Wheels turning – now let’s see traction in colonoscopy service improvements

EDITORIAL: All right then. Welcome signs of activity have emerged in pursuit of a properly functioning colonoscopy service for the south.

We’re fond of saying that activity doesn’t always translate into achievement.

It’s also true that achievements are seldom attained without activity, so we trust a chastened sense of renewed and reorganised purpose is at work in this case.

The Southern District Health Board has lately apologised for the lack of focus, clarity and reporting that has caused delays for patients. Bear in mind that in this context, delays tend to result in heightened risk, increased suffering and more frequent deaths.

* SDHB promises colonoscopy, cancer care improvements
* Southern District Health Board apologises for colonoscopy issues
* Southland surgeons call for ‘decisive’ colonoscopy action

The board’s acknowledgment was sorely needed after a raft of mightily critical reviews backing up a thundering chorus of reproach from surgeons.

Now the SDHB is developing a plan – sorry, it’s an action plan, which presumably distinguishes it from plans that exist chiefly for public commentary and admiration.

It’s good to see wheels turning but by the board’s account it has already been working on the problem for some time. Quite so. And many’s the medical professional and ill-served patient, who would want to discuss how consequential this background work has been to date.

Atop which, it’s no small thing that the delays are conspicuously longer for Southlanders than for those in Otago.

Look, puddling progress doesn’t suffice, especially when the problems go beyond fragmented record-keeping to also include inadequate capacity and staff tensions.

A smattering of applause, then, for assurances that internal referral processes will be digitised and referrals from gastroenterologists will be flagged to ensure they are not processed under the criteria for GP referrals.

The board has acknowledged the need to meet ministry guidelines for faster cancer treatment, keep patients better informed and streamline its processes.

One unassailably good move has been to make crown monitor Andrew Connolly – who was the author of one of those critical reports – the chair of the oversight group developing the plan.

Connolly has already had his way on one significant point. The board has been using a category C waiting list for patients who do not fit the normal categories of A for urgent patients ands B for non-urgent patients.

This C category simply shouldn’t exist in Connolly’s view.

Absolutely. There seems to be no evidence that this was some sort of idiosyncratic cleverness or helpful subtlety.

Rather, it smacks of daft inconsistency, throwing things unhelpfully out of sync with Ministry of Health reporting guidelines and the practices of the great majority of other boards.

So it was grimly pleasing that the board’s chief executive Chris Fleming has told the health board that this is the last month members would see that extra category in reporting.

Let’s not forget that of 50 patient records reviewed, shortcomings were found in the management of 19 of them.

And if that seems an oddly small sample size, the reason the reviews were fewer and slower than wanted was because the system for managing the patient journey was found to be almost impossible to audit.

Real traction on this matter is, quite simply, imperative.

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