A NUMBER of commitments made in advance of the transfer of breast cancer services from the South Infirmary Victoria University Hospital in Cork to Cork University Hospital (CUH) had not been met six months after the transfer took place, according to a report published yesterday.
A review carried out by the Health Information and Quality Authority (Hiqa) in June found that the Victoria hospital was due to provide an outreach medical oncology service, like at Kerry General Hospital, but this was not in place.
In addition extra capacity for the centralisation of symptomatic breast cancer services was to be facilitated by the transfer of ophthalmology services out of CUH to another facility. However, at the time of the review this had not happened resulting in day and inpatient accommodation and theatre services for breast cancer patients being provided in different areas, rather than in one unit, within the CUH campus.
Hiqa’s review, published yesterday, also draws attention to governance and operational management issues following the centralisation of services which needed to be addressed. It noted there were “competing demands” between symptomatic breast disease surgeons working in CUH while concurrently providing their contractual commitment to elective and emergency surgical on-call cover at the Victoria hospital.
It also found a large variance in the number of patients seen per sessional commitment of individual consultants. “This suggests that there may be a possible variation in the quality of service provided to individual patients.”
Some 1,964 new patients were seen at the symptomatic breast cancer services at CUH between January and June this year and 103 new cases of breast cancer were diagnosed.
More than 1,200 of the new patients were non urgent referrals and all were seen within the recommended 12-week timeframe and 95 per cent of the 700 or so urgent referrals were seen within the recommended two weeks laid down in Hiqa standards.
As a result of the establishment of the mobile BreastCheck unit in Waterford in July 2009, there had been an increase in patient flow to CUH that had not been previously accounted for, the report said.
It added that theatre and medical oncology services “did not have the full complement of staff required for the volume of patient activity seen”. Medical oncology staff highlighted difficulties in finding sufficient time to deliver personalised care to patients.
But Hiqa concluded that CUH overall had in place the core requirements for quality and safety of services, including triple assessment clinics.
There will be a follow-up review early next year and the report says the HSE had responded with a plan to address the issues.