The man was admitted to Dunedin Hospital four times between April 2018 and October 2019. Photo: RNZ / Nate McKinnon
A man who met the criteria to be urgently seen for a colonoscopy ended up waiting for three months, and was later diagnosed with bowel cancer.
Health and Disability Commissioner Morag McDowell found Southern District Health Board, now Te Whatu Ora Southern, breached the code of health and disability services consumers' rights in the man's case.
The man was admitted to Dunedin Hospital four times between April 2018 and October 2019 and was scheduled for a colonoscopy 12 weeks after his second admission. The eventual colonoscopy and subsequent biopsy revealed he had colon cancer.
The man's symptoms and history met the health board criteria and Ministry of Health referral guidelines for an urgent colonoscopy within two weeks.
McDowell said the 12-week wait exceeded the health board's own recommended timeframe and the ministry's guidelines by at least six weeks.
It was possible the low urgency was a result of relying on a normal result from a previous colonograph. In light of this, the commissioner's independent surgical advisor said the request could have been prioritised under a six-week timeframe.
McDowell acknowledged the pressures faced by colonoscopy services across the country due to an increase in demand, along with workforce shortages and recruitment challenges.
"However, it is my view that when investigations are clinically indicated as urgent, or semi-urgent, healthcare consumers have the right to expect them to be scheduled sooner than occurred in this case.
"A timely diagnosis can be particularly important for reducing morbidity and mortality for cancer patients, and often it is a key factor in survivability.
"Long waits for diagnostic procedures can also have a significant psychological impact on patients and their whānau who may be concerned that they have cancer."
There were no other breaches of the code in relation to other aspects of the man's care, but McDowell noted the concurrent use of anticoagulant medication and the lack of clarity in the discharge advice about anticoagulation.
She said Te Whatu Ora Southern had taken actions to address restricted access to colonoscopy services, including commissioned external reviews.
She was satisfied the problem had been addressed but would continue to take a close interest in the service and keep an eye on the pattern of complaints.
McDowell recommended Te Whatu Ora Southern provide the man and his whānau with a written apology, consider providing a checklist of anticoagulation advice on discharge, and report back to the commission on current colonoscopy wait times and any actions to address delays if they are outside expected timeframes.