Overhaul of the long waiting lists for an outpatient consultation
A redesigned hospital outpatient system will include asking GPs to audit all patients who have been waiting more than three years, to clear the backlog.
SA News
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A landmark overhaul of the hospital outpatient system should see average waiting times for an appointment swiftly slashed by 30 to 40 per cent, Chief Medical Officer Dr Michael Cusack says.
A $1.5m program to redesign the system will include asking GPs to audit all patients who have been waiting three years or longer in an effort to clear the backlog.
As revealed by The Advertiser, in some cases people are waiting a decade or more for an outpatient appointment — however this is down from the maximum of 16 years since 2018.
Waiting times vary considerably depending on the condition and the hospital — maximum wait time has blown out to more than 100 months in eight cases, including for urology, orthopaedics, ophthalmology, neurosurgery, gastroenterology, and ear, nose and throat consultations.
See the waiting times by condition and clinic.
These are for patients classified as routine or non-urgent, while urgent cases are expected to be seen by a clinician within 30 days.
The audit will determine how many people are actually on the list — more than 2.1 million outpatient appointments are made at SA public clinics in the average year.
Dr Cusack said the majority of people are waiting between one and three years for an appointment, in which time their condition may change.
Key points in the overhaul include:
The patient audit to see who can be taken off and who would benefit from alternative treatment such as physiotherapy;
A focus on alternative care pathways rather than a referral to a specialist;
Standardising the criteria for a referral;
Putting patients back in GP care after an specialist consultation with a care plan, rather than clogging the system with ongoing outpatient review appointments;
Better use of IT to streamline the system.
Dr Cusack said the fast, comprehensive response to the pandemic was a catalyst for tackling the issue with a new committee including GP representatives meeting up to three times a week.
“With just the review of the outpatient list it has been estimated that maybe 30 to 40 per cent of patients may be diverted to other places — either continue their care in general practice or their GP says on balance you might be better served by seeing allied care than staying on the wait list for one of the metropolitan hospitals,” he said.
“We might find for people who have been waiting, their situation has changed and they may benefit from something else they can access in a more timely way.”
Dr Cusack said his short term aspiration is to have no-one waiting longer than three years, then to aim for a one year maximum.
Committee GP liaison officer Dr Emily Kirkpatrick said it is important people facing long waits for a consultation to touch base with their GP and see if that referral is still appropriate.
“Patients often get fixated on one particular outcome for their clinical condition, they think ‘my knee is painful, it must need surgery to fix the pain’ but often there are other options — we need to make those pathways really clear,” she said.
Health and Wellbeing Minister Stephen Wade said the government has reduced the maximum waiting time by almost 40 per cent but more work is needed.
“Under new reform measures, the immediate priority is to clear the backlog and reset the system which will provide us with an opportunity to do things better than before and embed a ‘new normal’ in the way outpatient services are delivered in future,” he said.