The Otago District Health Board is undertaking 200 extra colonoscopy procedures this year in response to concerns raised about access to colonoscopy in the province.

On Friday, the DHB received an audit of 33 patients referred for colonoscopy in the Otago region.

The DHB acknowledged the recommendations in the report and Chief Medical Advisor, Mr Richard Bunton, said that initiatives which addressed those recommendations were well underway.

The Southern Cancer Network audited the files of 33 patients referred by GPs over the last five years. The network indicated that the number of colonoscopies performed in the Otago district against the number of cancers diagnosed, was low
compared to the national average.

Otago DHB acknowledges that many of the 33 patients had prolonged journeys receiving treatment through the public system. "We regret that," Mr Bunton said.

However, the specific reasons for delay did not form part of the report. Each patient's whole case would need to be individually considered in order to understand why there were delays and whether this had an impact on the patient's outcome.

To answer this question the Otago DHB has offered, through the GP network, to meet with patients and families who gave consent for their notes to be used in this survey so it can address each individual's concerns.

A Gastroenterology Project Board, involving the DHB's clinicians, has been working on areas which needed to be addressed, including access to colonoscopy services in the Otago region.

In spite of limited resources, the DHB's own gastroenterology department, with support from their surgical colleagues, has agreed to complete an additional 150 procedures by the end of June this year, and the DHB will work with Southland
DHB to provide another 50 procedures.

That will mean the DHB as a whole will undertake around 700 colonoscopies in the 12 months to 30 June this year, instead of the 500 it performed in the previous year.

Mr Bunton said that the review was quite technical but provided good base information on which the DHB could act. "The number of referrals for colonoscopy has increased over the last six years and the district health board as a whole needs to support our clinicians to meet the demand," he said.

The Cancer Network acknowledged in its report that the patients surveyed were not necessarily representative of patients referred for a colonoscopy in the Otago region.

GPs put names of patients forward because they felt there were significant issues with the treatment of those particular patients.

The Cancer Network looked at the hospital and GP notes to determine the length of time between referral and diagnosis of each patient who consented to their notes being audited, and checked if, and when a colonoscopy was provided.

Mr Bunton said that the DHB had already put in place measures to perform an extra 200 colonoscopies by the end of June this year. "We are working on both short and long term initiatives," he said.

"Our gastroenterologists, with help from their surgical colleagues, have found a way to provide some extra clinics each
week, while we put in longer term measures to increase our capacity.

Their Southland colleagues have offered to undertake some procedures and I think that is a sign of what can be achieved if the two provinces work together."

Mr Bunton said that a range of measures were being undertaken by the DHB to provide a higher capacity for colonoscopies long term. "We are increasing staff numbers, working on re-organising the department physically, re-organising the administration systems and other support services," he said.

These are all issues raised in the Southern Cancer Network report.

Mr Bunton said that the gastroenterology team had been doing an excellent job with the resources available to them, and that the DHB as a whole needed to provide them with more resources, in order to increase capacity.