An important landmark in the reorganisation of NI hospital services has today been reached, with the announcement of new regional centres for day surgery.
From December, the new prototype elective care centres will undertake routine day surgery for cataracts and treatment of varicose veins.
Alongside providing details of their locations, the Department is setting out a clear indication of the impact they will have in terms of significantly reducing waiting lists for both procedures.
The initiative represents a significant step forward in the transformation of health care, and clearly demonstrates the benefits to patients of that process.
It is expected that the development of prototype elective care centres will have a significant impact on the number of patients treated. For cataracts, this could mean up to 2,000 additional treatments annually and for varicose veins, this could mean up to 500 more treatments. This means productivity increases of up to 30% in both cases.
With this improvement in productivity, combined with additional waiting list activity currently ongoing to stabilise waiting times, it is the Department’s expectation that, for patients who have been assessed as requiring treatment for cataracts and varicose veins:
- By December 2019, no patient will wait longer than 1 year;
- By December 2020, no patient will wait longer than 26 weeks;
- By December 2021, all patients will be treated within the ministerial target of 13 weeks.
The prototypes for varicose veins will be based at Lagan Valley Hospital and Omagh Hospital and Primary Care Complex; and those for cataracts will operate from three locations - Mid-Ulster Hospital, Downe Hospital, and South Tyrone Hospital.
In all cases, the prototypes will serve patients from across Northern Ireland.
The prototypes, will help inform the development of regional daycase elective care centres for all appropriate specialties.
Regional centres for routine day case surgery will secure important progress in the efficiency and effectiveness of care. Crucially, they will operate on separate sites from urgent and emergency hospital care – meaning they will not be competing for operating rooms and other resources, leading to fewer cancellations of operations. While some patients may be asked to travel further for their treatment, they will be seen faster and have a better experience.
Department of Health Permanent Secretary Richard Pengelly said: “The development of elective care centres is an important step in the transformation of hospital services in Northern Ireland.
“The current waiting times for hospital surgery are totally unacceptable, and elective care centres are central to our plans to eradicate this scourge on our service.
"Delivering services on fewer hospital sites will increase the capacity of the health system and allow us to deliver more procedures. While this will be an important step forward, I would emphasise that additional investment is still needed to clear the significant backlog of patients who are waiting for an operation.
“Some patients may have to travel a bit further for their day surgery. But the clear trade off will be a significant reduction in the time spent waiting for that surgery.
“This is transformation in action and it is very fitting that we are announcing it almost two years to the day from the publication of the Delivering Together document.
“I would like to thank everyone from across the system whose combined efforts have helped to bring us to this point, and who I know are continuing to work tirelessly to improve the quality and timeliness of the care we provide."
Notes to editors:
- Elective care centres
The new elective care centres – routine day surgery hubs – for varicose veins will be based at Lagan Valley Hospital and Omagh Hospital and Primary Care Complex.
The centres for cataracts will be at Mid-Ulster Hospital, Downe Hospital, and South Tyrone Hospital.
They will be prototypes to help with the planning of day surgery centres for a range of specialties. They will be evaluated on performance, quality, service user, staff experience, productivity and overall value for money.
Final decisions on permanent elective care centre locations will be subject to public consultations and will be for Ministers to take.
Now that the sites have been identified, the prototype project teams will work closely with the Health and Social Care Board and Health and Social Care Trusts to develop detailed plans for implementation. Among other things, these will address the key aspects of implementation relating to HSC staff, governance, IT, estates and workforce. The first prototypes will be in place from December 2018 with all sites operational early in the New Year.
Patients requiring complex varicose vein and cataract surgery will not be affected by the change and will continue to be treated as at present.
The Department of Health/NISRA 2017 Health Survey indicated that 78% of those surveyed would be prepared to travel beyond the nearest acute hospital if treatment was available in a more timely manner. 82% of people surveyed thought that a journey time of up to one hour would be reasonable.
The elective care centre model has been based on the work of a clinical panel headed by Dr Niall Herity.
Building on this work, two review groups have taken forward the plans for the varicose vein and cataract surgery prototypes, identifying the most appropriate sites.
The elective care centre model was a key part of the Elective Care Strategy, agreed and published by the then Minister in February 2017. It is firmly in line with the transformation vision for health and social care set out in the Delivering Together document published in October 2016.
Routine cataract and varicose vein procedures have been spread over a number of hospital sites in recent years, although activity has been limited due to competing demands.
- Waiting lists
Waiting lists in Northern Ireland continue to be the worst in the UK and there is an ever growing gap between demand for care and the capacity of the system as it is currently organised to meet that demand.
Waiting list initiatives for several years have involved spending on adding temporary additional capacity – eg paying for patients on waiting lists to have operations in private hospitals. The money available for such stop-gap investment has been limited in recent years, as spending power in the health service and across Government has been squeezed.
Some temporary additional activity will still be required to address the backlog of patients who are waiting, but Elective care centres offer a long-term, sustainable way to build the capacity of the health service to meet current and future demand.
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