Progress Made But National Collaborative Action Needed To Stabilize Oncology Workforces

The Health and Disability Commissioner has acknowledged the progress made since the publication of her Commissioner Initiated Investigation (CII) into Southern Blood and Cancer Services (SBCS) in April 2023.

In Morag McDowell’s addendum to the CII, released today, which looked into the responses from Te Whatu Ora Southern, Te Whatu Ora National Office and Te Aho o Te Kahu | Cancer Control Agency to her recommendations, she said these agencies had met the recommendations she made.

"Having reviewed the information received following the conclusion of my investigation, it appears that considerable work has been undertaken, in collaboration with Te Aho o Te Kahu|Cancer Control Agency, to make improvements to the service. However, it is evident that progress is greatly hindered by the difficulties in recruitment of the workforce, and the service has faced significant challenges since the publication of my report."

While acknowledging the work undertaken to date, Ms McDowell stressed the need for urgent collaborative action and a coordinated programme of work nationally to address the workforce challenges faced by SBCS and other cancer centres around the country.

Ms McDowell recognised that challenges facing oncology services in the Southern district are also being faced by other regions across Aotearoa New Zealand, particularly workforce shortages in radiation oncology.

"The issues faced by services in the Southern district are not isolated with cancer services across the motu facing similar challenges and I am encouraged by Te Whatu Ora’s commitment to instituting clear pathways for escalation of clinical risk nationally. It remains critically important that progress continues to be made and that patient safety remains the focus of actions taken," she said.

Ms McDowell acknowledged that until oncology workforces are stabilised and enhanced, there is no guarantee that patients will be seen and treated within appropriate timeframes and therefore there is no guarantee there will not be ongoing patient harm.

Ms McDowell noted Te Whatu Ora Southern had been active in seeking solutions to build the SMO workforce. "I am sympathetic to the disappointing outcomes of significant efforts to recruit radiation oncologists," She added that it was important to acknowledge that the constraints on the system are complex and will take time to resolve, but that she was encouraged by Te Whatu Ora’s focus on local and national recruitment efforts.

Ms McDowell was pleased by improvements made, in response to her recommendations, to the support provided to patients waiting for oncology care in the Southern District. This includes the implementation of a patient navigator service for those awaiting assessment. However, she took the opportunity to suggest further improvements that could be made relating to the information provided to people about their options for private care.

In her CII Ms McDowell found Te Whatu Ora Southern breached the Code of Health and Disability Service Consumers’ Rights (the Code) in relation to delays in the provision of non-surgical cancer services between 2016 and 2022.

"I remain concerned by the challenges faced by cancer services nationally, and the impact this has on people for whom care is time dependent.

"I am acutely aware that the incidence of cancer is increasing, and the introduction of advanced cancer treatment options is also placing further demands and pressure on cancer services nationally. The focus Te Whatu Ora and Te Aho o Te Kahu|Cancer Control Agency are placing on these issues is extremely important.

"I will continue to engage with Te Whatu Ora and Te Aho o Te Kahu|Cancer Control Agency on steps being taken to address these issues and those issues I see in complaints."

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