Routine cancelling of elective surgery poor

Photo: ODT files
Photo: ODT files
Cancelling elective surgery has become a daily function of the Southern District Health Board and it should not be, a review of the organisation says.

Elective procedure waiting lists vary from service to service and some have few patients awaiting treatment.

However, orthopaedics, ear nose and throat, gynaecology and general surgery combine to make up two-thirds of the 1886 SDHB patients where guidelines for how long they should wait to be seen have been breached.

A confidential review of the Southern District Health Board by external consultant Leena Singh said the organisation was not keeping pace with both its monthly rates of acute surgery and elective lists, which meant patients were routinely being turned away.

This resulted in significant problems in scheduling operating theatres, planning clinical teams, and for patients who had been prepared for anaesthetic the previous day but then had procedures cancelled.

"Staff believe it [cancelling electives] has become an embedded practice ... this practice should cease and cancellations should only occur after all avenues are explored days in advance," the review said.

The day procedure theatre at Dunedin Hospital was poorly programmed and additional effort needed to go into avoiding delays and gaps in usage.

Ms Singh said orthopaedic staff had told her that the surgical team had not filled a complete elective list since December last year: interviews for the review were done in April.

"This is compounding the elective waiting list issue and has resulted in an almost impossible situation of recovery without significant financial implications."

Similar problems were highlighted to the board earlier this week in a presentation on behalf of its clinical council, a group of medical professionals created to bring staff concerns to the notice of management and the board.

The board was told an acute theatre management plan had been introduced to drop a 24% elective cancellation rate due to acute theatre needs to less than 5%, and that alteration of planned lists because of acute theatre block would reduce from 20% to 2%.

Like all district health boards, the Southern District Health Board is still dealing with a backlog of electives caused by last year’s Covid-19 lockdown.

The situation has been exacerbated by a shortage of nurses, which has meant some beds which might otherwise have been able to be used by a patient were unable to have staff assigned to care for them.

The most extreme consequence so far of the electives issue came in March, when Dunedin Hospital had more patients than beds and a "code black" emergency was briefly declared.

A special task force has since reported monthly to the board on progress to address the issue.

This week, Southern District Health Board chairman Pete Hodgson said the board accepted the problem could not be fixed immediately, and that it supported the ongoing work by staff to try to improve patient flow through all its hospitals.

mike.houlahan@odt.co.nz

Comments

Sufficient funding would help. Cut back on MoH and govt. PR spending and spend the millions saved on the health service.

I got a letter from General Surgery Outpatients telling me my specialist might see me in 50 weeks! So my surgery may be over a year away. I think there are 52 weeks in every year! I am still in pain...

 

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