Screening plan believed to be unsafe

The Southern District Health Board pitched a confidential plan to Counties Manukau DHB for it to employ Southern breast-screening radiologists, but was refused as the idea was deemed unsafe, documents released under the Official Information Act show.

The June pitch was made a week after a Counties Manukau DHB assessment said its own breast-screening radiologists' cancer detection rate for first-screening reads in 2012 was twice that of the Southern board's. The Southern service has been relying on Counties Manukau support, which is ending in the middle of next year. The Southern board announced last month it was relinquishing the contract, which is being re-tendered by BreastScreen Aotearoa.

A low initial detection rate increased Southern's reliance on Counties Manukau for second and third readings, the assessment released by the board this week shows. A major factor in the lower detection rate was found to be inadequate understanding of the computer software system, which was not being used to full capability.

There was an impression of poor morale and isolation among the three Southern breast-screening radiologists, only one of whom was in Dunedin. They all seemed ''extremely stretched'' - the Invercargill radiologists were also Southland Hospital's only general radiologists.

''None of the radiologists seemed to know where they currently stood in terms of meeting targets and which areas needed improvement.''

Other clinical risks included the lack of a lead radiologist to oversee and ''trouble-shoot''.

''There is a perceived lack of ability to manage finances internally within [the service] to quickly enact change for the better.''

Counties Manukau DHB hospital services director Jennifer Coles said, in a letter in July rejecting the proposal, the arrangement could be problematic because Auckland and the South had ''very different and geographically distant populations''.

There were ''potential problems with communication, resource management and equipment purchases''.

''In our opinion, providing clinical leadership at a distance is not a safe option.''

The board said in its proposal to Counties Manukau it had been ''unable to fill all professional roles (both screening and diagnostics) required to provide this service''.

It proposed a ''joint service'', with Counties Manukau the lead provider.

The Auckland board would be paid to employ and manage the breast-screening radiologists. In the two years to November 2012, the Southern service screened 35,708 women in Otago and Southland.


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