According to the Public Services Ombudsman, Northern Ireland's system for contacting patients on medical waiting lists is in disarray.
The significant and ongoing failures to update patients were determined to constitute "systematic maladministration" after a year-long investigation.
The Office of the Ombudsman urged the Department of Health (DoH) to collaborate with trusts, GPs, and other parties to address the shortcomings.
According to DoH, it understands the anguish and frustration of patients on waiting lists.
They trust that the report will be carefully considered by them, it was added.
The investigation discovered that after a referral was made, patients received little to no information due to trusts across Northern Ireland's failure to adhere to recommendations.
This included details about:.
- if there is a waitlist, if so.
- whether the client's situation is considered routine, urgent, or red flag.
- they anticipated waiting for.
- who to call if their situation changes.
The study, titled "Forgotten - a report into Healthcare Waiting List Communications," included data from the Department of Health and trusts as well as GPs and public survey responses. .
It also included a number of case studies that described the effects this has had on patients.
The investigation discovered that despite there being a procedure for updating people on waiting lists, trusts in Northern Ireland routinely failed to acknowledge receipt of a patient's referral when they received it. .
The IEAP stands for "integrated elective access protocol.".
In a survey of over 640 members of the public, the report found that 88 percent of respondents felt forgotten.
Less than half of those polled (44%) said they didn't want to put more pressure on the healthcare system by asking questions, but they did learn the status of their referral through persistence or by complaining to a trust, according to the study's findings.
The department was criticized in the report for failing to review this protocol since 2009 and for taking no steps to enforce the rules even though it was aware that they were not being followed in some places.
The investigation's survey received responses from about 20% of Northern Ireland's doctors of medicine.
96% of respondents believed that patient communication of waiting list information needed to be greatly improved.
The investigation found that updating patients was not the responsibility of general practitioners and that the trusts' apparent reliance on them to do so was misplaced.
Ombudsman Margaret Kelly commented on the findings, calling the waiting list system "in disarray and at times, even chaos.".
"The system's various components don't work together well, there isn't clear communication, and there isn't a comprehensive plan for improvement that everyone can agree on.
The department should collaborate more closely with the trusts, GPs, and patient representatives, she urged, in order to address the need for improvement. "On the basis of this, as well as those of repeated failures in many parts of the system, I make an overall finding of systemic maladministration," she said.
To make things better for patients, according to the ombudsman, a number of things must occur.
- for patients to understand what information they can anticipate from the trusts, the department will review the IEAP.
- a standard letter of acknowledgment to every patient, indicating the urgency of the referral as well as the anticipated wait time.
- across the trusts, uniform appointment and discharge letters.
- anyone who has waited longer than six months will receive updates.
- There is a section called "Waiting List Information" with pertinent patient information on each trust website.
In order to make sure that her recommendations are implemented, the ombudsman said she will keep in touch with the department and the trusts over the course of the upcoming 12 months.
The department issued a statement in which it stated that the investigation by the ombudsman "underscores the importance of health service communication with patients on waiting lists.".
It stated that while better information provision is required, the "ultimate solution" is "a sustained program of investment and reform to reduce and eventually eliminate the current backlog of care.".
It has taken years for this backlog to accumulate, and the department stated that it will "take years to be fully addressed.".
The department further stated that, in line with the NIPSO report, it is making efforts to raise the quality of information made available to patients.
It recently launched a webpage called "My Waiting Times NI" that informs patients about the typical outpatient wait times in Northern Ireland so they can get ready for their outpatient hospital consultation.
In the upcoming months, this website will continue to be improved.
The department stated that while it will continue to collaborate closely with NIPSO, GPs, and health and social care trusts to improve patient access to waiting time information, many of the report's recommendations would necessitate additional staffing and financial resources during a period of severe budgetary constraints.
