How a man's aggressive cancer likely spread after delays at Nelson Hospital

A review by Health New Zealand has found a Nelson man suspected of having aggressive cancer was seen later than less urgent patients, likely causing the cancer to spread.

Hospital bosses have apologised to Daniel Walker who was meant to be seen within two weeks and instead waited nine.

It was discovered he had testicular cancer which spread to his abdomen, requiring chemotherapy and major surgery which may not have been needed if he'd been seen on time.

The Nelson dad said the delay in 2024 and the extensive treatment dramatically impacted his life.

"It basically caused the cancer to spread... for me, life will never go back to normal," Walker said.

It was initially thought a change in wording on the referral was to blame for the delay in Walker being seen. But a review by Health New Zealand has found that wasn't the case – rather, there were a range of issues at play.

At the time that Walker was referred to the urology department the review said, "the number of patients on the list was beyond service capacity to manage within the expected timeframe".

"The referral was prioritised as urgent, and it was triaged as high suspicion of cancer and put on the two-week waitlist," the review found.

But around this time, a super clinic was held where doctors were flown in to help deal with the backlog of patients in the urology department.

That meant, in Walker's case, he "was not re-prioritised when a large number of additional patients were added to the list". As a result, the review found patients "with a lower clinical priority are likely to have been seen ahead of Daniel".

That part of the report was particularly difficult for Walker to read.

"It clearly states in the report I got lost in the shuffle. I shouldn't have got lost in the shuffle. If you're making a decision to do all of these scans and do a super clinic why are you not planning on how these results are prioritised and seen?" he said.

It was also found the staff making the bookings had no clinical knowledge which meant they weren't able to re-prioritise patients.

Nelson Marlborough Interim Group Director Operations Jo Gibbs says the hospital was still digesting the review but accepted all of the recommendations.

"I've met Daniel a couple of times now. He's an incredible person and certainly I've taken the opportunity to apologise to him".

Among the recommendations of the review was for the department to have a process to escalate situations where urgent patients weren't seen on time. It should also ensure that better processes were put in place so the most urgent patients were seen first.

Nelson Marlborough Interim Chief Medical Officer Derek Sherwood said clinicians prioritised the most urgent cases, but clearly with Walker's case that didn't happen as it should due to the volume of patients.

"We've already made steps to make sure that there's much greater visibility of when those urgent patients are waiting too long and allowing us really to put on measures to try and remedy that quickly".

The urology department faced staffing issues on and off since 2021, as highlighted in a 1News investigation last year.

Urologist Dr Suzanne Beuker said extended periods of leave often haven't been covered and that meant many patients have waited longer than they should to be seen.

"Certainly I have seen patients that I believe their disease has gone from curable to incurable during that waiting time," she said last March.

At the time, Nelson Hospital had the worst wait times in the country and an extensive review sparked by the 1News investigation found "significant" staffing issues.

Sherwood says progress is being made within the department. "We're using the resources of Canterbury to provide some support for the service here but also actively recruiting," he said.

Walker is currently cancer free and has informally began advocating for others who are struggling to navigate the health system.

While life has on the surface returned to normal, Walker says he's still dealing with physical and mental impacts of the cancer treatment.

He says he's tens of thousands of dollars out of pocket from that time in his life because of things like taking out his Kiwisaver and taking annual and sick leave from work. Walker would like Health New Zealand to compensate him for this, though Gibbs says that is looked at on a case by case basis.

Walker said going through the review process was difficult, but he felt everyone involved wanted the system to improve.

"I'm proud that while I had to go through all of that, what came out of it and what it could do to help other people is a very humbling experience for me," he said.

When asked if he was confident others won't go through what he did, Walker said: "I think it's a work in progress. I think in an ideal world we'd like to get to that right now. I think I've at least started the process."