Update on the West/North West Hospitals Group at the Regional Health Forum

Bill Maher, CEO of the West/North West Hospitals Group and Tony Canavan, Chief Operating Officer attended the Regional Health Forum meeting in Galway yesterday and gave a brief overview of the formation of the new Hospital Group and formally welcomed Sligo, Mayo and Letterkenny Hospitals to the Group.
 
The West/North West Hospitals Group is one of six new hospital groups announced by the Minister for Health, Dr. James Reilly TD in May, 2013, as part of a re-organisation of public hospitals into more efficient and accountable hospital groups that will deliver improved outcomes for patients.
 
In July, the Group – then incorporating Galway University Hospitals, Portiuncula and Roscommon Hospital - was enlarged and took on responsibility for Mayo, Sligo and Letterkenny General Hospitals, becoming the West/North West Hospitals Group in the process.
 
Across the counties of Donegal, Sligo, Mayo, Leitrim, Roscommon and Galway, the Group is now a leading provider of emergency, acute and outpatient care to a total population of 820,880 and provides a range of high quality services for its catchment area with one overall Group Management Team, one financial budget and one staff complement WTE (whole time equivalent).
 
West/North West Hospitals Group has 1,770 beds and 7,620 staff and a budget of €600m.
 
Progress is being made on preparing the Group Service Plan for 2014, which will encompass all seven hospitals. The Group priorities for 2013 remain the improvement of access to services for patients and this means working on admission times from the Emergency Departments and maintaining the inpatients waiting time targets (which includes a reduction to 8 months wait time for adults). It also includes meeting the SDU’s outpatient waiting time target that no patient should wait longer than 12 months by the end of November.
 
Letterkenny Hospital Flood
Bill Maher gave a brief update on the aftermath of the flooding at Letterkenny Hospital. He said, “The flood at Letterkenny Hospital was without doubt the most serious natural disaster to befall any Irish hospital and the management of the aftermath and the speed at which services have been restored is a huge credit to a long list of people which includes: the General Manager, Sean Murphy and his staff; our health service colleagues in Community Services and at the hospitals in Sligo, Mayo, Altnagalvin and the South West Acute in Enniskillen; the Ambulance Service; An Garda Síochána; Donegal Fire Service; Donegal County Council; the Army (particularly troops from Finner Camp); and members of the public and the local business community in Donegal.
 
“The flood waters wiped out 40% of the floor space of the hospital, eliminating more than 70% of the hospital’s capacity. An indicative budget of circa €10m has been identified to rebuild eleven key areas, including the Gynaecology/Obstetrics Department, the kitchens, the Emergency Department, Radiology and Outpatients, Coronary Care / Haematology / Oncology / Echo Departments and Medical/Records/Medical Wards. The design team has already been appointed and the scope of works identified. This has been carried out in parallel with the installation of temporary facilities such as the temporary ED and radiology departments.
 
“Within a month of the flood the diversion arrangements effected by the Emergency Department were stood down. The re-build of Emergency Department will be completed around the end of the first quarter in 2014 with the overall re-building project finishing by autumn 2014.
 
“We aim to resume virtually all services at the hospital in the coming weeks but it will be some months before they return to pre-flood conditions and in the meantime we will be relying temporary and offsite facilities.
 
“The hospital will be strengthened not just by new and better infrastructure but also by being part of the West/North West Hospital Group, enabling it to contribute to better integrated patient services.”
 
Maternal Death Update
Mr Tony Canavan, Chief Operating Officer for the Group, speaking in his capacity as former General Manager of University Hospital Galway, provided an update on the investigations into the maternal death at UHG in October 2012.
 
“We await the HIQA report, which is expected in the near future. Once received, the recommendations from it will be integrated into our current action plan for the Maternal Death Review Recommendations Implementation team. This is continuing to meet on a regular basis to review and monitor progress with implementing the recommendations from the HSE/Arulkumaran Review and the Coroner’s Inquest.
 
“I would ask members of the Forum not to raise any questions or issues that impinge on patient privacy or encroach on the work of the regulatory bodies or HIQA or impinge on the legal proceedings that have now been issued by Mr Halappanavar’s legal team.”
 
Other topics covered during the meeting included:
 
Outpatient Waiting List
This year we embarked on a major project to change the way outpatient services are managed from the way appointments are assigned to the delivery of the actual service. This work started at the end of last year with an extensive validation exercise and we have been arranging appointments for those who have been waiting longest, first.
 
As of 12 September the number of patients waiting over 12 months for an appointment at GUH, Portiuncula and Roscommon Hospitals has dropped from 43,576 to 16,682.
 
A new call centre has been set up for patients to contact GUH in relation to their appointment and we have increased the use of web text reminder services to assist patients contacting us.
 
We are working hard to provide appointments on dates that suit patients which in turn will mean that there should be fewer ‘no shows’ which put an unnecessary burden on the hospitals. The Do Not Attend (DNA) rate is now below 10% for new patients and we are striving to reduce this to 7.5%.
 
All patients are advised to notify the hospital if they are unable to attend their appointment and there is a dedicated telephone number available for patients to call to rearrange outpatient appointments. If patients are unable to attend and take the time to notify us in advance it means that we can reschedule their appointment and also offer the original appointment time to another patient, which in turn reduces the length of time that patients wait for an appointment.
 
Epilepsy Care Service in GUH extended
A Vagal Nerve Simulation clinic commenced in the GUH Department of Neurology on Friday 20 September 2013; this service will run in conjunction with the epilepsy clinics. Vagal Nerve Stimulation therapy uses a pulse generator to send mild electrical stimulations to the vagal nerve with the aim of reducing the number, length and severity of seizures.
 
This is a positive new service development and will allow patients in the Galway region who previously had to travel to Dublin, to receive all their epilepsy care at GUH.
 
Private Health Insurance Claims
We have made significant progress in reforming our systems in order to make processing of claims easier and quicker. A new electronic claims management system has been implemented at GUH and Sligo and is being rolled out to Portiuncula Hospital Ballinasloe and Roscommon Hospital with Mayo and Letterkenny to follow. The new system allows consultants to access the system remotely and results in a quicker and more streamlined claims management process.
 
Senior Management and Senior Medical staff are meeting with relevant Consultants emphasising the need to complete forms on a timely basis.
 
The amount outstanding to GUH in Private Health Insurance Claims at end of August 2013 was €5,828,352. The amount outstanding for West/North West Hospitals Group is €10,392,481 which equates to 17% of W/NWHG total debt.
 
The outstanding Health Insurance Claims is a key financial performance area which is closely monitored and a reduction of €2m has already been achieved.