Southern District Health Board applogises for colonoscopy issues

Southern District Health Board issues public apology saying it accepts responsibility for lack of focus, clarity and reporting.

Robyn Edie/Stuff

Southern District Health Board issues public apology saying it accepts responsibility for lack of focus, clarity and reporting.

The Southern District Health Board has apologised to the public for issues within its gastroenterology department.

Speaking at a public board meeting Tuesday, deputy chairman David Perez said that while some progress had been made since concerns were first raised, there had been a lack of clear management focus.

“The board accepts responsibility for the lack of focus, lack of clarity, and lack of reporting. We’d like to apologise for any harm that it’s caused patients.”

Perez also apologised to SDHB staff for the frustration the situation had caused them.

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He was responding to the latest in a series of independent reviews and reports highlighting issues like staff tensions, fragmented record-keeping and inadequate capacity, that had caused delays for Southland and Otago patients in need of colonoscopies.

“We need board resolutions for structures and procedures for the future,” Perez told the board.

He acknowledged the three recent reviews (the Bagshaw/Ding review released in 2018, the Andrew Connolly report released in January, and the most recent Bissett/Broome review, released Friday), adding that they were broadly similar in their recommendations.

“Since these reports came in, there has been work behind the scenes, and there have been improvements,” Perez said.

But these had been partly invisible and there was still work to be done, he said.

Board members resolved to set up a group to monitor referrals, to develop an action plan, and to appoint a project manager for 12 months to help clinicians and management implement the plan.

It was widely agreed that crown monitor Dr Andrew Connolly – who wrote the report released in January – would chair the oversight group.

The Auditor-General of Health John Ryan had advised him that this would not be a conflict of interest, he told the board.

On Connolly’s recommendation, the board also resolved that patients should be categorised by Ministry of Health guidelines.

The ministry recommends that waiting lists be divided in a category A for urgent patients, category B for non-urgent patients, a category for the National Bowel Screening Programme and a surveillance category for follow-ups.

The SDHB has been using a category C waiting list for patients that do not fit the normal categories.

Southern District Health Board Crown Monitor Andrew Connolly says the fact that Southland and Otago have among the highest rates of bowel cancer in New Zealand is undisputable. (File photo)

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Southern District Health Board Crown Monitor Andrew Connolly says the fact that Southland and Otago have among the highest rates of bowel cancer in New Zealand is undisputable. (File photo)

These patients wait an average of 110 days for a colonoscopy if they’re from Southland, data from chief executive Chris Fleming’s report in September revealed, or an average of 32 days if they’re treated in Dunedin.

“Category C shouldn’t exist,” Connolly told the board. “I’m not simply going to referee a group of people arguing about whether a patient is category A, B, or C.”

Board member Dr John Chambers raised concerns that there were no plans to increase capacity.

According to the latest report, SDHB’s colonoscopy numbers had been stagnant from 2013 to 2019, despite national capacity increasing 45 per cent during the same period.

The board’s referral decline rate is among the highest in the country at 15 per cent, the report says.

That represented two months of productivity, Connolly said.

The board agreed it would review its current resources, address inefficiencies and then propose a business case to increase capacity.

Other solutions discussed included outsourcing procedures to the private sector, running clinics, and making use of an extra room that’s sometimes available at Dunedin Hospital.

Crown monitor Tuari Potiki echoed Perez’s apology.

“Taking responsibility for the problem is also taking responsibility for the solutions. I want this work to have teeth. We as a board are saying ‘enough is enough’,” he said.

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