FINDINGS:THOUSANDS OF patients are "queuing" to get on waiting lists to be seen in the outpatient department of Dublin's Tallaght hospital, according to a report published yesterday.
The Hayes inquiry report, into unprocessed GP referral letters and unreported X-rays at the hospital, found the information system “can only look ahead into time by a period of 12 months” and therefore patients are “queuing to queue” on waiting lists.
At the end of June there were 2,762 patients queuing to get on waiting lists to be seen by specialists such as urologists, dermatologists and cardiologists.
In addition to those queuing to register on waiting lists there were more than 17,000 patients already on outpatient waiting lists at the hospital at the end of May, the report said, with many waiting more than a year to be seen.
In relation to those queuing to register on waiting lists the report says: “such referrals which are queuing to queue are stored by the administrative staff in boxes within administrative areas. This is an unfortunate feature of the processing of outpatient department referrals at the hospital of which patients and their GPs may not be aware”.
In some cases the letters are not even acknowledged.
In March it came to light that thousands of GP referral letters may have remained unopened at Tallaght hospital. The report goes on to look at this issue and found more than 3,400 GP referral letters dating back to 2002 were not dealt with appropriately but no letters were “unopened”.
Some 97 per cent of the patients named in these GP referral letters have now been seen by a consultant and the remaining 157 have been offered appointments. To date no patient appears to have been endangered by the delays.
The report says the absence of a clear policy or written procedures and protocols for dealing with outpatient referrals from GPs was one of the main reasons for the letters remaining unprocessed.
The letters in the main were for orthopaedic appointments and “a dispute between hospital management and orthopaedic consultants about the failure to ringfence beds required for elective surgery, and the sacrifice of dedicated orthopaedic beds to meet the pressure of emergency admissions” was at the root of the problem.
Given the lack of ringfenced beds, consultant orthopaedic surgeons decided not to accept new referrals. There was “a failure on the part of senior management to deal effectively and decisively with the decision” of consultants, the report says.
The report goes on: “it was evident to us that the problem did not arise from a single cause or from the action or inaction of a single individual. There were multiple factors and actions and failures to act by many people which collectively brought about the problem”.
While the report makes a number of recommendations, including calling on the hospital to address the IT system, it says “it is difficult for us to be confident that systematic and effective plans are in place to prevent the problem from recurring”.
Both problems at the hospital examined in the Hayes report – the unreported X-rays and unprocessed GP referral letters – were symptomatic of wider problems at management and hospital board level, the report adds. “There were severe systemic and other weaknesses at management level, and the structures at board level were simply not robust enough to provide the level of governance, supervision and direction required”.
The hospital which had a 23-member board of management says the board has now been slimmed down. It has undertaken to implement the report, as has the HSE.