Delays in medical supplies are disrupting home care across Ontario

A Newmarket woman says home care for her husband, who is in palliative care with stage 4 cancer, has been disrupted by delays and shortages across Ontario of home and palliative care services.

Patti Moss is a full-time caregiver for her husband, Steven Clark. When they started in-home care in August, she said everything went smoothly.

“It was an incredible service,” she said.

But last month, Clark’s nurses began reporting they were having trouble getting the right supplies. On September 24, Ontario Health atHome launched new supply contracts for the delivery of medical supplies.

Since then, Moss says some critical supplies have stopped coming.

In one case, after a round of chemotherapy in October, the hospital ordered Clark to be hydrated for three days, but by the second day nothing had arrived. Clark’s home care nurses borrowed hydration supplies for him from other patients, Moss said.

The delays have caused anxiety and stress for her entire family, especially her husband.

“The nature of his diagnosis means he’s always worried about us and what the future holds for us,” Moss said. “This has created a new level of worry for him.”

The situation is unacceptable, says the Minister of Health

Dying people can’t get sedatives and patients are going to the hospital because their supplies have run out, county doctors say.

Health Minister Sylvia Jones said on Monday that she and her ministry are working hard to rectify the “frustrating” situation, calling it “absolutely unacceptable.”

“We have worked with Ontario Health atHome to ensure that no patient, no patient family, no physician is affected by a logistical problem,” she said.

In a statement, Ontario Health atHome said it is doing everything possible to stabilize the supply of critical medical supplies.

“Ontario Health atHome takes any impact on our patients very seriously, and we understand the distress this causes,” the agency said.

Jones said she has directed the agency to reimburse any patient, family or physician who paid out-of-pocket for the necessary equipment.

But Moss said there is no plan or logistics behind the claim, including how the government will investigate the receipts or where the receipts should be submitted.

“People are being left behind in these decisions being made by the government and that is unacceptable,” she said.

On his websiteOntario Health atHome says it is aware that some patients have experienced issues with the distribution of medical supplies, adding it will reimburse any patient, caregiver or family member who has paid out of pocket for medical supplies due to supply issues.

People are buying medical supplies on Amazon, doctor says

Dr. Joyce Cheung, president of palliative medicine for the Ontario Medical Association, said palliative care physicians across the province have raised concerns about medications and supply delays that have sent patients to emergency rooms, and a lack of medications and needles that cause people pain.

One of her palliative care patients went 30 hours without a pain pump, she said, and another patient with metastatic cancer was running out of ostomy bags to collect stool.

“I don’t know what to do,” she said. “Are people buying supplies from Amazon when we can’t validate the quality of these supplies? We’re hearing these stories. They’re happening in every corner of the province.”

Moss said she knows other healthcare providers who buy supplies on Amazon, but she refuses to do the same.

“This is a service I signed up for, this is something I paid for in taxes,” she said.

The province passed legislation late last year to create Ontario Health atHome to better coordinate home care across the province. Cheung said physicians were not part of any transition planning when the agency switched to new providers this fall.

“We were all surprised,” she said. “We’re like, ‘What’s going on?’ We just see what’s happening on the ground, and we don’t even know how to turn because we didn’t realize this was going to be such a disaster.”

There were likely good intentions behind standardizing supply contracts, but implementation went awry and it appears suppliers did not anticipate how many deliveries they would need, she said.

“I think afterwards there will be a forensic investigation into what actually happened,” Cheung said. “How can we prevent this from happening again?”

As people head to emergency rooms for supplies, hospitals are now seeing a supply shortage, says Dr. Hershl Berman, palliative care physician and Toronto district chair for the Ontario Medical Association.

“It’s a domino effect,” he said.

Every day, at least one of his patients experiences a problem related to the shortage, he said.

“We all want our loved ones to feel as comfortable as possible at the end of their lives,” Berman says. “This fiasco has effectively made that impossible for some patients.”

Stock problems are partly to blame, the distribution company says

Bayshore Specialty Rx, one of the companies responsible for distributing the inventory, said a confluence of factors, including unexpected inventory issues, impacted their fulfillment system.

“We sincerely apologize to those affected and are fully committed to restoring the level of service that home care patients in Ontario deserve,” the company, which operates in the southwestern region of Ontario, wrote in a statement.

“Our entire team is focused on mitigating these challenges and ensuring continuity of care for every patient under our services.”

Bayshore said it is restoring and improving tracking systems, deploying additional staff to manage the distribution of urgent supplies, improving communications and locating alternate supplies.

NDP Leader Marit Stiles said she wants clear answers as to why this happened in the first place.

“It is not only unacceptable what is happening in home care right now, but it is also unethical, very unethical,” she said.