Minister Donnelly welcomes government approval of new strategy to address outpatient procedures and surgical waiting lists and enhance future capacity

• 3 new Elective Hospitals to be developed in Cork, Galway, and Dublin
• these facilities will cater for up to 940,000 planned procedures and operations every year
• procedures provided for in first phase will include Gastrointestinal, Gynaecology, Ophthalmology, and Orthopaedics

The Minister for Health, Stephen Donnelly TD today welcomed government approval of Sláintecare’s National Elective Ambulatory Care Strategy, which will change the way in which day case, scheduled procedures, surgeries, scans and outpatient services can be better arranged to ensure greater capacity in the future and help to address waiting lists.

The development of scheduled procedure/ outpatient capacity will be provided through dedicated, standalone Elective Hospitals in Cork, Galway and Dublin. These elective hospitals will provide coverage for 60-70% of the overall population, catering for up to 940,000 procedures annually.

The Elective Hospitals will provide additional capacity and help address waiting lists, while being as flexible and adaptable as possible to facilitate a future phase, which would include some elective in-patient treatment. Day procedures offered in the first phase will include Gastrointestinal, Gynaecology, Opthalmology, and Orthopaedics.

Minister Donnelly said:

The development, construction, and operation of Elective Hospitals will be progressed in line with Public Spending Code requirements.

This model of care will be considered in conjunction with several other transformative initiatives across the Public Healthcare System and other strategic capital investment proposals in Cork, Galway, and Dublin over the medium to longer term.

The Cross Party Sláintecare Report in 2017 articulated a new vision for healthcare in Ireland, including the provision of elective only hospitals, providing protected capacity for elective care.

The provision of additional elective care delivery capability in Cork, Dublin and Galway is a stated government policy objective.

In 2019, the Sláintecare Programme Implementation Office established an “Elective Hospitals Oversight Group”, under the joint governance of the Health Service Executive, Department of Health and Sláintecare, to guide the development of the elective hospital proposals.

The Strategy for Elective Ambulatory Care represents a step-change in the ability of the national public hospital network to deliver high-quality and timely elective care services that will provide:

• resources to address the known demographic changes to 2035 (up to a 40% increase in day-case surgeries)
• significant additional service delivery capacity, with resources and governance that are physically separate from, but adjacent to, an existing public hospital, thereby enabling separation of elective and emergency work
• dedicated focus on day case patients, initially
• Centres of Excellence in provision of Elective Care Services
• ability for public hospital network to provide timely access to care
• opportunity for wider system reform (and help clear existing waiting lists)

The development of three elective hospitals, in Cork, Galway, and Dublin, will provide coverage to 60-70% of the overall population (travel distance within 120km, or approximately 90 mins).

Some patients currently travel longer distances for some elective care procedures.

The proposed service model for elective services would be, initially, high volume, low complexity procedures, and a range of related diagnostic services. The range of specialties will account for approximately:

• 63% of all Day Procedures (excluding those relating to cancer and dialysis)
• 84% of all Day Case surgery waiters
• 60% of all Outpatient waiters

The procedures within scope and to be provided in each area will be subject to additional refinement following further local engagement with clinicians and hospital groups.

The provision of three Elective hospitals would cater for up to 940,000 procedures annually:

• approx. 215,000 Day Case surgery & Minor Operation procedures
• approx. 115,000 Endoscopy procedures
• over 400,000 outpatient diagnostics and treatments
• almost 200,000 outpatient consultations

The development of three elective hospitals, as referenced in National development Plan 2021 – 2030, will require significant infrastructural investment and therefore the Oversight Group is following the process outlined in the updated Public Spending Code, setting out the value for money requirements for the evaluation, planning, and management of large public investment projects.

Preliminary Business Cases for each Elective hospitals are at an advanced stage of development and are expected to be submitted to the Department of Health in early 2022.

If technically compliant with the Spending Code requirements and approved, the preliminary business cases will be further reviewed by the Department of Expenditure and Reform.

Subject to all Public Spending Code requirements at Gate 1 being met, further Memoranda for Government seeking approval-in-principle to proceed to the next stage of the Spending Code could be brought forward in the near future.