Covid impact still felt on surgery waiting times

Covid-19 has been largely blamed for a substantial rise in the number of southern patients waiting longer than recommended for cardiothoracic and cardiology surgery.

The latest Ministry of Health data for treatment times show that since October, the number of southern cardiothoracic patients promised treatment within four months but who had yet to receive it had dramatically increased.

From a starting point of 18%, by March more than half — 54% — of patients were waiting longer than recommended to be seen.

By the end of July (the most recent figures available) things had improved marginally, to 46% of cases missing the four-month target.

"The impact of Covid has meant that ward bed availability reduced the number of (cardiothoracic) surgical cases we could safely undertake," a Te Whatu Ora — Southern spokeswoman said.

"The intermittent pressure on the intensive care unit also impacted on this."

Clinicians were concerned that patient safety might be at risk due to pressure on the wider hospital system related to Covid, winter illness and staff sickness, in line with the government regulations at the time.

"This translated into reduced cardiac surgeries being performed, hence the increase in our waiting list.

"As the pressure begins to dissipate, we are hopeful that we can resume more surgeries to ensure people are getting their surgery on time."

Cardiology seldom features in the red in southern treatment time charts, as usually less than 2% of patients have a lengthy wait for treatment.

However, Te Whatu Ora New Zealand Heath Southern (NZHS) crept into the red in May, and by the end of July still had 10% of heart patients waiting longer than the promised four months to be treated.

NZHS said the issue was also partly due to Covid-19, as well as staff sickness and bed-block issues preventing patients flowing through the hospital rapidly.

"Southern cardiology is also carrying a vacancy for a senior medical officer role . . . we are actively recruiting for an SMO and once that role is filled we will be able to increase capacity," the spokeswoman said.

"This will hopefully coincide with an increase in the number of beds available as more nurses are recruited to the wards."

Other specialist areas with high percentages of patients breaching the four-month target were neurosurgery (70%), orthopaedics (70%), vascular (66%), ear nose and throat (53%), general surgery (45%), pain (43%, and gynaecology (40%).

However, it was not all gloom for southern patients, as NZHS had recorded improvements in problem areas such as dental and rheumatology treatment.

At the end of last year, almost two-thirds of dental patients were not being seen within four months, the high point in months of poor statistics which had prompted debate at the former SDHB.

By the end of July the breach rate had been greatly reduced, and was down to 27%.

"Southern is reviewing the dental waitlist and ensuring those that are able are offered non-intervention pathways," the spokeswoman said.

"The service has employed a part time locum and are utilising the short notice main theatre opportunities, and we are also increasing throughput on the mobile surgical bus, which has helped with the rural long-waiting patients."

In September last year, 40% of rheumatology patients breached the four-month target, but by July that had dropped to 11%.

The spokeswoman said that service had also reviewed its waitlist and several patients had either gone private or their symptoms had resolved and they no longer needed an appointment

"Southern is also focusing on getting the long-wait patients booked, with SMOs seeing additional long-wait first specialist appointments when they have spare capacity."

mike.houlahan@odt.co.nz

 

 

 

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