Waiting List Improvements

We are transforming the patient experience through strategic reforms and innovative approaches to scheduled care. Our commitment is to ensure timely and efficient healthcare services for all patients awaiting treatment.

Patient Initiated Review (PIR)

Empowering patients to self-manage their outpatient journey.

Patient Initiated Review (PIR) is a ground-breaking approach where patients are empowered to self-manage their own outpatient journey. Suitable candidates for PIR can proactively schedule follow-up outpatient appointments as needed, such as during symptom flare-ups. This patient-centred initiative not only enhances the overall healthcare experience but also optimises appointment availability, allowing us to extend care to more patients on outpatient waiting lists.

The 2024 Waiting List Action Plan has mandated that PIR is rolled out in all hospitals across all specialties, where clinically appropriate to do so.

Introduction to PIR

Introduction to PIR by Dr Colm Henry, Chief Clinical Officer (video 2 minutes 27 seconds)
In this video, Dr Colm Henry outlines the concept of PIR, its origins, and importance in healthcare improvements

The PIR process explained by Dr Mike O’Connor, National Clinical Advisor and Group Lead for Acute Operations (video 2 minutes 35 seconds)
In this video, Dr Mike O’Connor introduces how the PIR process works

Testimonials from clinical and operational teams about PIR (video one minute 49 seconds)
In this video, clinical and operational staff describe how PIR has worked for them

Patient Initiated Review FAQ (PDF, size 218 KB, 5 pages)
This document provides all the information required to implement and deliver PIR in Ireland

Support for implementing PIR

Patient Initiated Review National Guidance Document (PDF, size 2.1 MB, 36 pages)
This document addresses some of the commonly asked questions providers and system users have asked around implementing PIR

PIR Inclusion and Exclusion criteria (PDF, size 533 KB, 40 pages)
This document provides sample inclusion and exclusion criteria for a range of specialities

PIR Training (video 11 minutes 32 seconds)
This video provides step-by-step training for staff implementing PIR

PIR webinars

PIR webinar for clinicians (video 28 minutes 39 seconds)
This webinar features clinicians in Irish hospitals speaking about their experience of using PIR

Central Referrals Office (CRO)

Streamlining care with CRO

The Central Referrals Office (CRO) is a key component in our mission to streamline patient care. By centralising all referrals, including those from GPs, consultants, and specialist clinics, the CRO ensures that each patient's needs are assessed, prioritised, and addressed promptly.

Centralisation of referral receipt, which is the first step in the CRO process, has been mandated in all hospitals for all specialities as part of the 2024 Waiting List Action Plan.

Learn more about Central Referrals and CRO here:

Central Referrals National Guidance Document (PDF, size 3.1 MB, 50 pages)

Central Referrals Office National Guidance Document (PDF, size 4 MB, 78 pages)

DNA Strategy

Improving attendance with the DNA Strategy

The DNA Strategy ensures that patients receive communication in relation to their appointment at the most appropriate intervals, highlighting the importance of attending an appointment. By providing clear and accessible options for appointment cancellation, we can reallocate time slots to other patients, which minimises wait times and maximises clinic efficiency.

Contact Details

For more information please email Access.programme@hse.ie