Referral Criteria Published - December 2013

HIQA publishes referral criteria

By Catherine Reilly
HIQA has published a series of reports outlining recommended referral and treatment thresholds for nine more elective surgical procedures to treat common hand and back conditions.

The Health Technology Assessments (HTAs) cover release of carpal tunnel; surgery for Dupuytren’s contracture; ganglion cyst surgery; surgery for trigger finger/thumb; spinal injections for pain due to degenerative lumbar spine disease; vertebroplasty and kyphoplasty for osteoporotic vertebral compression fractures; radiofrequency lesioning for chronic spinal pain; surgery for adult degenerative lumbar spine disease and spinal cord stimulation for chronic pain.
The reports set out minimum criteria a patient should meet before being referred for such treatment in order to help achieve a more streamlined referral process, standardisation of care and improved patient access to beneficial interventions.
According to HIQA, demand for scheduled procedures continues to exceed available capacity with a 22 per cent increase in demand for these services in 2011 compared to the previous year.

Dr Máirín Ryan, Director of HTA in HIQA, said publication of the thresholds, following a public consultation process, would help identify patients who stood to benefit most from the scheduled procedures assessed and those for whom more effective alternatives existed.
The key aim was that people with the most pressing clinical need would “have speedy access to necessary procedures”, Dr Ryan told IMT.
She said the HSE was developing an implementation plan that would require activity “right across the spectrum” from primary to tertiary care.
The introduction of thresholds would help reduce regional variation in clinical practice and access to these procedures, while the Authority did not expect a decrease in the number of these procedures undertaken in hospitals.
Successful implementation of the thresholds would depend on timely access to primary care services for those who can be effectively managed in the primary care setting and who do not warrant referral to secondary care, it stated.

View press release here