Replies to LegCo questions
LCQ17: Telephone Appointment Service of Hospital Authority
Following is a question by the Hon James To and a written reply by the Secretary
for Food and Health, Dr York Chow, in the Legislative Council today (July 6):
Question:
The original intention of implementing the Telephone Appointment Booking Service
(Telephone Appointment Service) of general outpatient clinics (GOPCs) is to
prevent patients from having to visit clinics in person and spend much time on
waiting for consultation quotas, as well as to alleviate the crowded queueing
conditions in clinics. In recent years, it has been reported that the
consultation quotas allocated through telephone booking were often full,
resulting in longer waiting time. It has also been reported that although the
quotas reserved for civil servants in some GOPCs have not been fully allocated,
the GOPCs do not release such unallocated quotas for the general public to book.
In this connection, will the Government inform this Council whether it knows:
(a) the number of consultation quotas allocated by the various GOPCs in Kowloon
West Cluster in each of the past three years; among them, the quotas reserved
for civil servants and the average utilisation rate; the number of appointments
cancelled by civil servants on their own initiative; and how unallocated quotas
for civil servants are handled by GOPCs;
(b) given that various clinics have different number of unallocated consultation
quotas each day and the public have no way of knowing whether they can be
allocated such quotas, how the authorities dispose of the unallocated quotas; if
a notification mechanism will be put in place to announce the number of
unallocated quotas through web site or hotlines;
(c) the number of complaint cases received in each of the past three years in
which the complainants were not able to get through to the Telephone Appointment
Service hotlines; if there are channels for compiling statistics on the number
of unsuccessful booking; given that it has been reported that such hotlines were
always busy, if the authorities have assessed if the present 500 odd telephone
lines are adequate in meeting the demand;
(d) given that some chronic patients complained that they were not able to
receive timely treatment because the consultation quotas booked through
telephone were full, if the authorities have any plan to assist them in securing
the unallocated quota; and
(e) focusing on the complicated instructions of the Telephone Appointment
Service System, what improvement measures the authorities have; what changes are
actually made as the authorities have indicated that they would streamline the
procedures?
Reply:
President,
The service of public general outpatient clinics (GOPCs) of the Hospital
Authority (HA) is primarily targeted at the low-income and underprivileged
groups, including the chronically ill, frail and vulnerable or disabled elders,
and low-income families. Patients taken care of by GOPCs can be broadly divided
into two main categories, namely chronic disease patients with stable conditions
(e.g. patients with diabetes mellitus (DM) or hypertension (HT)) and episodic
disease patients with relatively mild symptoms (e.g. patients who have fever or
suffer from influenza, gastroenteritis, etc). In order to enable civil servants
to return to work as early as possible after treatment, GOPCs offer priority
consultation quotas to civil servants at specified periods (half an hour in the
morning and afternoon).
Since 2006, HA has introduced a Telephone Appointment Service (TAS) for
individuals to book a consultation timeslot at GOPCs, in order to improve the
crowded queuing situation, reduce the risk of cross-infection at GOPCs and make
the best use of GOPC consultation quotas. HA has been keeping in view the use of
the TAS by different groups of the public. It also regularly reviews the
operation mode of the appointment system and implements corresponding
improvement measures with a view to optimising the use of resources and
providing high quality services.
My reply to the respective parts of the question is as follows:
(a) At present, there are 23 GOPCs in the Kowloon West Cluster (KWC) of HA,
offering consultation quotas to the public through the TAS system. KWC also
offers priority consultation quotas to civil servants at specified periods. In
2009, KWC offered more than 1.5 million consultation quotas in total, and
currently about 500 priority consultations quotas per day are allocated to civil
servants. Civil servants will receive consultation as soon as they are allocated
a consultation quota, and, in general, a cancellation of allocated quota is
unlikely to occur. To make better use of consultation quotas, priority quotas
not being allocated will be released immediately to the public via the TAS
system after the specified periods for civil servants. In 2009, the overall
utilisation rate of the GOPCs in KWC was about 97%.
(b) The TAS system is designed to link the GOPCs in the same cluster together to
form a network. When the consultation quotas of a particular clinic are full,
the system will automatically connect to the nearby clinics in the same cluster
and identify remaining consultation quotas for members of the public to choose
via the TAS, with a view to making better use of the unallocated GOPC quotas.
The TAS system will also adjust consultation quotas according to various
factors, such as quotas cancelled by the public, allocation of manpower,
unallocated civil servant priority quotas, etc., to achieve better utilisation
of consultation quotas. HA has also uploaded a report on the unused quotas of
particular GOPCs on average for the preceding four weeks at its website for
public information. In 2009, the overall utilisation rate of GOPCs over the
whole territory was about 97%.
(c) and (d) The TAS is designed mainly for use by patients with episodic
illnesses. Chronic disease patients requiring regular follow-up consultations
are assigned the next timeslot after each consultation, and do not need to book
appointments through the TAS for their follow-up consultations. Currently, there
are a total of some 500 telephone lines which operate 24 hours a day and allow
patients to reserve consultation quotas available in the next 24 hours. In order
to ensure services are provided to primary service targets, the TAS accords
priority to elderly people, Comprehensive Social Security Assistance (CSSA)
recipients and people granted with medical fee waiver, and a mechanism has been
put in place to prevent abuse of appointment (e.g. missing appointments
repeatedly, etc.). Past records have indicated that the average proportion of
utilisation of the TAS system telephone lines was not high. Nonetheless,
circumstances regarding usage vary during different seasons and time periods,
and it would be inevitable for lines to be relatively busy at certain days and
time periods.
There are more than 2.5 million episodic illness consultation quotas offered by
GOPCs in a year, and the number of complaints received is around 40 to 50
annually, including complaints concerning various administrative arrangements,
as well as those concerning failure to connect to the TAS or acquire a
consultation quota. HA will continue to monitor the usage of telephone lines of
the TAS system. To better utilise unallocated quotas, HA has also produced short
clips to educate patients the procedures in cancelling a consultation
appointment, so that those patients who are not in need will release the quota
allocated to him/her for others' use. In 2009, 93% of elderly patients were
allocated a GOPC timeslot within two working days through the TAS.
(e) Since the introduction of the TAS in 2006, HA has been conducting review and
rolled out enhancement measures to streamline the telephone appointment process
making the system more user-friendly. These measures include simplifying data
entry procedures, increasing the number of telephone lines to more than 500
while operating 24 hours a day, offering priority quotas that focus on primary
service targets, introducing reminder messages to assist patients to use the TAS
system, etc. Since September 2010, people with hearing impairment can also make
appointments by facsimile. Moreover, HA has provided assistance to the elderly
to use the TAS through various channels. These include the issuance of a
"Telephone Appointment Pocket Tips Guide" to clinics, offices of District
Councillors and institutions providing service to the elderly, and collaboration
with community organisations to guide and assist the elderly to use the TAS
system. Besides, help desks have been set up in every GOPC to provide suitable
assistance to the elderly and individuals who may encounter difficulties in
using the TAS.
Ends/Wednesday, July 6, 2011
Issued at HKT 13:12
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