Launching the Orthopaedics Integrated Clinical Assessment and Treatment Services across Northern Ireland, Health Minister, Michael McGimpsey today said patients will no longer face lengthy waits to see a specialist.
He said: “Until recently, patients were waiting many months or years to see a specialist and then had to endure a further long wait for surgery. This was unacceptable and had to change.
“Excellent progress has been made over the last two years and now no patient is waiting more than six months for an outpatient assessment or for surgery.
“I commend the efforts of health service staff to meet these targets. However, six months is still too long for patients to wait who are experiencing pain and anxiety. That is why I have set more challenging targets to reduce the time patients wait for assessment to no more than 13 weeks by March 2008.
“To achieve these targets will require dedication and commitment from staff across the health service and a change to the way services are delivered. ICATS represents one of the most significant elements of this change.”
Previously patients who were referred by their GP were automatically placed on a list to see a hospital consultant. In future, patients who do not require urgent treatment will be referred to a team of health service professionals for assessment, treatment or diagnostic tests.
The Minister said: “Orthopaedic ICATS is currently being put in place across the four Health Boards. Many patients who need orthopaedic treatment are elderly and some had to wait up to seven years to see a consultant. This was simply not acceptable.
“ICATS services for orthopaedic treatment have been piloted in some areas since November last year. In that short period of time it has made a major impact with around 2,500 patients having been assessed by the ICATS teams. Around 80 % of those patients did not require a further appointment with a consultant.
“As well as rolling out the orthopaedics service across Northern Ireland, urology and ophthalmology ICATS services are being progressed quickly. There are also plans to introduce ICATS for ENT, dermatology and cardiology specialities later this year. By April 2008 ICATS services for all these specialities will be fully implemented.
“ICATS is about providing patients with the right service at the right time and in the right place. It is already transforming services for patients in Northern Ireland. Consultants’ time is also being put to best use – seeing only those patients who need their highly specialist care and treatment.
“The year ahead will be very challenging but the end result – a world-class health and social care service for the people in Northern Ireland - will be worth the effort.”
Notes to Editors:
1. Until recently, the waiting time for a first outpatient appointment in Northern Ireland was among the worst in the United Kingdom. In March 2005, over 67,000 people were waiting more than six months for a first appointment with a consultant and of these, 33,000 were waiting more than a year and almost 13,000 were waiting in excess of two years.
2. In January 2006 Shaun Woodward announced the second stage of the major programme to reform the delivery of elective services, aimed primarily at tackling long waiting times for outpatient assessment, including the introduction of the new Integrated Clinical Assessment and Treatment Services (ICATS).
3. The introduction of ICATS is a central part of the Department’s outpatient reform programme. Traditionally, patients referred by their GP were automatically placed on the list to see a hospital consultant. These new services will be provided by integrated multi-disciplinary teams of health service professionals, including GPs with a special interest, specialist nurses and allied health professionals. ICATS will be provided in a variety of primary and secondary care settings and will include assessment, treatment, diagnostic and advisory services.
4. Where a primary care referral is assessed as not clinically urgent, it will be directed to ICATS to determine the appropriate next step. This is the primary function of ICATS, namely to ensure the appropriate next step for non-urgent referrals. There are five possible next steps:
- To Diagnostics, e.g. imaging services, scopes, pathology.
- For Direct Treatment to an inpatient or day case list.
- Return to Primary Care for discharge with advice or to request further information.
- To Tier 2 Outpatient Services. Tier 2 is the name given to the new clinical services that should typically form the core of the ICATS. These services will take referrals that are not initially indicated for consultant led clinics and will undertake face to face assessments and examinations, commencing treatments where appropriate.
- To Hospital Outpatients. Even with the introduction of the above services, there will be a significant remaining stream of non-urgent patients for whom a traditional outpatient appointment will be the appropriate next step – in other words, they will need to see a consultant.
5. ICATS will ensure that in future patients are referred to the most appropriate next step in the care pathway. For those patients who are assessed as needing to see a hospital consultant, they will do so after having had all the necessary diagnostic tests completed.
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