CHI actively working to improve waiting list management, patient experience and access to care for children and families

Children's Health Ireland (CHI) today welcomed the publication of the HSE Internal Audit Report on Governance and Equity in Patient Access and Waiting List Management, together with a narrative review capturing the experiences of patients, families and staff. The reports and response can be viewed here and here.

The reviews provide important insights into both the systems that support waiting list management and, most importantly, the experiences of children and families waiting for care.

Families who contributed to the narrative review described the impact that long waits, uncertainty and poor communication can have on children and their loved ones. They spoke about wanting clearer information, more involvement in decisions about their child's care, and communication that is timely, compassionate and easy to understand.

CHI acknowledges these experiences and is committed to learning from them.

Lucy Nugent, CEO of Children's Health Ireland, said:

"I would like to sincerely thank the children, young people, parents, carers and staff who shared their experiences as part of these reviews. Their honesty and openness provide valuable insights into where we need to improve.

"Waiting for an appointment, procedure or treatment, can be stressful and worrying. We recognise that families need clear information, regular communication and confidence that their child's care is being managed appropriately. While progress has been made in a number of areas, we know there is more work to do.

"We accept the findings and recommendations of both reports and we have been actively implementing the improvements required. Our focus is on strengthening governance, improving data quality, enhancing communication with families and continuing to reduce waiting times so that children can access the care they need as quickly as possible."

The Internal Audit Report, which examined services across Orthopaedics (including Spinal), Urology and Respiratory Medicine between January 2023 and May 2025, found no clear evidence of inequity in access to care. The report also identified areas where governance, documentation, data quality and oversight processes should be strengthened to improve consistency, transparency and assurance.

The audit recognised the significant pressures facing paediatric services, including capacity and workforce challenges, which have contributed to delays in care. It also acknowledged a number of positive developments across CHI, including increased activity, reductions in some long-waiting patient groups, improvements in average waiting times, expansion of nurse-led models of care and the use of additional HSE and NTPF-funded initiatives to increase capacity.

In response to the audit findings, CHI has developed a comprehensive action plan comprising 32 actions. Twenty of these actions are already fully or partially completed, with the remainder in progress.

A separate Quality Improvement Plan has also been developed in response to the narrative review. Of the 26 actions identified, 65% have been completed, with the remaining actions underway.

Over the past two years, CHI has also continued to introduce a number of initiatives designed to improve access, oversight and the patient experience, including:

• The continued roll-out of the Central Referrals Office
• Preparation for implementation of the Electronic Health Record (EHR)
• Strengthened policy governance and standardisation through Q-Pulse
• Enhanced Clinical Specialty Lead roles
• Improved patient communication processes
• Development of patient experience measurement initiatives, including outpatient surveys
• Ongoing engagement with children, young people and families through CHI's Family Advisory Network and Youth Advisory Council

CHI has also continued to improve waiting list performance, with reductions achieved in both outpatient and inpatient/day-case waiting lists, including spinal services.

The findings of both reports will inform ongoing improvement work across CHI as the organisation continues its transformation and prepares for the opening of the new children's hospital.

While the reports identify areas requiring improvement, they also provide a clear roadmap for change. CHI is committed to implementing all recommendations and to working closely with children, young people, families, staff, the HSE and the Department of Health to ensure services are safe, equitable, transparent and responsive to the needs of patients.

Every child and family should have confidence in the care they receive and in the systems that support that care. CHI remains committed to earning and maintaining that trust through openness, accountability and continuous improvement.

During and after the review period, CHI has progressed a number of important enabling developments, preparation for implementation of the Electronic Health Record (EHR), consolidation of policy management through Q-Pulse, strengthening of Clinical Specialty Lead (CSL) roles, and the appointment of key executive and senior leadership posts. These developments provide an important foundation for further strengthening governance, operational oversight and service planning.

• All Executive Management Posts Permanently Filled by Q1 2026
• CHI has appointed a clinical speciality lead (CSL) to all specialities in the hospital – the first hospital group in Ireland to do so
• Significant improvement in Waiting Lists in the last 12 months
• OPD Weighted average improved from 7.8 months to 6.7 months
• IPDC Weighted average improved from 8.9 months to 6.9 months
• Spinal OPD Weighted average improved from 9.4 months to 4.7 months
• Spinal IPDC Weighted average improved from 5.7 months to 4.9 months
• Strengthened patient engagement both in service planning and policy development
• Over the last year CHI has strengthened our governance over insourcing initiatives with stronger oversight and monitoring of all initiatives and waiting lists in general through the Chief Operations Officer. The review highlighted that several initiatives in the review period provided additional capacity through evening, weekend, external or home-based activity.

Patient experience survey:

CHI has also begun a real-time patient experience survey across various departments so that we can actively explore the experience of families. The survey is available to access in common areas in OPD and Planned Admissions, through QR code and in paper format, and includes questions exploring experiences of communication, appointments, ward staff, doctors/specialists, overall satisfaction and future appointment preferences. The survey began in March 2026, and CHI will provide updates on the results on a quarterly basis.

We know that coming to hospital can be a difficult experience for children and their families. While our current hospital facilities were not designed for modern paediatric care, we are committed to making every visit as positive and supportive as possible. The new children's hospital has been designed around the needs of children and families, creating spaces that enable children to be children, even while receiving treatment. We look forward to moving into an environment that is truly built for children and that will help us deliver the best possible experience alongside the best possible care.