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Fears, frustrations and critical risks highlighted in report on Hawke’s Bay hospital

Published

3 years ago

September 12, 2023

Doctors have been grappling with mistrust around information entered into the IT systems at Hawke’s Bay hospital, including what it tells them about patients and critical scan results.

A newly released report has revealed 15 critical risks that assessors found in late June, before suspending the radiology department’s international accreditation in July.

It described reporting gaps which critical results about patient health had slipped through.

“The uncertainty of the delivery of [scan] reports was of particular concern for the radiologists, adding to their stress.”

“Mistrust” and frustration are mentioned five times in the short report by International Accreditation, or IANZ, released to RNZ.

Read the report: IANZ – Hawke’s Bay Surveillance Assessment, June 2023 (964K)
“There was an inherent mistrust of the system” among senior doctors, it said.

Staff “were overworked, tired and frustrated, and they have become fearful not of ‘if’, but ‘when’, a major incident of patient harm will occur”, it said – and indeed, there were documented cases of harm, it added.

One failing was that the radiology IT system and the clinical IT were not able to share critical results.

They were “not integrated” and “therefore reports are not automatically sent out”.

“Critical results are sent out via a manual process or a phone call if the referrer can be identified.”

But the system often failed to show which doctor had made a referral.

“There is no way to easily identify the referrer and unnecessary time is spent doing so.”

Referrals by GPs for a scan were having to be typed into the system.

The system was stabilised in May but problems persisted, it said.

Doctors were being forced to work after-hours to get scan reporting done.

Te Whatu Ora: two reviews into patient records
Te Whatu Ora was now randomly going through patient records in Hawke’s Bay to find any harm that had gone unreported.

The agency said a review of a risk register “did not find a significant number of harm events logged, and those which had been are all being investigated”.

But this was during a period of low reporting, it said, so it had begun a second review, this one of random patient records, to find unreported events of harm, or potential harm

Cases would be managed as they were found.

And once it had looked through a large enough sample, it would be in a better position to assess the rate of harm.

It said the concerns of the local community and radiology staff had been heard.

“Substantial work has been in place for some time to stabilise and enhance the reporting system, and this work will continue under a governance group,” it said in a statement.

Latest IANZ report adds to issues raised in earlier review and report
But poor reporting had harmed patients, IANZ said. At least four events were being investigated in August; RNZ has asked Te Whatu Ora for an update.

The IANZ report comes on top of a scathing external review in April of the district’s radiology, which Te Whatu Ora had kept under wraps for months.

Once it was forced to release the report in August, the agency then told the public all the risks were being dealt with.

The Minister of Health echoed this, saying the “immediate safety risks” at Hastings hospital (Hawke’s Bay hospital) had been addressed. She added the way IT was set up there, “is not present in other hospitals”.

However, an internal agency report last September about radiology reporting problems across the whole central region – from Hastings to Wellington to Whanganui – stated:

“The risks are alarming to read considering the serious nature and length of time they have been present.

“… these risks have been present for a long time in many districts in the region … The risks are present and we must address them.”

It listed failings that echoed Hawke’s Bay’s, including:

A “missing clinical result” from a scan; “delayed or missed communication of clinical result”; “reduced capacity/clinical capability due to lack of integration”; and “unavailability/poor performance of system”.

Hastings’ radiology system was upgraded in May 2023 and had been “stabilised” – and new rooms were being built for it – but the problems remained “unresolved” as of late June.

Similarly, Hutt Hospital’s radiology IT had just been upgraded, but was rated as “high risk” just last month by IANZ. Counties Manukau’s system was, too.

The mid-2023 IANZ assessment at Hastings said problems with its clinical IT portal “were common across other hospital services including Medical Laboratory and Cardiology”.

“Discussion with key staff indicated they were frustrated by the system and the lack of perceived engagement from IT to resolve the issues.”

On top of that, Hawke’s Bay was short of doctors and medical technicians, with vacancies worst for radiologists, the assessment said.

Cyclone Gabrielle’s impacts had made trying to recruit harder, the hospital told IANZ, when it pleaded in May 2023 for the assessment to be postponed. “We … cannot stress enough the impact that Cyclone Gabrielle has had,” it said.

IANZ went ahead anyway, finding that the staff shortages and IT woes had combined to present “several recognised and documented critical risk of patient harm issues … which remain critical even after controls were applied”.

The problems have added to the long wait lists for scans.

Routine scans have a six-week target to get done, but at Hastings this had blown out by midyear to:

2-6 months to get a CT scan
MR 2 months
Nuclear medicine 3-4 months
Community-referred ultrasound 3-4 months
Steroid injections up to a year
Fine-needle aspirations up to 5 months
The hospital continues to deliver radiology services.

Te Whatu Ora has repeatedly told the public that the “tireless work of our clinical staff” ensured the services were safe.

But the assessors in June reported back that “discussion with key staff identified low morale, staff were overworked and frustrated with inefficient workflow”.

The health agency did not mention frustration or mistrust in its media release about Hawke’s Bay’s suspension in July, though these featured in IANZ’s findings.

Te Whatu Ora was due to report back to IANZ last week on what safeguards it had put in place. RNZ asked for an update.

If it does not fix things properly within a year, Hastings will have its accreditation formally withdrawn, as happened recently to Palmerston North Hospital.

VIA RNZ

Latest News

Police say person who fired gun at officers still at large

Published

2 days ago

November 12, 2026

News Staff

Police say a person who fired a gun at officers in Napier is still at large.

Eastern District Commander Superintendent Joel Lamb said Police tried to stop a vehicle in the Pirimai Area at about 10pm on Tuesday.

He said someone in the back seat pointed what was presumed to be a firearm at officers pursuing the vehicle.

“Staff have then heard two distinct gunshots as the firearm was discharged.

“Fortunately, neither of our officers were injured, and the patrol vehicle did not sustain any damage.”

He said hours later, the vehicle was seen travelling north on the Waikato Expressway towards Auckland.

Police seized the vehicle at an address in Manurewa, but they had not found the alleged offender.

Lamb said people who lived at the Manurewa address were engaging with Police.

He said Eastern District and Counties Manukau Police were making enquiries.

“Presenting a firearm at a Police officer is a serious escalation that puts our staff and the wider community at risk. This behaviour is entirely unacceptable.

“We are taking this incident extremely seriously and will be pursuing all lines of enquiry to locate the offender and hold them accountable.”

Police asked anyone who witnessed the incident to contact Police on 105 or online using the reference number 261111/3764.

Information could also be provided anonymously via Crime Stoppers on 0800 555 111.

rnz

Latest News

New Zealand sides named for RLWC finals

Published

3 days ago

November 11, 2026

News Staff

The players tasked with ending Australia’s Rugby League World Cup dominance have been named.

The Kiwis and Kiwi Ferns have announced their squads for this Sunday’s World Cup finals in Brisbane.

Both sides are chasing their first titles since 2008, and both are looking to end their opponents run of three crowns in a row.

“Our Kiwi Ferns have been so dominant in years gone by, and we want to bring dominance back to this jersey, so I think it will be a case of who wants it more,” said co-captain Georgia Hale of the impending clash.

The Kiwis get a major boost for the final as they welcome back Ronaldo Mulitalo after he served a one-match ban for a high tackle against Fiji Bati.

Mulitalo replaces Charnze Nicoll-Klokstad, who moves to the six-man bench, which again includes utility Te Maire Martin, middle forwards Naufahu Whyte, Erin Clark and Xavier Willison plus fullback Keano Kini.

Loose forward Joseph Tapine will make his 30th Test appearance in a familiar pack again, including second-rowers Isaiah Papali’i and Briton Nikora, and props James Fisher-Harris and Moses Leota.

Winger Jamayne Isaako is on the cusp of claiming the New Zealand record for most Test points.

His five goals against Tonga lifted his career points tally to 225 – level with Shaun Johnson – while centre Casey McLean goes into the final with 16 tries in just eight Tests.

Fisher-Harris will again captain the team.

Fullback Ponga said the goal of the group was clear.

“We have high expectations around what we want to achieve, and obviously winning a world Cup is one of them.”

Meanwhile, Ricky Henry has selected a settled side to take on the Jillaroos, led by their lethal centre combination of Stacey Waaka and Mele Hufanga.

Veteran Apii Nicholls takes the number one jersey, Leianne Tufuga and Mackenzie Wiki on the wings.

Henry has stuck with his halves pairing of Chantay Kiria-Ratu and Raecene McGregor with Alexis Tauaneai, Georgia Hale and Otesa Pule up front.

Rounding out the starting pack is Shaniece Monschau, Kaiyah Atai, and Angelina Teakaraanga-Katoa.

“We have been building well throughout the tournament; we understand the Jillaroos side, and will give it our all to make New Zealand proud this weekend,” said Henry.

RLWC Finals:

Kiwi Ferns vs Jillaroos- 6.10pm

Kiwis vs Kangaroos – 9.35pm

Sunday November 15

Suncorp Stadium, Brisbane

Live blog updates on RNZ

Kiwi Ferns:

1. Apii Nicholls 2. Leianne Tufuga 3. Mele Hufanga 4. Stacey Waaka 5. Mackenzie Wiki 6. Chantay Kiria-Ratu 7. Raecene McGregor 8. Alexis Tauaneai 9. Georgia Hale 10. Otesa Pule 11. Shaniece Monschau 12. Kaiyah Atai 13. Angelina Teakaraanga-Katoa.

Interchange: 14. Ashleigh Quinlan 15. Annessa Biddle 16. Shannon Mato 17. Ivana Lauitiiti.

Reserves: 18. Brooke Anderson 19. Zahara Temara 20. Brianna Clark 21. Abigail Roache 22. Tenika Willison.

Kiwis:

1. Kalyn Ponga, 2. Jamayne Isaako, 3. Dane Gagai, 4. Casey McLean, 5. Ronaldo Mulitalo, 6. Kodi Nikorima, 7. Jahrome Hughes, 8. James Fisher-Harris (c), 9. Jeremy Marshall-King, 10. Moses Leota, 11. Isaiah Papali’i, 12. Briton Nikora, 13. Joseph Tapine (v/c).

Interchange: 14. Te Maire Martin, 15. Naufahu Whyte, 16. Erin Clark, 17. Xavier Willison.

Reserves: 18. Keano Kini, 19. Phoenix Crossland, 20. Charnze Nicoll-Klokstad, 21. Scott Sorensen, 22. Leo Thompson.

rnz

Latest News

Parliamentary Service working on extra chairs and offices for increased number of MPs

Published

3 days ago

November 11, 2026

News Staff

The chief executive of the Parliamentary Service is confident there will be enough room to accommodate the increased number of MPs and their staff coming into Parliament.

On current numbers, up to 131 MPs could be sitting in the Chamber following the election, brought on by a record overhang result.

Clerk of the House of Representatives Dr David Wilson told the Spinoff that currently the debating chamber had enough chairs to seat 124 MPs – including the Speaker of the House – and work was being done to accommodate more by altering the seating arrangement.

In a statement, Parliamentary Service chief executive Rafael Gonzalez-Montero said planning for a larger Parliament had been going for “some time”.

“Now that the election results have confirmed an increase to the number of members we are looking at several options.

“We are confident we will be able to accommodate all members within the Chamber.”

Chief Executive of the Parliamentary Service Rafael Gonzalez-Montero appears before select committee. — Parliamentary Service chief executive Rafael Gonzalez-Montero.

VNP / Phil Smith

Gonzalez-Montero said office accommodation for members and their staff would be “stretched” for a short time, but the new Members’ Building was only a few months away from “practical completion”.

That building – located behind Parliament – was due to be ready to occupy in April next year and had capacity to accommodate around 30 backbench MPs.

“All members should be in fit-for-purpose accommodation from that point,” Gonzalez-Montero said.

Following the 2023 election, 123 MPs sat in the Chamber – a record number at the time. That decreased to 122 following the resignation of National MP Judith Collins.

Collins held the seat of Papakura and stepped down in May and Parliament voted against holding a by-election because it was too close to the election.

The election result also meant high-ranking National Party MPs like Chris Bishop, Paul Goldsmith, Nicola Willis and Gerry Brownlee – Speaker of the House and an MP for 30 years – would likely not make it back into Parliament.

Only resigning or retiring MPs were permitted to give a valedictory speech meaning none of them would get the chance to give a valedictory statement.

Asked if their would be special allowances for valedictories, Wilson said in a statement that normally only MPs were allowed to speak in the House but the House could suspend its own rules or temporarily alter them.

“It could do so to allow former members to address the House.”

Wilson said no such arrangements could be made until the next Parliament opened and members sworn in.

rnz