GPs report weeks-long waits for LUH to assess outpatient referrals
GPs in Donegal have been left with "no option" but to send patients to Letterkenny University Hospital's Emergency Department because their outpatient referrals are being left unassessed for weeks, a Donegal councillor has warned.
Councillor Declan Meehan said GPs have reported that some referrals remain without an assigned clinical team four or five weeks after being submitted.
It was revealed at Tuesday's Regional Health Forum that only that 52% of referrals were triaged within 20 days.
While no more specific figures were given, the HSE acknowledged that the five-day national target was not "consistently" being met at Letterkenny University Hospital, apart from the breast service, gynecology, oncology and diabetes mellitus services.
Cllr Meehan said the delays were leaving doctors with limited options when patients needed urgent care.
He explained that when a referral is properly assessed, a patient is assigned to a consultant or clinical team, allowing their GP to make direct contact if an urgent outpatient appointment is needed.
He raised cases of some GPs who say they contacted the hospital only to discover that referrals made weeks earlier had still not been assessed or assigned to a team.
"Not triaging in a timely manner has a huge impact because, in order for people to be seen in a timely manner, the GPs often have no option but to refer them into the Emergency Department," Cllr Meehan said.
The councillor said Letterkenny's ED was already under enormous strain following "the worst summer of Emergency Department wait times and overcrowding".
He warned: "If we don't have a functioning triage system at Letterkenny University Hospital, which we do not, based on these figures, then we're going to be contending with those referrals in through the Emergency Department instead."
Cllr Meehan also challenged the hospital for failing, for a second time, to provide the figures he had specifically requested on outpatient referral delays.
Under the National Outpatient Waiting List Management Protocol 2022, referrals must be clinically assessed and the outcome returned to the relevant administrative office within five working days.
However, the hospital's written response only referred to patients triaged within one to 20 days.
"When we break it down to five days, what is the figure that's been hidden here? Because it is a figure that's been hidden," Cllr Meehan told the forum.
"It's the second time I've asked it, and it's been obfuscated."
The councillor demanded a breakdown showing the proportion of referrals that were not assessed within the required timeframe.
In a written reply, it was confirmed that Letterkenny University Hospital registers all referrals within 24 hours. They are then forwarded to the relevant consultant team for clinical triage.
Among the factors contributing to delays that were listed by the HSE are staffing and resource constraints, varying referral volumes, consultant absences and the need for additional clinical information.
A new electronic referral management system is also being introduced across the West and North West region to allow consultants to assess referrals electronically and improve communication with GPs through Healthlink.
HSE representative Amanda Doyle, Head of Service Primary Care, agreed to seek the missing five-day compliance figures and a timeline for the new system.
A written statement added that: "Letterkenny University Hospital remains committed to improving referral management processes and ensuring that patients with urgent and time-sensitive conditions are identified and prioritized appropriately. Continuous monitoring of triage performance, together with the implementation of the new electronic referral management system, forms part of the hospital's ongoing efforts to improve compliance with national standards and enhance patient safety."
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