Patients could have to wait longer for diagnostic scans in the community this year on foot of “a rebalancing” by the HSE of the scheme which is operated by GPs.
The scheme allows GPs to refer patients directly to mainly privately run clinics for specified testing such as MRIs or x-rays without going through the hospital system.
There will be fewer imaging scans carried out this year than last year under the initiative, but more laboratory tests, the health authority said.
The GP access to community diagnostics scheme was introduced in January 2021 with the aim of providing family doctors with direct access to diagnostic tests and diagnostic imaging for their patients.
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However, the HSE is now concerned that the scheme is being over-utilised and used inappropriately in some cases.
The HSE said on Tuesday that that, as the scheme evolved, “we’re learning that there are some tests that are not appropriate or are being over utilised”.
It said on this basis the HSE had developed a quick reference guide for GPs “focusing on the use of specific imaging modalities for various clinical issues”.
The HSE said the new guide would aim “to assist GPs in rationalising imaging studies for the various clinical issues encountered regularly in daytime general practice and we are doing a webinar in consultation with the Irish College of General Practitioners (ICGP) next month”.
The HSE said on Tuesday that last year about 515,000 tests and scans had been carried out under the scheme.
It said this was made up of 182,000 tests and 333,000 images.
The HSE said that the scale of diagnostic imaging funded last year was possible as diagnostic testing activity “did not come on stream at the level expected”.
Essentially, the HSE diverted money originally earmarked for testing to increase the level of diagnostic images funded under the radiology element of the overall scheme.
“The resource available was used to increase the radiology planned activity in 2023, thereby reducing waiting times below the three-month wait for routine scans.”
“In 2024, the diagnostic test activity will come on stream and we are rebalancing the activity between imaging and tests with an expected end-of-year activity of 530,000 (tests and scans).”
The HSE said this would be made up of 260,000 tests and 270,000 images.
“There isn’t a limit on the number of tests or imaging (for which) a GP can refer, however, waiting times may be impacted”, the HSE told The Irish Times in a statement.
The Minister for Health Stephen Donnelly said in January that, under the general practitioner access to community diagnostics scheme, family doctors could refer patients directly for tests including X-ray, dual-energy X-ray absorptiometry (DXA), computed tomography (CT), and magnetic resonance imaging (MRI).
He said these services were available at no cost to the patient, with access to the scheme open to the full adult population.
“Demand for community radiology diagnostics delivered through the scheme has more than doubled since it launched in 2021.”
“There were 138,000 radiology scans undertaken in 2021 (versus a target of 94,000); 250,000 in 2022 (versus a target of 195,000); and over 331,000 (versus a target of 240,000) in 2023″, he said.
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