More than 1,700 children categorised as urgent were left waiting for an appointment beyond a four-week target, according to an internal audit at Children’s Health Ireland (CHI).
The investigation found another 2,450 referrals that had not been “triaged” within five days, as required under national protocols.
A total of 1,706 referrals considered urgent were older than 28 days without receiving an appointment, the audit said.
Under the protocol for waiting-list management, all of these patients should have received an appointment within a four-week period.
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It said a sample of cases showed unscheduled appointments, appointments that were cancelled by parents and not yet rescheduled, and some that had been dealt with by the time of the report.
The 2024 internal audit, released under the Freedom of Information Act, also found 5,088 semi-urgent referrals that were left 13 weeks without a set date to see somebody.
A further 15,506 non-urgent referrals were found to have been delayed beyond the timeframe set out in protocols.
“Capacity issues mean that these two categories of triage tend to experience the greatest delays,” the report said.
In addition, the auditors discovered 295 cases where appointments were cancelled by a CHI hospital but had not been rescheduled.
Seventy-seven of those cases involved patients who were categorised as urgent, with some cases dating back to 2022 and 2023.
“The sample reviewed indicated that hospital-cancelled appointments have not been rescheduled due to capacity issues,” it said.
The audit also identified 491 referrals for patients aged over 16, despite a policy that such cases should not be accepted.
For most of the cases, they had been added to waiting lists either just before or after their 16th birthday, or the date of birth was entered in error.
The review said that although improvements were being made, issues remained in the scheduling of patients.
The internal audit concluded that CHI’s overall process for outpatient waiting list management was rated as “adequate”.
“Considerable issues were identified as part of waiting list data review which need to be improved over the coming months,” the internal auditor said.
The audit recommended improved procedures for the timely review of triaged referrals. It also recommended looking into better ways of scheduling urgent, semi-urgent and non-urgent appointments.
It said issues around waiting lists had the potential to cause CHI “reputational damage due to negative public opinion” and “risk of poor morale for employees due to heavy clinical demands”.
In response to the report, management said regular meetings were taking place and that providing extra capacity for appointments was a “daily priority”.
