10,700 people removed from hospital waiting lists in Cork after validation process

A CORK GP has voiced concern about the hospital waiting list validation process, which he said can mean that people are being taken off waiting lists when they do not want to be.

It comes as figures show more than 10,700 people were removed from outpatient hospital waiting lists in Cork last year through a National Treatment Purchase Fund (NTPF) ‘validation’ process.

At the end of last month, 74,243 people in Cork were on waiting lists for outpatient appointments at hospitals in the city and county.

Dr John Sheehan, a GP in Blackpool and Fianna Fáil councillor for Cork North West, is calling for changes to the validation system.

“When we refer someone to hospital it’s usually after something significant has happened, it’s not done lightly,” he said.

“Some people come off the list because things may have developed and they’ve gone elsewhere or into hospital, but some of those who come off, the system said that they were notified, but when we talk to them they haven’t received any notification.”

NTPF validation

There were 6,063 outpatient removals due to NTPF validation at CUH up to the end of November, the fifth-highest such figure in Ireland.

The figures, provided through a parliamentary question, also show 2,570 removals from the list at the South Infirmary Victoria University Hospital, 1,463 at the Mercy University Hospital, 111 in Bantry General Hospital, 104 in Cork University Maternity Hospital, and 398 in Mallow General Hospital.

The validation system involves hospital administration contacting patients on waiting lists to ensure that they are still available to attend appointments or require their procedure, as many patients will have made alternative arrangements due to the length of time on the waiting list or may no longer be suitable for treatment.

Calls for changes to process

The Cork GP said changes are needed to how the process is carried out.

“People think they’re still on the list and they’re waiting, then they come into us and they find out that they’re not on the waiting list anymore, and that can cause a lot of stress and anxiety.”

He explained that people may receive a letter asking if they want to stay on a waiting list, and said that taking patients off the list because they did not reply to a validation letter needs to be looked at.

Even those who do receive communication are often unable to respond to it, Dr Sheehan explained, saying that he would see “a significant number of elderly patients who come to us with a form because they don’t know what to do... also there’s so many scams out there at the moment that many are nervous to click onto anything because they’ve heard all these warnings.

“I would see people every day, of all ages, who have literacy problems, and they often will ignore letters and won’t respond because they’re not sure what it says and it can be embarrassing to admit that.”

He added: “I can understand from a hospital point of view why they’re doing it, they have long waiting lists and they need to check and make sure people haven’t gone elsewhere, but the solution is more communication, and a clearer way of organising it.”

Time spent managing cases like these adds more pressure on already stretched GP services, he said, explaining that “there’s a lot of time spent explaining letters to people and writing to hospitals on their behalf”.

Validation process

A HSE spokesperson told The Echo: “As part of the Waiting List Action Plan, the HSE and the NTPF have a data quality programme of work under way to ensure that the information on the waiting list accurately reflects the number of patients waiting, and that patients waiting are correctly accounted for on the appropriate waiting lists.”

Both clinical validation and administrative validation are a continuous process, the spokesperson said, adding that a formal bi-annual hospital validation is undertaken on all inpatient and day case waiting lists over six months, with many sites validating patients who are waiting over three months.

Administrative validation aims to identify patients on waiting lists who can proceed with hospital care, to “improve efficiencies for treating patients by reducing the DNA [did not attend] rate nationally” and “improve information for managing waiting lists by improving data accuracy”.

The spokesperson said this “is fundamental to the good management of waiting lists internationally”.

Hospitals engage in clinical validation to establish if “the patient should remain on the waiting list, there is a change to their clinical prioritisation category, any tests are required in advance of an outpatient appointment, and whether the patient is suitable for any insourcing/outsourcing initiatives or any new clinical diagnostic initiatives.”

The South/South West Hospital Group was contacted for comment.