The number of people waiting for follow-up outpatient appointments at hospitals in Wales has increased substantially since 2015, according to a report published by the Auditor General for Wales. With approximately 375,000 patients currently experiencing delays in receiving their follow-up appointment, urgent action is needed.
Health Boards have made some progress in response to recommendations made by the Auditor General in 2015-16, but the pace and impact on reducing the backlog of delayed follow-up appointments is limited, with significant variations between specialties and health boards across Wales. The average number of patients on the follow-up waiting list has increased by 12% over the last 3 years, with the number of patients waiting twice as long as they should be increasing by 55% to just short of 200,000.
Outpatient departments see more patients each year than any other hospital department. Two thirds of all outpatient appointments are follow-ups, but with the focus on seeing new patients in order to achieve the 26-week waiting time target, follow-up appointments are not being prioritised. The growing number of patients on follow-up waiting lists is creating a challenge in ensuring only those with a clinical need are on the list and that, while waiting, their clinical condition does not deteriorate, causing them harm.
This report calls for significant attention to be given, both locally and nationally, to reducing the number of patients experiencing delays, and says that health boards need to get better at assessing and managing the risks to patients from delays. To enable this to happen, modernisation work to improve outpatient systems needs to pick up pace and arrangements around performance management, national working groups, informatics and clinical leadership also need improvement.
Auditor General, Adrian Crompton said:
“I find the worsening trend around delays to outpatient follow-up appointments extremely concerning and patients are being put at risk. This needs to be addressed urgently across Wales. There are some encouraging signs. We’ve seen pockets of good practice and a recognition among senior leaders and clinicians that things need to change. But this really needs to be shared, spread and upscaled more widely, and quickly, if it is to achieve the change that is urgently needed.”