Patients suffered “poor outcomes” because of delays for heart services at a major hospital, according to a government report obtained by the Herald.
Some people became so sick while stuck in backlogs for cardiology treatment and cardiac surgery at Waikato DHB that they had to be rushed to hospital for emergency treatment.
Others had procedures that could have been avoided had they been seen on time. And there were concerns the delays would worsen inequities and poverty because people caught in them were unable to work.
Those warnings were made by officials at Lakes DHB, which covers Rotorua and Taupō and sends heart patients to Waikato for treatment, in a report to the Ministry of Health in August last year.
The Lakes report sheds new light on problems at Waikato’s heart services that have been exposed by a Herald investigation.
Last week the Herald revealed hundreds of people, including some who needed urgent care, were caught in Waikato’s cardiology backlogs, prompting the Government’s own cardiology adviser to sound the alarm about patient safety in late 2019. In response, both the ministry and Waikato said the situation had improved and they weren’t aware of any patients being harmed because of the wait times.
However, since that story was published the Herald has been contacted by numerous readers who say they’ve experienced delays that disrupted their lives.
One is still waiting for a follow-up specialist appointment, seven months after a major heart attack. Another, who had severe pain, paid hundreds of dollars to get an echocardiogram done privately after getting nowhere in the public system, and found she had a leaking heart valve.
The report from Lakes DHB, obtained by the Herald under the Official Information Act, shows that problems at Waikato spilled over into neighbouring DHBs that sent patients there for heart treatment.
“Lakes DHB is in ongoing communication with Waikato Hospital in relation to cardiac surgery and cardiology waiting lists regarding ongoing poor service delivery, including minimal access to waiting list information, and poor communication with clinicians regarding patients waiting,” the August 2020 document states.
“The long wait lists lead to acute hospital admissions and bed block, avoidable investigations being repeated, and poor patient outcomes.”
Similar concerns were expressed in a November 2019 letter by the chairman of Lakes DHB to Waikato. The situation had “deteriorated to a point which has become completely unacceptable”, the letter warned.
“This current level of service for both acute and urgent patients is seriously affecting the clinical care and outcomes of Lakes DHB patients…this issue has significant impacts on our community and is driving increased inequity with Lakes DHB having a large Māori population…many of the patients on cardiology waiting lists are unable to work and this will be driving further poverty.”
A spokesperson for Waikato DHB stood by the assertion that no patients had been identified as coming to harm as a direct consequence of cardiology delays.
“Any instance where a patient is not able to receive care within a targeted time frame or the patient is inconvenienced can be considered suboptimal care; that does not necessarily lead to harm.”
Waikato DHB and the ministry say progress had been made on cardiology wait lists, with more staff recruited and an extra catheter lab opened. However, work had been set back by disruption from Covid-19 restrictions and, more recently, the cyber attack that crippled IT systems.
The latter meant Waikato DHB couldn’t give information on current wait lists. However, the ministry confirmed wait times are “longer than anticipated” for some patients.
A Lakes DHB spokesperson said the situation for its patients had improved over the last year, “and we are expecting further improvements this year”, with nobody currently outside the accepted four months waiting time.
Readers who have contacted the Herald about delays include the family of a man in his 70s who had a heart attack last November. He spent six days in Waikato Hospital ICU after contracting septicaemia, and his family was told he may not live past 48 hours.
He was discharged after 35 days, and was meant to see a cardiologist in February or March, said his wife, who asked not to be identified. After no contact, she phoned the DHB at the start of May, and he was booked for later that month. However, that was cancelled after the cyber attack, she said.
They see a community nurse regularly, but the couple is desperate to see a specialist, to know how damaged his heart is, and whether medication changes are needed. (After speaking to the Herald, they were contacted last week and given an appointment for the end of the month.)
“We have nothing but praise for the cardiologists and staff in ICU and the cardiac ward,” the woman said. “But the system is broken.”
A Waikato DHB spokesperson said feedback on the man’s situation couldn’t be given without knowing his identity. However, cardiology services were restored to near full capacity within 48 hours of the cyber attack.
“As this incident affected access to our records the DHB has been working to contact those people whose appointments may have been affected by the outage. We have encouraged patients to actively contact their GPs where they have any uncertainty, or to contact the DHB patient service centre if they have a query about their appointment.”
In April the Herald revealed Waikato DHB’s cardiac surgery service, a related but separate department to cardiology, was overhauled through 2019 and into 2020 after a secret review found major problems including gross understaffing and bullying had affected patient care. A “recovery programme” was widened to specifically include cardiology services, because of the backlogs.
Despite wait times still being an issue in some areas, the ministry now considers Waikato’s cardiology service “excellent”, and says the cardiac surgery service now “provides a very good service to the Midland region”.
• HELP US INVESTIGATE HEART CARE AT WAIKATO DHB
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