Medical supply delays 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 amid delays and shortages across Ontario for home and palliative care supplies. 

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

"It was an incredible service," she said. 

But last month, Clark's nurses began mentioning they were having issues obtaining the correct supplies. On Sept. 24, Ontario Health atHome launched new supply contracts for the delivery of medical items. 

Since then, Moss says some critical supplies stopped arriving. 

In one instance, after a round of chemotherapy in October, the hospital ordered hydration for Clark 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, particularly her husband. 

"The nature of his diagnosis means that he's always worrying about us and what the future holds for us," Moss said. "This has created another level of worry for him." 

Situation is unacceptable, health minister says

Dying people have been unable to get sedatives and patients are going to hospital because their supplies have run out, the province's doctors say.

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

"We have been working with Ontario Health atHome to ensure that no patients, no patients' families, no clinicians are impacted by a logistics issue," she said. 

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

"Ontario Health atHome takes any impact to our patients very seriously, and we understand the distress this is causing," the agency said. 

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

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

"People are being left behind in these decisions that are made by the government and it's unacceptable," she said. 

On its website,Ontario Health atHome says it is aware some patients have experienced issues with the distribution of medical supplies, adding that it will be reimbursing any patient, caregiver or family member who has paid out of pocket for medical supplies due to delivery issues.

People buying medical supplies on Amazon, doctor says 

Dr. Joyce Cheung, the Ontario Medical Association's chair of palliative medicine, said palliative care doctors across the province have been raising concerns about medication and supply delays that have sent patients to emergency rooms, and a lack of medication and needles leaving people in pain.

One of her palliative patients went 30 hours without a pain pump, she said, and another patient with metastatic cancer nearly ran out of ostomy bags for collecting stool.

"I don't know what to do," she said. "Are people buying supplies off Amazon where we cannot validate the quality of these supplies? We're hearing these stories. They are ongoing in every corner of the province."

Moss said she knows other caregivers who are buying supplies on Amazon, but she refuses to do the same. 

"This is a service that I'm signed up for, this is something that I've paid for in taxes," she said.  

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

"We were all taken aback," she said. "We're just like, 'What is going on?' We're just seeing what's happening on the ground, and we don't even know how to pivot, because we didn't realize this was going to be such a disaster."

There were probably good intentions behind standardizing supply contracts, but the implementation has gone awry and it seems as though the vendors did not anticipate the amount of supplies they would need, she said.

"I think there's going to be some forensics to be done afterwards of what actually happened," Cheung said. "How can we prevent this from happening again?"

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

"It's a domino effect," he said. 

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

"We all want our loved ones to be as comfortable as possible at the end of life," Berman said. "This fiasco has actually made that impossible for some patients." 

Stock issues partly to blame, distributing company says

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

"We sincerely apologize to those impacted and we are fully committed to restoring the level of service that Ontario home health-care patients deserve," the company, which operates in the southwest 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, dedicating additional staff to manage the distribution of urgent supplies, improving communications and sourcing alternative supplies.

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

"Not only is it unacceptable what's happening in home care right now, but it's unethical, deeply unethical," she said.