It said yesterday it was consulting BreastScreen Healthcare staff and unions about the service, which it provides under contract for BreastScreen Aotearoa (BSA) through the National Screening Unit. The contract expires on June 30 next year.
The smallest breast-screening service in New Zealand, it had not been able to recruit enough medical staff despite a strong recruitment drive, the proposal document said.
Counties Manukau District Health Board provides second and third-screen readings, but could not provide it past June 30 next year.
The southern service also relies on other external providers, and on locums. Patient services director Lexie O'Shea said the board could either find a way to deliver the service itself, or not renew the contract and allow BSA to find another provider.
''The consultation process is a way to engage with our staff and their representatives to ensure that the model we come up with is the right one for the service and the community.''
Because of an ongoing 1.3 full-time equivalent radiologist vacancy, radiologists worked excessive hours to fill gaps.
The National Screening Unit had indicated that even if the board fully recruited its radiologist positions, it would not have the critical mass on its own to ensure adequate peer review and audits, the proposal document said.
Reliance on external support led to a ''disconnected patient pathway'', and high cost for the board.
If kept in-house, the service had to be significantly strengthened: ''This option will require much more work to investigate how these issues can be resolved when strategies to date have been unsuccessful'', the proposal document said.
The service involves on-site screening and assessment at both Dunedin Hospital and Southland Hospital, screening only on the mobile screening unit, and a health promotion role in the community.
Diagnostic mammography is not part of the BSA contract, and further investigation was needed into how it could be provided. The proposal was released yesterday for staff and union feedback. Staff will be told the final decision on October 8.
