Number of outpatients seen per consultant has fallen by nearly 30% since 2016

The number of outpatients seen in hospitals per consultant has fallen by close to 30 per cent since 2016, according to figures released by Minister for Health Stephen Donnelly.

They suggest that if outpatient activity per consultant in acute hospitals last year was at the same level as in 2016, more than 1.4 million additional appointments could have taken place.

Mr Donnelly said the data, made publicly available on the Health Service Executive (HSE) website on Thursday, “shows significant variations in the average number of outpatients being seen by consultants in the same speciality”. He said the data also revealed “a big reduction in the overall number of outpatients being seen per patient-facing consultant”.

However, doctors argued that the HSE had privately acknowledged to them last month that key factors affecting productivity had not been considered in the data.

The Irish Medical Organisation (IMO) said the HSE had told it there were “a number of reasons why there will be variances (in productivity) between hospitals and within specialities”. It said these included the delivery of care through multidisciplinary teams, different types of consultant outpatient work and greater inpatient demands.

Prof Matthew Sadlier, chair of the IMO’s consultant committee, said there were multiple factors that could be influencing the trends seen such as consultants’ access to clinics, patient treatment complexity, and access to diagnostics, beds and theatres.

He said this could mean “patients are making repeat visits to manage their condition (as outpatients) while awaiting inpatient care”.

According to the data, there were 2,325 medical specialists in the public system in 2016 and average outpatient appointments per consultant stood at 1,429. Last year, it says, there were 3,563 whole time equivalent medical specialists and the outpatient appointments per consultant had fallen to an average of 1,024.

“I will continue to fight for more funding for patients and our health service,” the Minister said. “However, we must also do more with the funding we already receive. The publication of this data aims to improve transparency and allow the public to see how each hospital and each speciality is doing with the resources they have.

“The information will also be used to benchmark activity at speciality, hospitals and HSE health regions.”

Mr Donnelly said he would be putting in place a new policy for next year which would link the provision of funding for new consultant appointments to productivity. The Irish Times reported on Thursday that the Government is to withhold State funding for new consultant positions from hospitals that cannot demonstrate that their existing medical specialists are seeing the same number of outpatients as their peers elsewhere.

“While waiting lists have fallen for the last two years, and the average waiting time for treatment continues to decline, we need to make much more progress. And we must do everything we can to ensure that we maximise productivity in our hospitals and community services,” Mr Donnelly said.

Under a significant policy change, increasing the number of newly referred patients seen in outpatient clinics in individual hospitals, as well as the implementation of other reforms, are to become “significant” factors in determining how funding will be allocated and prioritised in the budget.