Why is there a two-month delay for biopsy results at a major Malaga hospital?

The lack of staff in the pathology department at Malaga city's Hospital Regional Universitario has led to delays of up to two months waiting for the results of biopsies, a situation that has been confirmed to SUR by sources from the Medical Union of Malaga (SMM).

Medical sources have explained that there is no regional protocol which establishes the time that should elapse from when the biopsy is performed until it is analysed and communicated to the patient, although "what common sense dictates is that it takes between seven and ten days, depending on the complexity and that is what it took in that service before," the sources say. However, SUR has found that the regional decree 96/2004 states that the maximum response time for diagnostic tests is 30 days, so that cancer would fall within this range.

Two different sources including the SMM have confirmed to SUR that the hospital currently has a backlog of 3,000 biopsies and surgical specimens from some 1,500 patients. At least three other sources have also confirmed the backlog in the department, although without offering any figures. Unfilled positions and staff cuts since the end of the pandemic are the reasons for the situation, according to the SMM.

SUR has tried on several occasions to get the Junta de Andalucía to provide the data it handles related to the situation, but has not had a response. In any case, the Andalusian government does acknowledge that this year there has been a 29.5 per cent increase in the number of biopsies but says that it has increased the numbers of supply staff in the service and created new positions, introducing five new professionals in total. The new staff have been in place since the end of October in order to reduce the backlog.

On 19 September, according to SMM sources, there were 3,500 samples to be biopsied corresponding to some 1,700 patients. Now, the average waiting time for a patient to receive the results is around two months, says the union, which explains the difference between patients and samples to be analysed: "when you biopsy a tumour you don't take one sample, you take two or three, or when you do a prostate biopsy, you take four or five."

Sources from the service consulted highlighted that there are urgent and preferential biopsies and that those cases that are accompanied by complementary imaging tests (X-rays or CT scans), samples that have priority over the rest. "These are worked on before others", they stress. Medical sources estimate that, of these 3,000 samples, 30 per cent could correspond to cases of cancer.

As for the cuts, the SMM points out that in the hospital's pathology department there are 15 pathologist positions, but since the final months of the Covid pandemic there were three unfilled positions (one due to medical leave, another unfilled and a third due to retirement), in addition to a reduction in hours due to maternity and a professional who worked in the afternoons, who post was removed.

There are also five positions for senior health technicians in the section and "of these technicians, only one position was filled, because two were released from the trade union and two others were on sick leave". The backlog got worse over summer due to staff holidays: a third took leave in July, another third in August and another third in September. However, the union does recognise that the numbers are already going down thanks to the recruitment drive and clarify that, in two months, the situation could be resolved.

The union has compared the Malaga hospital with a similar hospital, the Virgen del Rocío in Seville, which has 26 doctors compared to the 15 here. "In 2024, the separation of the anatomical pathology services of the Clínico and the Regional, which as a result of the failed hospital merger of 2013 was one of the few that remained as a merged unit, was requested," says the SMM.

It added that after the separation they "have suffered staff shortages due to the economic deficit of the hospital with cuts in afternoon activity (continuity of care) and no coverage of vacancies due to sick leave, The management says that this is in the process of being resolved, as otherwise the structural staff, which has not grown in the last 20 years, would be left uncovered, despite the fact that the techniques, complexity, activity and reference population have all grown".

The population of the Hospital Regional for this service is 591,637 residents, but there are ten services that are provincial, that is to say, samples from almost 1.8 million Malaga residents are received: these are neurosurgery, maxillofacial, thoracic surgery, nephrology, molecular biology techniques, paediatric surgery, obstetrics, transplants, digestive surgery, as well as being a reference centre for complicated pathologies.

Other union sources explain that in anatomical pathology after the summer there were a total of 6,000 unprocessed samples, "pending cutting, because the biopsies are kept in drawers and then they have to be sectioned, filleted and processed for analysis" and, with the new contracts, this has been reduced to more than 3,000, eliminating those from the months of August and September.