tables: Table 1: Patient waiting times for most common surgical procedures by volume Table 2: Analysis of patient status on surgical waiting lists - August 2005 Table 3: Total number and percentage of patients waiting for surgical procedures: 3-6 months, 6-12 months etc Table 4: (a) Patient wait times and volumes for surgical procedures (b) Patient wait times and volumes for medical cases The data based on named patients for the first seven hospitals included in the tables on the following pages shows: Waiting times are significantly lower and the total numbers of patients waiting have also reduced. For the most common surgical procedures (17 out of 20), patients are waiting 2 to 4 months for their operation. The number of patients waiting in the 6 to 12 month waiting time band has been halved, while those waiting over 12 months is down two thirds. In total there are 4,944 named patients actively waiting for a surgical procedure (including 628 day cases not previously recorded). Report on the Patient Treatment Register page 5

7 Introduction continued Each hospital or regional area has a designated NTPF Liaison Officer who manages issues associated with waiting lists, waiting times and referrals to the NTPF. They can be contacted regarding any queries. Their contact details are available on the website. The NTPF will carry out a regular audit of the system to check it is up-to-date and accurate and is being used correctly and consistently. This will ensure that the Patient Treatment Register is an accountable, authoritative and transparent system with regard to the number of patients waiting for surgical procedures and waiting times. The Patient Treatment Register will give a clear indication of how long patients are waiting for treatment, the number of people on the Patient Treatment Register at any one time and the progress each hospital is making in getting patients treated. The NTPF would like to acknowledge the effort made by hospitals working with the NTPF. With the implementation of the new Patient Treatment Register, Ireland is at the forefront internationally in the collation and management of surgical waiting times, and in providing patients and GPs with user friendly access to information when making referrals. Furthermore, with the introduction of the Patient Treatment Register card, patients will be informed, be able to exercise more control and have choice in accessing their treatment. page 6

8 Glossary The Patient Treatment Register Report Provides statistics on the number of patients and waiting times for patients who are actively waiting for surgical procedures on an in-patient and day-case basis. Actively Waiting Is defined as a patient who is available for treatment and not yet scheduled for their treatment. A Suspended Patient Is defined as one who is not currently ready (for clinical reasons) or not available (social or personal reasons) for their procedure. A Pre-Scheduled Patient Is defined as one who has a scheduled date for a procedure within 3 months. The Median The average used in calculating patient waiting times is the median, this is the measure applied by health systems internationally. ICD-10AM Classification Procedures are designated by the ICD-10AM classification, which is a standardised index for procedure level information. Medical Cases Are those who require hospital treatment but not a surgical procedure. Surgical Cases Are those who require hospital treatment for a surgical operation/procedure. Waiting Times Are measured from the date a patient is placed on a list for in-patient or day-case hospital treatment, surgical or medical. Waiting List A patient is defined as being on a waiting list if they are waiting over 3 months. page 8

9 TABLE 1 Patient Waiting Times for most common surgical procedures by volume INDIVIDUAL HOSPITALS MEDIAN WAIT TIME (months) Procedure Name Phase 1 Hospitals AMCH Beaumont Connolly Mater St. James s St. Vincent s St. John s Median Wait Time* Tallaght Blanchardstown Misericordiae MTHS MTHS MTHS MTHS MTHS MTHS MTHS MTHS 1 EXCISION OF SKIN LESION LIGATION OF VARICOSE VEINS TONSILLECTOMY n/a n/a 4 MAXILLO FACIAL (Surgical removal of tooth) 4 n/a 7 n/a CHOLECYSTECTOMY (Gall bladder removal) DISCECTOMY (Removal of spinal disc) n/a n/a 7 CATARACT EXTRACTION 2 n/a n/a n/a 2 n/a 2 n/a 8 HIP ARTHROPLASTY (Hip replacement) 4 3 n/a n/a 14 n/a 8 n/a 9 SEPTOPLASTY (Nasal repair) n/a n/a 10 HERNIA REPAIR (Inguinal) KNEE ARTHOPLASTY 3 3 n/a n/a 0 n/a 6 n/a 12 REDUCTION MAMMOPLASTY (Non-cosmetic breast reduction) n/a 13 MALE CIRCUMCISION TRANSURETHRAL RESECTION OF PROSTATE (TURP - Removal of prostate) n/a 15 ARTHROSCOPY KNEE n/a 16 RELEASE OF CARPAL TUNNEL EXCISION OF PILONIDAL CYST CRANIOPLASTY (Surgical repair of the skull) 30 n/a 30 n/a 0 n/a n/a n/a 19 DILATION AND CURETTAGE OF UTERUS (D&C) HERNIA REPAIR (Incisional) *Phase 1 hospital median wait time is based on all patients actively waiting from all seven phase 1 hospitals Top twenty surgical figures exclude diagnostic scopes n/a = Procedure not applicable to this hospital Report on the Patient Treatment Register page 9 0 = No patients waiting for this procedure

10 TABLE 2... Analysis of patient status on surgical waiting lists August 2005 Hospital Name Active Suspended Pre-scheduled NATIONALLY AMNCH (TALLAGHT) BEAUMONT CONNOLLY (BLANCHARDSTOWN) MATER MISERICORDIAE St. JAMES S St. VINCENT S St. JOHN S (LIMERICK) TOTALS page 10

11 TABLE 3 Total number and percentage of patients actively waiting for surgical procedures in time categories Phase 1 Hospitals 3-6 months % 6-12 months % over 12 months % TOTAL OVERALL TOTAL % % % 4944 AMNCH (TALLAGHT) Adult TOTALS % % % 368 AMNCH (TALLAGHT) Child TOTALS % % % 84 BEAUMONT TOTALS % % % 1615 CONNOLLY (BLANCHARDSTOWN) TOTALS % % % 239 MATER MISERICORDIAE TOTALS % % % 633 St. JAMES S TOTALS % % 6 0.6% 1048 St. VINCENT S TOTALS % % % 926 St. JOHN S (LIMERICK) TOTALS % % 0 0.0% 31 Report on the Patient Treatment Register page 11

12 TABLE 4a.. Patient wait times and volumes for surgical procedures Procedure 3-6 months 6-12 months over 12 months Total TOTAL SURGICAL VOLUME AMNCH (Tallaght) ADULT ENT GENERAL SURGERY GYNAECOLOGY ORTHOPAEDICS UROLOGY VASCULAR SURGERY TOTAL AMNCH (Tallaght) CHILD ENT GENERAL SURGERY UROLOGY TOTAL BEAUMONT ENT GENERAL SURGERY GYNAECOLOGY MAXILLO FACIAL NEUROSURGERY OPHTHALMOLOGY ORTHOPAEDICS PLASTIC SURGERY UROLOGY VASCULAR SURGERY TOTAL CONNOLLY (Blanchardstown) GENERAL SURGERY GYNAECOLOGY ORTHOPAEDICS PLASTIC SURGERY TOTAL table continues on page 13 page 12

13 TABLE 4a cont table continued from page 12 Procedure 3-6 months 6-12 months over 12 months Total MATER MISERICORDIAE CARDIO THORACIC ENT GENERAL SURGERY GYNAECOLOGY MAXILLO FACIAL OPHTHALMOLOGY ORTHOPAEDICS PLASTIC SURGERY UROLOGY TOTAL St. JAMES'S CARDIAC THORACIC SURGERY ENT GENERAL SURGERY GYNAECOLOGY MAXILLO FACIAL ORTHOPAEDICS PLASTIC SURGERY UROLOGY VASCULAR SURGERY TOTAL St. VINCENT'S CARDIAC THORACIC SURGERY DENTAL SURGERY ENT GENERAL SURGERY GYNAECOLOGY OPHTHALMOLOGY ORTHOPAEDICS PLASTIC SURGERY UROLOGY VASCULAR SURGERY TOTAL St. JOHN'S (Limerick) GENERAL SURGERY GYNAECOLOGY TOTAL Wait time is based on all patients actively waiting from all seven phase 1 hospitals Report on the Patient Treatment Register page 13

14 TABLE 4b.. Patient wait times and volumes for medical cases Procedure 3-6 months 6-12 months over 12 months Total TOTAL MEDICAL VOLUME AMNCH (Tallaght) ADULT ANAESTHETICS CARDIOLOGY DERMATOLOGY ENDOCRINOLOGY GASTROENTEROLOGY NEPHROLOGY NEUROLOGY RESPIRATORY MEDICINE TOTAL AMNCH - (Tallaght) CHILD N/A N/A N/A N/A N/A BEAUMONT CARDIOLOGY DERMATOLOGY ENDOCRINOLOGY GASTROENTEROLOGY GENERAL MEDICINE GERIATRICS HAEMATOLOGY IMMUNOLOGY NEPHROLOGY NEUROLOGY PAIN RELIEF PSYCHIATRY RESPIRATORY MEDICINE RHEUMATOLOGY TOTAL CONNOLLY (Blanchardstown) RESPIRATORY MEDICINE TOTAL table continues on page 15 page 14

15 TABLE 4b cont table continued from page 14 Procedure 3-6 months 6-12 months over 12 months Total MATER MISERICORDIAE CARDIOLOGY DERMATOLOGY GASTROENTEROLOGY GERIATRIC MEDICINE INFECTIOUS DISEASES NEPHROLOGY NEUROLOGY PAIN RELIEF RESPIRATORY MEDICINE TOTAL St. JAMES'S GASTROENTEROLOGY PAIN RELIEF TOTAL St. VINCENT'S CARDIOLOGY ENDOCRINOLOGY GASTROENTEROLOGY GERIATRIC MEDICINE NEPHROLOGY NEUROLOGY PAIN RELIEF REHAB MEDICINE RESPIRATORY MEDICINE RHEUMATOLOGY TOTAL St. JOHN'S (Limerick) GENERAL MEDICINE PAIN RELIEF TOTALS Wait time is based on all patients actively waiting from all seven phase 1 hospitals Report on the Patient Treatment Register page 15

16 Acknowledgements The NTPF wishes to acknowledge with appreciation the hospital personnel involved in the development of the Patient Treatment Register system. CO-ORDINATING PROJECT GROUP Sandra Daly Cork University Hospital Robbie Breen Department of Health and Children Jennifer O'Leary Beaumont Hospital Louise McMahon Health Service Executive Aine Smith Midland Regional Hospital Fionnuala Duffy Health Service Executive Finian Lynam St. James's Hospital Brendan Carr Tallaght Hospital Chris Lyons Letterkenny General Hospital Lucy Nugent Children s University Hospital, Temple Street INFORMATION TECHNOLOGY LIAISON GROUP Deirdre Hyland Mater Misericordiae University Hospital Lloyd Felton St. Vincent's Hospital DJ. O'Sullivan St. James's Hospital Andrew Redmond Beaumont Hospital Sylvia O Donnell Tallaght Hospital Therese Callinanan Beaumont Hospital Susan Kiernan Mater Misericordiae University Hospital Breda Ryan St. John s Hospital, Limerick Caroline Ryder University College Hospital Galway Bernie Mooney Health Service Executive, Shared Services, Dr. Steeven s Hospital OPERATING GUIDELINES LIAISON GROUP Alison Lawlor Connolly Hospital, Blanchardstown Geraldine Dunne Mater Misericordiae University Hospital Jeff Virgo St. James s Hospital Niamh Gaffney St. Vincent s Hospital Mary Kelly Tallaght Hospital Ruth Fisher Tallaght Hospital Carmel Hennessy Beaumont Hospital Julie Cotter St. John s Hospital, Limerick Colette Nugent University College Hospital Galway Mary Shore St. Vincent s Hospital NTPF PROJECT TEAM Anna Lloyd Director of Patient Care Barbara Moulton Operations Manager Liz Shannon Project Co-Ordinator David Hickey Cornwell Consultants Dermot Carey Cornwell Consultants IMS Maxims plc Systems Developers page 16

17 This report is issued by: The National Treatment Purchase Fund Ashford House Tara Street Dublin 2 Lo-Call: Telephone: Fax: Website:

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