Measures aim to cut surgery waiting

Patients are to be pre-assessed for their suitability for surgical operations in a new attempt to cut waiting lists.

Under the new system, patients would have to have reach a defined symptom threshold before they could be referred by their GP for a particular operation.

The State’s health watchdog, the Health Information and Quality Authority, has been tasked with drawing up the criteria that may apply in relation to 80 different operations.

With 50,000 patients currently on waiting lists, the HSE wants to ensure that those most in need receive treatment as quickly as possible. Demand for procedures grew 22 per cent last year, when 130,000 operations were carried out, compared to 2010.

HSE director designate Tony O’Brien has asked Hiqa to assess the benefit of common surgical procedures by carrying out a series of health technology assessments. These will be carried out in batches next year and will form the basis for standardised referral guidelines to be drawn up for GPs.

Hiqa’s director of health technology assessment Dr Máirin Ryan said the new approach would reduce waiting lists but was not conceived as a cost-saving exercise.

She gave examples of the criteria which have been applied in the case of particular procedures in other countries. For a tonsillectomy, for example, these might include the number of episodes of tonsillitis in the previous year, the severity of pain and the extent of interference with daily living.

A person with varicose veins might have to show evidence of ulceration or difficulty walking before being referred for an operation. For total hip replacements, the review will assess criteria such as the age and current mobility of the patient.

Ms Ryan said the demand for healthcare services continued to increase and given Ireland’s changing demographics, it was likely to grow in the future. “Demand for scheduled surgery in particular continues to exceed available capacity. As a result, pressure on national waiting lists continues to grow despite increases in activity levels.”

Access to procedures may also be limited to patients who derive clear clinical benefit.

“By limiting such procedures in patients who may derive limited clinical benefit, there is a potential to free up capacity for treatments of higher clinical value thus maximising population health gain for the limited resources available.”

An expert advisory group has been set up to oversee the assessments.