‘Lot to be done’ in colonoscopy service

Andrew Connolly. PHOTO: ODT FILES
Andrew Connolly. PHOTO: ODT FILES
A surgeon who wrote a report highly critical of the Southern District Health Board’s ailing colonoscopy service is to chair an oversight group charged with fixing it.

Andrew Connolly will lead the committee, which will draft timelines and performance targets for the service and report to the board and its executives on progress.

The board yesterday apologised for the failings in its colonoscopy service and vowed to make improvements.

The Bissett-Broome report released on Friday audited several patients and found issues in some cases with inadequate care, unacceptable delays, or patients being declined treatment when they should have been screened.

Board deputy chairman David Perez said it accepted responsibility for the issues with the service.

"We acknowledge that some patients may have been harmed as a consequence, and the board collectively certainly wishes to apologise ... for any trauma that patients have suffered or any delays in having procedures done.

"I think there has been a lack of clarity and I think there has been a lack of a concerted focus by management ... and we haven’t had clear reporting because, I think, we have lacked clear objectives."

He also apologised to "frustrated and bitter" staff unhappy at the lack of progress.

On Monday, it was reported several Southland Hospital surgeons said none of the SDHB’s proposed actions following the Bissett-Broome report would truly improve patient access to services.

Their concerns were echoed yesterday by Phil Bagshaw, who last year wrote a report that criticised the SDHB for its failure to address issues with the colonoscopy service.

Dr Bagshaw said it was excellent that the board had accepted responsibility for the woes in the service, but management had known about them for years.

"They are blaming things like poor relationships for the problems.

"Those poor relationships are the result of the problems, not the causes."

Senior staff who had overseen the process now needed to suffer consequences, he said.

"There has been such a lack of action for such a length of time."

Mr Connolly, whose report into the service earlier this year found it was using national referral guidelines incorrectly, is also one of two Crown monitors installed by the health minister to assist the SDHB.

His new appointment has been cleared of any conflict of interest concerns by the ministry.

He said it was appropriate that apologies be made, but noted that none of the clinical staff had been criticised for the quality of their work.

"It is imperative that we solve this ... but there is a lot to be done."

The SDHB had to be honest, both with the public and internally, about the issues the service faced and what it was doing to remedy them, and use the Ministry of Health-mandated classification criteria for assessing patient referrals, he said.

"The DHB has the highest decline rate for referrals.

"That raises a few questions: are there unnecessary or inappropriate referrals ... but if the decline rate, which is 15% according to the Bissett report, is representative of capacity, then we have a very immediate problem."

The report found that while the rate of provision of colonoscopy had risen by 45% nationally since 2013, it had remained static in the SDHB region.

Board member Lesley Soper said it was vital that improvements be meaningful and be made quickly, a sentiment echoed by colleague Tuari Potiki.

"Taking responsibility for the problems is also taking responsibility for the solutions ... We want this work to have teeth."

Dr Bagshaw labelled the committee "a temporary expedient" and said outsiders could not be expected to resolve all the issues within the SDHB.

"It does need something, but as far as medium and long-term is concerned, people need to be appointed who will act responsibly and ensure the safety of the public and the quality of the care."

mike.houlahan@odt.co.nz

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