Capacity issues highlighted at NCCP meeting

The National Cancer Control Programme executive management team (EMT) has discussed continuing capacity deficits in the delivery of systemic anti-cancer therapy in a number of hospitals.

The EMT meeting in November 2022 heard there were capacity issues in the following sites: St Vincent’s University Hospital (SVUH), Dublin; Cork University Hospital (CUH); South Infirmary Victoria University Hospital (SIVUH), Cork; University Hospital Waterford; and University Hospital Galway (UHG).

SVUH was awaiting approval from HSE Estates for funding to extend the day ward to increase the number of chairs, according to the meeting minutes.

There was also a fall in key performance indicator (KPI) metrics due to capacity issues in CUH. This was “the result of an ACU [aseptic compounding unit]/compounding issue in the unit”.

A “slight decrease” in KPIs in UGH was also due to capacity issues, the meeting heard. In addition, there were “data gaps” in relation to KPIs in St James’s Hospital, Dublin; Letterkenny University Hospital; and SIVUH.

During an earlier discussion on ‘cancer intelligence’ and the related KPI report, the meeting heard that the “situation remains challenging in UHG”.

“[The] recruitment and retention of radiographers was highlighted as a particular challenge,” stated the minutes.

In relation to CUH, the breast cancer KPI was “progressively improving”, while for prostate cancer, overall KPIs had returned to normal. However, the situation at CUH was “particularly challenging”.

“Issues of manpower and process are under review,” according to the minutes.

The meeting heard “the main issues for radiation oncology services generally continue to be staffing and capacity”. Work was ongoing to address these matters. It was noted that a national review of radiation therapists was due to commence in the coming weeks.

Meanwhile, concerns over the impact of “loss of experienced staff” in cancer care were raised at a HSE meeting in October.

The meeting of the HSE safety and quality committee heard about the recruitment difficulties within the area. In relation to cancer care, HSE Chief Clinical Officer Dr Colm Henry told members that “the loss of experienced staff and difficulties in recruiting new staff is impacting on services and may be adding to capacity challenges”.

A HSE spokesperson told the Medical Independent that the referenced loss of staff and recruitment challenges were “not limited to consultants”.

“[It] is across the board in terms of doctors, nurses, radiation therapists, pharmacists, radiographers, medical laboratory scientists, and others,” according to the spokesperson. “This is not unique to cancer services or Ireland. Recruitment of skilled staff across these roles is a priority.”

Separately, the operation of the National Cervical Screening Laboratory (NCSL) was also discussed at the meeting.

The new NCSL at the Coombe Hospital in Dublin began processing CervicalCheck samples in December.

“The current staffing level at the NCSL is appropriate given the throughput of samples being processed,” said the HSE’s spokesperson. “The Coombe Hospital has recruited 11.9 additional whole-time equivalent (WTE) staff for the NCSL, including the role of Director, and Lead Pathologist for Cervical Cytology, with 5.3 WTE posts under recruitment.”