The major disruption to local hospital services caused by the recent cyber attack on the HSE’s IT system is expected to continue for a number of weeks with thousands of patients facing cancelled appointments and delays.
However, progress has been achieved in restoring three of the key hospital systems, radiotherapy, radiology, and laboratories but it is too early to say yet when hospital services will return to normal.
There are hundreds of different IT patient systems in the Saolta University Health Care Group which runs the seven public hospitals in the west and north-west in Galway, Mayo, Roscommon, Sligo, and Letterkenny (there are 2,000 different IT systems in the HSE ). Tony Canavan, the chief executive of Saolta, says having so many different systems is a “weakness in itself” and means that it will “take a lot of time to have them up and running."
30,000 appointments cancelled
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About 30,000 hospital appointments have been cancelled in the public hospitals in the west and north-west since the lightning ransomwear attack occurred on May 14.
The majority of these are out-patient appointments and mainly affect people from Galway, south Co Mayo, and south Co Roscommon. Some patients from Donegal, Sligo, and Clare are also impacted by the cancellations.
Mr Canavan, who heads up the hospitals at UHG, Merlin Park, Portiuncula, Mayo, Roscommon, Sligo, and Letterkenny, says he cannot confirm when all the hospital services will be restored.
Uncertainty
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“I still can’t say for sure that in three to five weeks [for example] the IT situation will be sorted. Part of our difficulty is not knowing. We can only go from week to week.
“The [most recent] plan we put together was in place until Wednesday (yesterday ) and it was reviewed then. That original plan involved the cancellation of all out-patient appointments, all out-patient diagnostics (X-rays, CT, and MRI scans ), appointments associated with endoscopy as well as the cancellation of appointments for people coming in for elective surgical procedures. Essentially, what we are saying is: Your appointment is cancelled unless you hear from us by telephone.”
“We will assess where we are at now and make a plan for the long weekend, until Monday. I hope our plan will change, that we will get more functionality back into the system to allow us to bring more patients in, to re-open our out-patient department in the near future.”
Progress
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Mr Canavan, who took over as Saolta chief in September 2019, said the good news is that progress has been made in three key hospital systems. “These were radiotherapy, radiology, and laboratory – three systems that were really important to get up and running.”
One of the top priorities, radiotherapy, was restored on Wednesday last. “That was one of our key areas, one of our priorities. We are able to treat patients now, we are more or less able to provide care to all patients.”
The only outstanding issue in this regard is connectivity with other hospitals. “One of the limitations is while we can get radiotherapy working in our hospitals, we cannot transfer information from our hospital to another.
“Usually, patients receive radiotherapy in the west but sometimes they may require some other inpatient treatment for their cancer and we would send them to Beaumont or the Mater hospital in Dublin. We cannot transfer that information from our hospital to another. That’s one of the difficulties we have, the limitations for radiotherapy, and we hope it will change.”
Radiology services
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Radiology services are working but not on all hospital sites. There are some problems with the system at Mayo University Hospital but it is working well in the Galway hospitals, UHG and Portiuncula in Ballinasloe.
Mr Canavan says however, the system is limited, it is not available on every computer in every ward. “But it is working and we hope that in the other hospitals we will have it up and running in the near future.”
The third service that Saolta was keen to restore following the cyber attack was its laboratory system. “It is not fully functional but it is working to a degree”. This is the case for both UHG and Mayo University Hospital. The service is “very limited” at Portiuncula Hospital but the Saolta boss expects the issue to be sorted out in the next couple of days.
'Our processes in hospital are better now than before Covid-19. We are moving patients quicker than before'
He says “phenomenal” work was done to get to this point and there was major co-ordination at both local and national level to achieve this overall progress.
While Saolta sent fewer than 10 high priority radiotherapy patients to the Galway Clinic the week before last, it has not made any additional use of its services. It arranged to send eight cancer patients to St Luke’s Hospital in Dublin but on the day they were due to travel the radiotherapy service was restored at UHG which was “brilliant”, says the CEO.
Emergency Department
Meanwhile the emergency department at UHG was “extremely busy” this week after a 25 per cent drop in attendances in the week following the cyber attack. This reduction in numbers was recorded across the Saolta group.
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“At the time we were asking people not to use our emergency departments, if possible. In the second week [following the attack] and now, all our EDs started to pick up again. The numbers this week are comparable to 2019.”
However, despite the high attendances, the number of patients awaiting admission on trolleys is quite small. Mr Canavan attributes this to “better processes” and the increased availability of stepdown facilities which means patients no longer requiring acute hospital beds can be transferred there.
“Our processes in hospital are better now than before Covid-19. We are moving patients quicker than before. The level of support in the community is a lot greater than two years ago, too. There are more stepdown beds in the community, in the last month stepdown beds were opened at St Brendan’s Community Nursing Unit in Loughrea. That is helping. Also, there has been an increase in the amount of home help hours and funding, this is quite considerable.”
