Northern Ireland regional spine megaclinic: a patient-centered approach to tackle waiting lists

Abstract

In March 2017, waiting times for an outpatient appointment at a consultant-led spinal clinic in Northern Ireland had reached 152 weeks. This falls significantly outside national targets and has resulted in a backlog of 6000 patients. A specialist, multi-clinician, co-located, consultant-led NHS clinic that would enable us to evaluate these patients was designed. Six megaclinics have been held and in total 909 patients were reviewed. Patient numbers ranged from 88 – 185, with an average did not attend rate of 3.3%. Only 9.1% of patients were boarded for surgery, while discharge rates ranged between 78–91%. Patient satisfaction has been maintained at over 90% for each clinic. A significant increase in clinician confidence in the management of orthopaedic spinal conditions was demonstrated. Cost analysis has demonstrated a saving of £39 087, in comparison to previous waiting list initiative costs for patients reviewed in the private sector.