About 20,000 hospital appointments have been cancelled in the west and north-west in the past two weeks as a direct result on the cyber attack on the Health Service Executive’s IT system.
A total of 10,000 appointments were cancelled last week and a similar number was cancelled this week due to the lightning ransomwear attack by an international crime gang which occurred on May 14.
Some 1,500 appointments were cancelled daily in all the Saolta hospitals in the region which are located in Galway (UHG, Merlin Park, and Portiuncula ), Mayo, Roscommon, Sligo, and Donegal. About 900 of the daily cancellations were in UHG and Portiuncula hospitals.
The vast majority of the overall number of appointments cancelled were out-patient appointments. These schedules are set up months in advance. The remainder were for diagnostic tests such as CT and MRI scans, and endoscopy tests, in addition to some elective surgical procedures.
“Generally speaking, last week we got the urgent procedures done, we did some cancer surgery,” said Tony Canavan, the chief executive of the Saolta University Health Care Group which runs the seven public hospitals in the west and north-west of the country.
Cancer patients
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His biggest concern is the impact the cyber attack had and will have on patient care. He is worried most about cancer patients. “Cancer treatments are so time sensitive and so complex. These patients who are receiving treatment, particularly radiotherapy, are the group I am most concerned about. Patients’ history is very important in terms of treatment plans. When doctors do not have clinical records it is very difficult to deliver that care.
“When you look back at last week we only managed to send less than 10 patients to the Galway Clinic for radiotherapy, all the rest were deferred. This has a significant impact on patients and families. This week we intend to send more radiotherapy patients to the Galway Clinic. We are also sending cancer patients to St Luke’s Hospital in Dublin. But these are very small numbers, less than 10.
'We cannot put a timeframe on it as the situation is so complex. Our IT staff are working as hard as they can'
“All the time, we are trying to figure out when the [IT] system will be coming back up again and trying to balance it against getting treatment for patients wherever possible. It is not the right way to treat patients and it is an extremely worrying time for them and for clinicians. Everyone in the IT service is working very hard to come up with a solution.”
Speaking to this newspaper, the Saolta chief said some progress has been made in the three areas he was most concerned about, radiology, laboratory, and radiotherapy services.
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A “little” progress has been made in radiology services at UHG and Letterkenny hospitals which means that some radiology tests are going ahead. “These are limited but better than we had.”
Some further progress has been achieved in terms of laboratory services. The haematology department is operational at UHG, however it is only providing a “limited level of service”. Still, this is much better than previously, he said. “We are hopeful of making progress on radiotherapy services, soon.”
'There will be little incremental improvements on a daily basis over the next while. It may take weeks and weeks for the system to come back fully'
The disruptions at the local hospitals are likely to continue for some time. Mr Canavan, who took over at the helm of Saolta, which employs 11,000 staff, in September 2019, stated it is difficult to say when hospital services will be fully restored.
No timeframe
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“We cannot put a timeframe on it as the situation is so complex. Our IT staff are working as hard as they can. We’ve planned for the rest of this week - cancellations will continue until Friday. Then we will review the situation and plan for the following week.
“I think what is likely to happen is there will be little incremental improvements on a daily basis over the next while. It may take weeks and weeks for the system to come back fully. Once, we get back on track we have a plan to deal with the backlog [of appointments].
“Our emergency services are continuing to function as much as possible. If you have a genuine emergency you will be looked after and receive care. Outside of that, anything that isn’t emergency care, we are looking at very closely.”
The uncertainty regarding the duration of the crisis and the continuing fallout from it are a significant concern, according to the head of Saolta, which in addition to running public hospital services in the west and north-west, also has responsibility for the operation of the Covid-19 vaccination programme in these regions.
Mr Canavan said the longer this disruption continues, the greater the fallout in terms of delayed patient care and the likelihood of errors being made. These risks are accumulative. One involves the system of “manual workarounds” currently in operation in local hospitals. Information is now recorded on paper in the absence of an IT service.
“When you go in to the emergency department, for example, you register and this information is written on a piece of paper. This manual workaround is fine for a day or a couple of days. However, every day that goes by adds to the risk of a mistake being made in the information recorded.”
No Covid patients at UHG
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In terms of Covid-19 numbers, the Galway hospitals have good news to report. As of Tuesday morning, there were no Covid patients at UHG, there were four at Portiuncula Hospital in Ballinasloe.
“The number of Covid-19 patients in our hospitals is very, very low. Towards the end of last week, it crept up a small amount but it stabilised over the weekend.”
'Last week was a really busy week at the vaccination centres. This week will be a little quieter. The pace is driven by the availability of the vaccine'
The number of Saolta staff on Covid-related leave has stabilised, also. There are fewer than 300 employees absent currently across the whole group, 250 of these were on Covid-leave since the start of the pandemic in 2020. One of the reasons for this was because their underlying conditions places them at a particular risk of the virus.
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Meanwhile the Covid-19 vaccination programme is progressing well. The vaccination centres, which are located in Galway, Sligo, Letterkenny, Castlebar, Carrick-on-Shannon, and Roscommon have not been affected by the cyber attack, they have a separate and newer IT system.
More than 25,000 people were vaccinated in the west and north-west last week, which was the busiest week so far in the local centres.
“Last week was a really busy week at the vaccination centres,” said Mr Canavan. “This was the busiest week we have had in our centres. This week will be a little quieter but still the numbers will be high. In June it [the vaccine programme] will take off again. The pace is driven by the availability of the vaccine.
“We are still recruiting vaccination staff. We are interested in recruiting people during the summer months and are particularly interested in talking to medical and nursing students.”
