Health Minister Stephen Donnelly recently released figures indicating a roughly 30% drop in the number of outpatients seen per consultant in hospitals since 2016. The data, which was made available on the Health Service Executive (HSE) website last Thursday, suggested that if outpatient activity maintained the even pace as in 2016, there could have been an additional 1.4 million appointments last year. The figures also showed a significant difference in the average number of outpatients seen by consultants within the same speciality. Donnelly noted that there’s been a substantial decrease in the general number of outpatients being seen by each patient-facing consultant.
However, doctors have countered this claim by stating that the HSE had privately recognised the factors affecting productivity but failed to reflect these in the presented data. The Irish Medical Organisation (IMO) highlighted that a myriad reasons had been identified by the HSE as to why there will be productivity variations amongst hospitals and within specialities. These factors included diverse types of consultant outpatient work, the role of multidisciplinary teams in care delivery and the increased demands of inpatient care.
The IMO’s consultant committee chair, Prof Matthew Sadlier, cited multiple influences that could impact the trends, such as consultants’ reach to clinics, patient treatment intricacy, and accessibility to diagnostics, beds and theaters. He suggested that these factors could cause patients to repeatedly visit for their management (as outpatients) while they wait for inpatient care.
According to the released data, there were 2,325 medical specialists in the public health service in 2016 and the average outpatient appointments per consultant were 1,429. But last year, despite having 3,563 full-time equivalent medical specialists, the average outpatient appointments per consultant dropped to around 1,024.
Despite these findings, Minister Donnelly vowed to continue fighting for additional funding for patients and the health service, though asserting the need to optimise the current funding. The goal of publishing this data, according to him, is to bolster transparency and enable the public to track how each hospital and speciality utilises their resources. The information shall also be used for benchmarking activity across specialities, hospitals and HSE health regions.
Mr Donnelly has announced his intentions to establish a new approach next year, linking the allocation of resources for fresh consultant positions to productivity. In a pivotal policy shift, the government plans to cease State financial support for new consultant roles in hospitals unable to show equivalent outpatient throughput by their current medical specialists when compared to their counterparts in other settings.
Despite a decrease over the previous two years in waiting lists, along with continued reduction in the average wait time for procedures, Mr Donnelly believes we need to progress much further. He maintains that it is crucial to exhaust every possibility in maximising efficiency in our hospitals and community services.
An important part of this new policy requires hospitals to increase the number and frequency of newly referred patients seen in outpatient departments. Confluence of this measure with the execution of additional reforms, will play a “significant” role in determining the allocation and prioritisation of funding in future budgets.