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PATIENT SATISFACTION WITH
RHEUMATOLOGY SERVICES IN MUSGRAVE PARK HOSPITAL
4 Conclusions
Whilst it is recognised that
the focus groups consisted of only a small number of participants,
nevertheless, some important issues were highlighted which
have wider implications. The respondents were somewhat satisfied
with rheumatology services overall. In particular, the adult
patients praised the staff in Musgrave Park Hospital. In
addition, it was felt that the children's rheumatology service
has improved recently.
However, a number of areas
of dissatisfaction were highlighted by the respondents generally.
Patients and parents were dissatisfied with waits of longer
than three months for repeat outpatient appointments. In
addition, it was felt that the facilities in the outpatients
department of the Royal Victoria Hospital were less than
adequate. Although there was good information provision
generally, there is still a need to ensure that patients
are well-informed about any tests carried out. Similarly,
it was clear that the adolescent patients, in particular,
did not always understand the information they were given.
A number of staff training needs were identified, particularly
for porters in relation to ensuring the safe transport of
patients and, for GPs, in increasing their awareness of
the current management and treatment of arthritic conditions.
Whilst the focus group participants
did not highlight any concerns relating to waiting times
for first outpatient appointments, data obtained from the
relevant hospitals shows that these waiting times are very
lengthy. Waiting times for routine first appointments in
the RVH are 14-38 weeks, depending on the individual consultant.
Waiting times for routine first appointments in BCH are
15-16 months and, in the Ulster Hospital, the waiting times
are up to 9 months. In addition, waiting times in MPH for
children's first appointments are 13 weeks. Where a child
needs to be seen urgently, the assessment takes place in
the day ward or in the children's ward.
An assessment was carried
out in 1995 of the need for an inpatient rheumatology service
in the EHSSB area, and patient groups and GPs highlighted
concerns relating to long waiting times for first appointments
even then . The service review recommended that specialist
day and inpatient rheumatology services should be provided
on a hospital site which has access to the fullest possible
range of medical specialities and specialist investigation
facilities. The review also recommended that outpatient
and day patient services should be developed to enable inpatient
bed provision to be significantly reduced. However, the
integration of rheumatology services on one site has yet
to take place.
One of the focus group participants
(an adult patient) was on a waiting list for an anti-TNF
rheumatology drug and highlighted a concern about the availability
of these drugs. In addition, other patients have contacted
the Eastern Health and Social Services Council about this
issue. A waiting list for funding of these drugs exists
and funding has not been identified in the Priorities for
Action document recently issued by the Department of Health,
Social Services and Public Safety . This is clearly unacceptable
for those patients whose quality of life could be improved
by these drugs.
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