Need a scan? Get in the queue
On bad days, Ken Morris’ back pain is ‘‘bloody awful’’.
Morris, an auto-electrician, fell off a dining chair on September 20 last year and reactivated old back problems, which had been operated on more than four years ago.
He was referred to Capital & Coast District Health Board’s (CCDHB) radiology department for a MRI (magnetic resonance imaging) scan on November 6. He is still in the queue, with no date in sight.
Because Morris’ case isn’t deemed life threatening, and he is still able to work, Capital & Coast DHB put a ‘‘routine’’, or nonurgent, priority on his scan.
As he waits, Morris is trying to manage the pain himself, with the help of his doctor. He was prescribed diazepam twice a day.
‘‘Within the first two days of taking two a day, I nearly went to sleep at the wheel on two occasions.’’
Morris’ case is not unusual. In February, average waiting times were about five months for nonurgent MRIS, CCDHB said.
That is well short of the Ministry of Health target, which states 85 per cent of patients referred for non-urgent MRIS should be seen within six weeks.
CCDHB interim chief executive Ashley Bloomfield said a big increase in demand and staffing challenges were adding to waiting times – and other DHBS had the same problem.
Demand for MRI and CT (computed tomography) scans was growing at about 15 per cent every year, and ‘‘you simply can’t free up that space’’, he said.
‘‘We need staff to think carefully about which investigations they’re ordering.
‘‘Even if we deal with this waiting list, it will keep going up if we don’t address that demand.’’
CCDHB had 1.7 fulltime radiologist vacancies from a team of 18 fulltime positions, and 4.4 vacancies for radiographers and sonographers, from a team of 65.6 fulltime roles.
But at a board meeting on Wednesday, Bloomfield laid bare the extent of what he labelled ‘‘a nationwide problem’’ around radiologist shortages.
‘‘There are DHBS around the country that are really stretched. We seem to have a nationwide problem.
‘‘We really need to shift gear in terms of responding to this as a country.’’
Bloomfield is also chief executive of the Hutt Valley DHB, where he said there was ‘‘a real issue with the number of radiologists’’.
Hutt was down three fulltime radiologists, although waiting times were much better, with people waiting about a month for a non-urgent MRI scans, and roughly three weeks for CT scans.
Both the machines at Wellington Regional Hospital were new last year, and were meant to halve waiting times.
Instead, just 20 per cent of nonurgent referrals met the ministry’s target in January, and 30 per cent in February, Bloomfield said.
Several DHBS had ‘‘a significant number of vacancies’’ for radiologists, Bloomfield said. ‘‘The Waikato DHB is down 12 radiologists.’’
Acting Waikato DHB chief executive Derek Wright said there was ‘‘kind of worldwide problem’’ in growing demand for MRI scans.
‘‘As technology has developed and we become more sophisticated, you can now do more things with radiology, so the demand grows.’’
Wright said Hamilton found it difficult competing with Auckland as a destination for international recruits.
‘‘Sometimes we end up in a bit of a bidding war with some of the other DHBS and other countries.
‘‘The problem is this country only trains a few people a year, so there’s never going to be enough.’’
The number of radiologists in New Zealand has almost doubled since 2006, from 255 to 478 in 2017, according to Health Workforce New Zealand (HWNZ), which is a team within the Ministry of Health. HWNZ group manager Claire Austin said the team was continually reviewing the supply needs for present and future demands.
Radiologists had not been flagged as a vulnerable workforce but ‘‘we know things may change in the future’’, Austin said.
The ministry knew there was a high turnover in the profession, ‘‘especially among those newly qualified’’.
‘‘We’re looking at how we can better retain our key health professionals across a range of health provider types.’’
Tackling the problem in Wellington meant looking at whether the DHB could afford to run its MRI machines after hours and at weekends, Bloomfield said.
The cost of this was still being worked out.
A radiology demandmanagement group has been established and will meet every two weeks to pinpoint and plan for increased demand.
‘‘In the interim, we are continuing to outsource some [scans] to private to assist with reducing the backlog of patients waiting,’’ Bloomfield’s report to the board said.