The availability of colonoscopy services might be alleviated somewhat by the recent arrival of a colorectal surgeon from Sweden, the Otago District Health Board advised general practitioners yesterday afternoon.
As concerns about access to colonoscopy services in Otago began to be aired publicly yesterday and Health Minister Tony Ryall called for an urgent report from the board, the board sent GPs an update on the situation, something which was described as "no coincidence" by South Link Health executive director Prof Murray Tilyard.
It was revealed yesterday in a letter leaked to the Otago Daily Times that Prof Tilyard had gathered concerns from 26 GPs about access to colonoscopy services and forwarded them to the board.
Some doctors reported that patients who had symptoms of bowel cancer had been refused a colonoscopy but were later diagnosed with the illness.
Prof Tilyard said doctors needed to be able to have confidence in the process.
They needed to know when their clinical judgement of a patient with symptoms was accepted by those making colonoscopy decisions.
The update, which went out from the board GP liaison officer Dr Anne Worsnop, says with the restricted services in Otago the onus was partly on GPs to advocate for their patients and present to the colonoscopy panel the patients' symptoms and signs "in as succinct a manner as possible to achieve what is the best outcome".
In the preamble to the update, Dr Worsnop said the availability of colonoscopy in Otago and other boards was under pressure.
"This is the situation now. The problem will tend to only get worse when the Government's proposal to introduce faecal occult blood screening comes into being.
"This article is being sent to all GPs in Otago to remind/inform us of what the Otago DHB does actually offer, in an attempt to clarify any misunderstandings and help us give our patients the facts that will help them make the best decision about their specific large bowel problem."
The gastroenterology department and colorectal surgeon Mark Thompson-Fawcett were working on a referral template for colonoscopy which was expected to be electronic in the future, the report said.
It clarifies some of the issues which GPs have been concerned about, but also showed the board was not following New Zealand guidelines on follow-up colonoscopies for people who have had bowel cancer.
Since 2007, the board has not been offering surveillance colonoscopies for those with a family history in accordance with the guidelines.
About a third of the colonoscopies being carried out were for surveillance purposes, the report said.
The report shows that some people with previous bowel cancer who would qualify for three- to five-year screening under national guidelines are only being offered a colonoscopy every 10 years.
Doctors were also advised that the Southern Cancer Network was carrying out a project to map colorectal cancer patients' journeys through the health system, gathering information regarding public and private services with regard to diagnosis, treatment, follow-up and surveillance.
The numbers
Colonoscopies at Dunedin Hospital.-
- Carries out about 700 a year
- About 14 a week
- It receives about 20 referrals a week
