GPs: Ultrasound refusal poses risk to patient safety

GPs have warned a hospital management decision not to accept direct referrals for ultrasound scans could put patients at risk due to possible delayed diagnosis.

Management at Kerry General Hospital in Tralee have told GPs throughout the county that the hospital no longer has any available ultrasound slots for GP referrals.

The hospital noted referrals had increased by 34% last year.

In a letter to GPs seen by the Irish Examiner, management said patients needing urgent attention could instead be referred to the hospital’s outpatient or emergency departments.

However, GPs said such procedures would only add to waiting lists and increase waiting times for scans.

“The hospital is having trouble in dealing with numbers as it stands. Patients will now have to wait for months longer than they would if they were referred directly and will most likely end up getting the same test anyway,” said Farranfore GP Dr Brian White.

“Sending more patients to outpatients clinics will just create further delays and it’s quite possible there could also be delays in diagnosing some serious problem in a patient, as a result.”

Killarney GP Dr Gary Stack said what the hospital was doing added to costs and lacked financial sense.

“There is a huge difference now compared with 20 years ago in the complexity of the management of patients’ disease by GPs. Access to X-ray and ultrasound is essential to us in this management,” he said. “An ultrasound is now indicated in the management of many diseases and would be more important and more frequently requested than, for instance, a chest X-ray.”

A HSE spokesman said the hospital can process between 30 and 35 ultrasounds per day, which accounts for 10 referrals from outpatients plus 20-25 from the hospital’s Acute Medical Assessment Unit, inpatients and the emergency department.

“With such high numbers of ultrasounds being processed, the hospital does not have any available slots for direct GP referrals presently,” he said.

He also said hospital management had discussed the matter at length at a recent GP forum and told local doctors of the alternative arrangements.

According to the letter to GPs, the hospital dealt with the high number of ultrasound referrals in 2012 by putting on various “once off, out-of-hours blitzes” which helped clear more than 600 referrals.

The letter said the hospital received an average of 14 ultrasound referrals from GPs every day, but no longer had slots to cater for them.

Also, all referrals currently on hand are to be returned to the GP practices, it added.

Meanwhile, the HSE spokesman said hospital management will keep this situation under constant review and keep local GPs informed accordingly.