The patient treatment register

The patient treatment register Item Type Report Authors National Treatment Purchase Fund Publisher National Treatment Purchase Fund Download date 18/09/2018 17:35:28 Link to Item http://hdl.handle.net/10147/234063 Find this and similar works at - http://www.lenus.ie/hse

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 2006. 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

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 12-13 Table 4b Patient wait times and volumes for medical cases page 14-15 Acknowledgements page 16

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

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 www.ntpf.ie 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

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

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

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

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 3 0 3 3 4 3 3 2 2 LIGATION OF VARICOSE VEINS 4 12 6 9 3 3 5 4 3 TONSILLECTOMY 3 3 3 n/a 2 3 5 n/a 4 MAXILLO FACIAL (Surgical removal of tooth) 4 n/a 7 n/a 0 4 2 2 5 CHOLECYSTECTOMY (Gall bladder removal) 4 5 6 10 3 0 3 0 6 DISCECTOMY (Removal of spinal disc) 13 0 13 n/a 5 0 0 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) 4 2 10 n/a 3 3 6 n/a 10 HERNIA REPAIR (Inguinal) 3 10 0 5 2 2 0 0 11 KNEE ARTHOPLASTY 3 3 n/a n/a 0 n/a 6 n/a 12 REDUCTION MAMMOPLASTY (Non-cosmetic breast reduction) 4 0 6 8 4 4 4 n/a 13 MALE CIRCUMCISION 5 4 8 0 0 5 4 0 14 TRANSURETHRAL RESECTION OF PROSTATE (TURP - Removal of prostate) 3 0 7 0 1 2 2 n/a 15 ARTHROSCOPY KNEE 4 4 9 0 20 3 3 n/a 16 RELEASE OF CARPAL TUNNEL 3 0 9 9 0 2 3 0 17 EXCISION OF PILONIDAL CYST 4 6 3 2 8 4 7 0 18 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) 3 5 7 6 5 2 2 4 20 HERNIA REPAIR (Incisional) 4 4 8 0 11 3 4 0 *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

TABLE 2... Analysis of patient status on surgical waiting lists August 2005 Hospital Name Active Suspended Pre-scheduled NATIONALLY AMNCH (TALLAGHT) 452 5 491 BEAUMONT 1615 21 120 CONNOLLY (BLANCHARDSTOWN) 239 0 264 MATER MISERICORDIAE 633 232 31 St. JAMES S 1048 0 0 St. VINCENT S 926 286 0 St. JOHN S (LIMERICK) 31 0 114 TOTALS 4944 544 1020 page 10

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 2264 45.8% 1473 29.8% 1207 24.4% 4944 AMNCH (TALLAGHT) Adult TOTALS 132 35.9% 143 38.9% 93 25.3% 368 AMNCH (TALLAGHT) Child TOTALS 56 66.7% 18 21.4% 10 11.9% 84 BEAUMONT TOTALS 414 25.6% 483 29.9% 718 44.5% 1615 CONNOLLY (BLANCHARDSTOWN) TOTALS 84 35.1% 77 32.2% 78 32.6% 239 MATER MISERICORDIAE TOTALS 415 65.6% 134 21.2% 84 13.3% 633 St. JAMES S TOTALS 749 71.5% 293 28.0% 6 0.6% 1048 St. VINCENT S TOTALS 388 41.9% 320 34.6% 218 23.5% 926 St. JOHN S (LIMERICK) TOTALS 26 83.9% 5 16.1% 0 0.0% 31 Report on the Patient Treatment Register page 11

TABLE 4a.. Patient wait times and volumes for surgical procedures Procedure 3-6 months 6-12 months over 12 months Total TOTAL SURGICAL VOLUME 2264 1473 1207 4944 AMNCH (Tallaght) ADULT ENT 33 16 6 55 GENERAL SURGERY 42 57 23 122 GYNAECOLOGY 5 2 4 11 ORTHOPAEDICS 46 53 43 142 UROLOGY 6 10 9 25 VASCULAR SURGERY 0 5 8 13 TOTAL 132 143 93 368 AMNCH (Tallaght) CHILD ENT 43 12 3 58 GENERAL SURGERY 8 6 7 21 UROLOGY 5 0 0 5 TOTAL 56 18 10 84 BEAUMONT ENT 29 23 33 85 GENERAL SURGERY 103 125 128 356 GYNAECOLOGY 11 10 9 30 MAXILLO FACIAL 21 28 84 133 NEUROSURGERY 66 88 272 426 OPHTHALMOLOGY 0 0 1 1 ORTHOPAEDICS 22 28 19 69 PLASTIC SURGERY 14 25 51 90 UROLOGY 101 110 77 288 VASCULAR SURGERY 47 46 44 137 TOTAL 414 483 718 1615 CONNOLLY (Blanchardstown) GENERAL SURGERY 77 61 54 192 GYNAECOLOGY 2 1 0 3 ORTHOPAEDICS 0 4 2 6 PLASTIC SURGERY 5 11 22 38 TOTAL 84 77 78 239 table continues on page 13 page 12

TABLE 4a cont table continued from page 12 Procedure 3-6 months 6-12 months over 12 months Total MATER MISERICORDIAE CARDIO THORACIC 19 16 9 44 ENT 18 6 11 35 GENERAL SURGERY 64 27 12 103 GYNAECOLOGY 34 16 8 58 MAXILLO FACIAL 4 2 1 7 OPHTHALMOLOGY 156 8 3 167 ORTHOPAEDICS 10 3 7 20 PLASTIC SURGERY 34 28 25 87 UROLOGY 76 28 8 112 TOTAL 415 134 84 633 St. JAMES'S CARDIAC THORACIC SURGERY 17 7 0 24 ENT 36 4 0 40 GENERAL SURGERY 97 39 1 137 GYNAECOLOGY 36 9 0 45 MAXILLO FACIAL 117 71 1 189 ORTHOPAEDICS 28 22 0 50 PLASTIC SURGERY 225 54 2 281 UROLOGY 126 27 2 155 VASCULAR SURGERY 67 60 0 127 TOTAL 749 293 6 1048 St. VINCENT'S CARDIAC THORACIC SURGERY 1 1 4 6 DENTAL SURGERY 0 1 2 3 ENT 37 35 20 92 GENERAL SURGERY 75 76 59 210 GYNAECOLOGY 23 16 5 44 OPHTHALMOLOGY 66 28 24 118 ORTHOPAEDICS 14 14 3 31 PLASTIC SURGERY 52 45 53 150 UROLOGY 98 82 35 215 VASCULAR SURGERY 22 22 13 57 TOTAL 388 320 218 926 St. JOHN'S (Limerick) GENERAL SURGERY 24 2 0 26 GYNAECOLOGY 2 3 0 5 TOTAL 26 5 0 31 Wait time is based on all patients actively waiting from all seven phase 1 hospitals Report on the Patient Treatment Register page 13

TABLE 4b.. Patient wait times and volumes for medical cases Procedure 3-6 months 6-12 months over 12 months Total TOTAL MEDICAL VOLUME 710 566 827 2103 AMNCH (Tallaght) ADULT ANAESTHETICS 0 0 4 4 CARDIOLOGY 3 2 0 5 DERMATOLOGY 2 0 0 2 ENDOCRINOLOGY 1 0 0 1 GASTROENTEROLOGY 7 3 3 13 NEPHROLOGY 2 1 7 10 NEUROLOGY 6 5 9 20 RESPIRATORY MEDICINE 4 5 4 13 TOTAL 25 16 27 68 AMNCH - (Tallaght) CHILD N/A N/A N/A N/A N/A BEAUMONT CARDIOLOGY 38 19 42 99 DERMATOLOGY 20 26 15 61 ENDOCRINOLOGY 6 14 16 36 GASTROENTEROLOGY 33 69 56 158 GENERAL MEDICINE 0 2 6 8 GERIATRICS 1 1 3 5 HAEMATOLOGY 0 0 2 2 IMMUNOLOGY 0 0 0 0 NEPHROLOGY 4 7 3 14 NEUROLOGY 39 38 111 188 PAIN RELIEF 70 85 151 306 PSYCHIATRY 0 0 2 2 RESPIRATORY MEDICINE 11 9 17 37 RHEUMATOLOGY 4 9 20 33 TOTAL 226 279 444 949 CONNOLLY (Blanchardstown) RESPIRATORY MEDICINE 1 0 0 1 TOTAL 1 0 0 1 table continues on page 15 page 14

TABLE 4b cont table continued from page 14 Procedure 3-6 months 6-12 months over 12 months Total MATER MISERICORDIAE CARDIOLOGY 62 8 6 76 DERMATOLOGY 7 33 9 49 GASTROENTEROLOGY 24 5 4 33 GERIATRIC MEDICINE 0 2 0 2 INFECTIOUS DISEASES 0 2 0 2 NEPHROLOGY 1 2 5 8 NEUROLOGY 7 0 1 8 PAIN RELIEF 21 6 0 27 RESPIRATORY MEDICINE 5 0 2 7 TOTAL 127 58 27 212 St. JAMES'S GASTROENTEROLOGY 2 0 0 2 PAIN RELIEF 9 2 0 11 TOTAL 11 2 0 13 St. VINCENT'S CARDIOLOGY 24 11 10 45 ENDOCRINOLOGY 2 5 6 13 GASTROENTEROLOGY 80 44 118 242 GERIATRIC MEDICINE 2 2 0 4 NEPHROLOGY 2 5 0 7 NEUROLOGY 11 8 9 28 PAIN RELIEF 97 77 123 297 REHAB MEDICINE 0 1 0 1 RESPIRATORY MEDICINE 40 40 63 143 RHEUMATOLOGY 1 2 0 3 TOTAL 259 195 329 783 St. JOHN'S (Limerick) GENERAL MEDICINE 24 0 0 24 PAIN RELIEF 37 16 0 53 TOTALS 61 16 0 77 Wait time is based on all patients actively waiting from all seven phase 1 hospitals Report on the Patient Treatment Register page 15

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

This report is issued by: The National Treatment Purchase Fund Ashford House Tara Street Dublin 2 Lo-Call: 1890 720 820 Telephone: + 353 1 642 7101 Fax: + 353 1 642 7102 Website: www.ntpf.ie www.ntpf.ie