Proposed new thresholds aim to reduce waiting lists for 9 hand and back conditions

Hiqa has recommended new thresholds for nine common hand and back conditions which it says, if implemented, will help tackle waiting lists for outpatient appointments and elective procedures.

Reports, published on the Hiqa website yesterday, set out the minimum criteria a patient should meet before being referred for treatments or surgeries for conditions including carpal tunnel syndrome, trigger finger, degenerative lumbar spine disease and other back and hand injuries.

Hiqa was asked to conduct the reports by the HSE, which will decide whether the recommendations contained in them will be implemented.

Dr Máirín Ryan, director of health technology assessment in Hiqa, said the thresholds aimed to ensure that “those with the greatest clinical need will have faster and more equitable access to surgical review”, as well as reducing current waiting lists by minimising the number of people who were unnecessarily referred for surgery.

She noted that, in August 2013 there were 52,000 people on orthopaedic waiting lists, a third of who were waiting for more than 12 months, while in April of this year about 300 patients were waiting for more than six months for back surgery.

She said it was not anticipated that the thresholds would result in a drop in the number of procedures being carried and that the thresholds would instead streamline services.

The complete list of procedures covered under the reports are: release of carpal tunnel; surgery for Dupuytren’s contracture; ganglion cyst surgery; surgery for trigger finger/thumb; spinal injections for pain due to degenerative lumbar spine disease; surgery for adult degenerative lumbar spine disease; vertebroplasty and kyphoplasty for osteoporotic vertebral compression fractures; radiofrequency lesioning for chronic spinal pain and spinal cord stimulation for chronic pain.