In the aftermath of the pandemic, there are many regions that are unable to treat all the patients for whom they are responsible. The hospitals in the Västerbotten region are no exception, where the focus is on operations, says VK .
It is mainly the lack of staff, especially nurses, both in the nursing departments and in the surgical teams, that causes the waiting lists to grow. The number of patients who are treated outside the region is increasing, at a cost of almost 266 million kronor last year.
– The staff available today is only sufficient for emergency surgery, cancer surgery and other high-priority medical groups such as advanced vascular surgery, says Lena Svensson, accessibility strategist for the Västerbotten region.
If a patient has been promised an operation after a medical assessment, it must be carried out within three months, according to the care guarantee. If this is not possible, the Region Västerbotten is responsible for referring the patient to another care facility. In Västerbotten, it is the clinic where the patient is waiting that must be contacted to start the process.
This takes time and resources, so in order to relieve the clinics, an administrator has been hired to work with care guarantee issues. Claudia Kerttu has been working since January this year, looking for care options in other regions or with private care providers when the clinics ask for help. She is also responsible for helping the public understand how patients should proceed to take advantage of their care guarantee.
– It is important that patients know about the guarantee of care and that the responsibility lies with the clinic where they are waiting in line. I help them to know who to contact and where to go, says Kerttu.
The clinics that are most affected and send the most patients out of the region are the orthopedic clinic, the surgical center and the women's clinic.
–The situation is serious, but sending patients elsewhere is the only way to somehow fulfill the mission we have. But having to send patients away is bad for everyone, for Nus, for Norrland, and not least for the taxpayers, says Urban Arnelo, operations manager of the surgery center.
As the situation stands today, the surgical center is basically only able to operate on patients with a cancer diagnosis and advanced vascular surgery. What is sent elsewhere is mainly cancer treatment.
– Other patients may also be very sick, but have to wait, while cancer diagnoses and advanced vascular surgical procedures cannot be postponed, says Elsie Strömmer, deputy operations manager of the surgery center.
Not all patients can be referred. They must not be too sick or have other underlying conditions, because many providers do not have beds or access to intensive care or post-operative care.
The orthopedic clinic has the longest queues and has basically stopped performing scheduled surgeries. By the end of May this year, they had referred 241 patients, which is much more than in previous years.
– Last summer, we began to notice that the lack of nursing stations and operating rooms was making it more difficult than ever to perform surgeries, and this has continued throughout the year. This spring we have had access to a few more operating theatres, but there is still a lack of care places, and then it becomes difficult to manage, says Lisbeth Brax Olofsson, operations manager at the orthopaedic clinics in Umeå and Skellefteå, center for movement organs.
The clinic in Nus is relieved by the fact that the hospitals in Lycksele and Skellefteå perform standard operations. The orthopedists in Umeå perform many of these operations, especially in Lycksele. They also have access to operating theaters at Capio Sports Medicine and the specialist hospital in Umeå.
– Things are going well there, and the waiting time is approaching three months, but it is very difficult at Nus when we have seriously ill patients in the queue who can develop serious complications during the waiting time, which means that we have to operate on them urgently. Then the operations become much more difficult, and unfortunately we have to say no to referrals from the surrounding regions in Norrland, both urgent and planned operations, says Lisbeth Brax Olofsson.
Since Nus is a regional hospital, they also have to accept patients from Norrbotten, Jämtland and Västernorrland, which together with Västerbotten make up the Northern healthcare region.
– We try to take care of them as much as possible, but if we can't do it within the care guarantee, we refer them on. The problem is that the other regional/university hospitals in the country are in roughly the same situation, says Svensson.
The current situation requires increasingly strict priorities and creates a lot of frustration, says Arnelo, which can affect the mood between different groups of staff.
– Our nurses and nursing assistants are working as hard as they can, while at the same time doctors are trying to operate on patients, and the puzzle isn't fitting together, he says.
They work hard to find staff, and he suggests, for example, that perhaps they should start training their own nurses' aides and nursing assistants and look abroad for staff.
– Then everyone in public care needs an old-fashioned summer vacation. Now that there is a crisis, the same people who are working are being paid to work during the holidays, but everyone needs a break, says Arnelo.
Brax Olofsson sees a better future. The cooperation with the hospitals in Lycksele and Skellefteå is working, and they are currently recruiting staff for their own orthopedic unit, which is scheduled to start in the fall. The hope is to have two operating theaters for planned operations at Nus.
– We want to take care of our patients here in Umeå, and research shows that patients recover faster when the entire care chain is in the same place. There is a lot to do here at our fine university hospital, and we are working hard together, she says.