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Canterbury Charity Hospital founder Phil Bagshaw is calling for “heads to roll” in response to a new review of colonoscopy services from the Southern District Health Board released Friday.
Strained professional relationships and poor record keeping are among the problems causing colonoscopy delays in Southland and Otago, according to the report.
He was charged with addressing long-standing issues in the board’s gastroenterology department that have caused significant delays in diagnosing colorectal cancer, among other diseases, for patients in Southland and Otago.
“Southern DHB has one of the lowest colonoscopy intervention rates along with one of the highest bowel cancer rates in the country,” the report says.
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Bagshaw said five reviews, since 2017, had found serious problems with the Southern District Health Board’s colonoscopy service and bowel cancer management.
“Some people in high-level positions in government, administration and clinical leadership did not take responsibility or follow all of our recommendations; as a result, patients continued to suffer unacceptable outcomes from their bowel cancers, ”she said.
The Health Ministry should have stepped in a long time ago, Bagshaw said.
“I call on the Minister of Health to act immediately in the interests of patients and the public in the SDHB region.”
Health Minister Chris Hipkins said he had asked the ministry for advice on the report, which he had not yet had a chance to read.
He understood that the cases examined in the report were older and that SDHB had made improvements since then.
But he had made it very clear that he expected the ministry to closely monitor the performance of the SDHB colonoscopy, he said.
“It is clearly not good enough and the DHB has acknowledged that it is not.”
Written by Auckland colorectal surgeon and chair of the National Bowel Cancer Task Force Ian Bissett and Rutherford Clinic General Manager Kate Broome, the report reviews cases that Philip Bagshaw and Steven Ding were unable to access , due to time constraints, for your review published in 2019.
The Bagshaw / Ding review followed an internal survey of medical officers in 2017.
A third report, written by former Medical Council President Andrew Connolly, was released in January 2020.
Tensions between physicians were highlighted as an issue in all of these reports.
Other recurring themes include how referrals are managed and how selection criteria are applied.
The Bagshaw / Ding report was criticized for only reviewing 20 of the 102 cases (between 2013 and 2018) that the two set out to audit, but Bissett and Broom were only able to reach 50 patients.
“The patient trip management system was almost impossible to audit, involving two different databases and also paper notes. This makes it very difficult to track an individual patient’s journey through the system, ”their report says.
Bisset and Broome have recommended that referrals be better managed, preferably digitally.
They called for an update to the board’s reserve systems and an increase in colonoscopy capacity.
The latest report also recommends that gastroenterology specialists not be bound by national referral guidelines and that tensions between staff be resolved.
In a response, to be presented at next week’s board meeting, the board said it felt its Electronic Reference Management System, implemented in July 2018, was robust, but that a digital reference form would be developed. for internal references.
The response document says the board will seek clarity from the ministry on its intervention rates, as there were doubts that the figures they report are correct.
The board acknowledged that there were relationship problems and said that work was being done to correct them.
The board plans to appoint a project manager for six months to work on the Bissett and Broome recommendations.
Southern DHB President Dave Cull said the board was aware of the challenges in the colonoscopy service and efforts to address them in recent years.
“We will consider the most recent report at the board meeting, and it would be inappropriate for me or others to comment on the recommendations or next steps until we have done so,” he said.
Melissa Vining, cancer care advocate and founder of Southland Charity Hospital, said she had read the report and was sad and angry that the problem was no closer to being solved.
“The inaction of the Hospital Administration to accept responsibility and implement the recommendations that have led to patients suffering harm is outrageous and those responsible must be held accountable.”
While he did not trust the SDHB management team, Vining said he had worked with the chairman of the board, Dave Cull, and they had assured him that these and other issues would be resolved.
He was also confident that Crown Monitor Andrew Connolly had the expertise to guide the changes.
Connolly wrote one of the colonoscopy service reviews, which was published in January, and found that gastrointestinal specialists were subject to national referral criteria designed for GP referrals, which rationed access to the service.
He has now been appointed to chair the SDHB endoscopy oversight group, says an executive response.
