Ontario home-care patients and their nurses continue to report shortages of vital medical supplies despite repeated assurances by the provincial agency responsible for in-home care that it is 鈥渄oing everything鈥 it can to address the crisis.
For more than two months, patients who receive medical care at home, and doctors and nurses who provide that care, have been reporting that shipments of supplies they need for treatment have been delayed, incomplete or aren鈥檛 showing up at all when needed. These include catheters, drainage bags, pain pumps, syringes and pain-relief drugs.
Penny Moore, a home-care patient in London, Ont., says a shipment of supplies for her permanent catheter was supposed to arrive last week, but when the package arrived, the catheter wasn鈥檛 included.聽
鈥淢y home-care nurse says I cannot get it replaced until the next order in two weeks, which puts me at risk of getting another infection,鈥 said Moore, 61, who uses a wheelchair and has required a catheter for eight years.聽
In October, Moore had to be hospitalized after the catheter system she was using from Bayshore Specialty Rx, one of the new provincial distributors, backed up into her kidneys, causing spasms in her bladder.聽
鈥淚 was in so much pain because of the infection,鈥 she said. 鈥淚 felt like I was in labour.鈥
The lack of timely deliveries continues a pattern Moore says she began to notice after the provincial government changed the way home-care supplies are distributed to thousands of patients across the province in late September.
Under the old system, local suppliers, such as pharmacies and smaller medical supply companies, serviced areas that roughly coincided with the province鈥檚 14 former Local Health Integration Networks (LHINs). The new structure now has two master service providers, Cardinal Health and Ontario Medical Supply (OMS), as suppliers, and four companies 鈥 OMS, Bayshore Specialty Rx, Shoppers Drug Mart and Robinsons 鈥 responsible for distribution.
Industry sources previously told the Star that the “provincial formulary,” a list of supplies and medications needed for home care, wasn鈥檛 finalized by the province until just before the new procurement and distribution system launched in September, and that the forecasts for quantities of supplies were too low to meet demand.
Neither Cardinal Health nor OMS responded to the Star鈥檚 requests for comments. Bayshore Speciality Rx referred all questions to Ontario Health atHome, the provincial agency responsible for in-home and community-based care.
In an emailed statement, Ontario Health atHome said it continues to make 鈥渕eaningful progress鈥 in improving the distribution of medical equipment and supplies.聽
The agency said it has successfully implemented a 鈥済eographic redistribution鈥 of some medical supply volumes, 鈥渢o better serve patients, and their families, closer to home鈥 in Ontario鈥檚 southeast, and that it is continuing to review distribution processes and the formulary聽鈥渢o identify and implement any, and all, changes that better align with the needs of patients and providers.鈥澛
鈥淭his includes updates to the formulary as recently as last week based on advice from our patients, partners and clinical experts,鈥 the agency said, adding that its focus remains on 鈥渆nsuring patients receive the medical supplies they need, on time, and as ordered.鈥
One home-care nurse in York Region who spoke to the Star on the condition of anonymity out of fear of being reprimanded by their employer said 鈥渢he majority of stuff we order is still out of stock.鈥
鈥淚 just put in an order yesterday and I got a message today saying four out of the 10 items I ordered are out of stock and not replaced with anything,鈥 the nurse said, noting that getting wound-treatment supplies, such as foam dressings, tape and cleaning solutions, remains challenging.
The quality of many supplies, including bandages, wraps, catheters and drainage bags, has also dropped since the changeover to the new distribution system, the nurse added.
Moore concurs, saying the drainage bags she has been receiving for her catheter recently are smaller and don鈥檛 drain properly.聽
鈥淚 wake up in the morning and the spout for draining it into the toilet slides right off, so you have urine all over the floor,鈥 she said, adding that the new bags are so thin that if she goes outside in the cold, they freeze and split.聽
Ontario Health atHome says it will reimburse any patient, caregiver or family member forced to pay out-of-pocket for medical supplies since Sept. 24, the day the new distribution system came into effect.
But for Moore, who is on ODSP, that is not a solution.聽
鈥淚 don鈥檛 have the money to pay for the bags ahead and then submit it and wait for my money to come back,鈥 she said.聽
Doris Grinspun, CEO of the Registered Nurses鈥 Association of Ontario, says nurses are bearing the brunt of patients鈥 frustrations over the supply shortages.
鈥淧icture this. You鈥檙e going to take care of a patient. You don鈥檛 have the correct supplies, and the patients, it鈥檚 not their fault, but who do they take out their frustration on? The nurse,鈥 Grinspun said, adding that she has been assured by the health ministry and Ontario Health atHome that they are committed to fixing the situation. But she lamented that home-care nurses and those who operate home-care businesses were not consulted more on the new distribution system.聽
鈥淲hat is sad is that this was preventable.鈥
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