Southlake Regional Health Centre and its partners have embraced the new model of health care proposed by the provincial government.
Already engaged in a strategic planning process, looking at “growing our infrastructure to meet our growing needs,” the hospital has modified its plans to collaborate with community partners on a proposal for an Ontario Health Team – one of the 30 to 50 teams that will provide integrated health care to Ontarians, said Rick Gowrie, Southlake’s vice president of capital, facilities and business development.
Southlake and representatives of some of its 12 new partner agencies hosted a Community Open Forum at the Bradford West Gwillimbury Public Library on Tuesday night, presenting the new framework and asking for public input “for a new path to meet the changing needs,” said Gowrie.
The original Strategic Plan had asked for input on the challenges, needs, and gaps in the system in communities like BWG.
“At that point of time, you really told us that overcrowding is one of the biggest challenges at Southlake,” Gowrie said, referring to long waits in the emergency department, so-called hallway medicine, and waits for diagnostic imaging.
The new health-care framework presents additional challenges – in particular, how to provide seamless and co-ordinated care for patients beyond the boundaries of traditional hospital care.
“We have a complicated system. We have gaps in the system,” said Gowrie. “Health care is changing in Ontario. We’re seeing changes in alignment. We’re looking for more partnerships.”
Southlake and its partners are hoping, as a new Ontario Health Team, to “come together voluntarily to provide care, and are clinically and fiscally responsible for that care…. It should feel to the patient as one co-ordinated system,” said Shannon Brett, from the office of strategy management at Southlake.
The hospital's partners include Extendicare, Aurora Newmarket Family Health Team, Bayshore Health Care, LOFT community services, Enhanced Care Clinic, York Region, Southlake Academic Family Health Team, SE Health, Canadian Mental Health Association, Georgina Nurse Practitioners, and CHATS.
Gowrie suggested it could take five years for the new Ontario Health Team to reach “maturity,” and provide a “full and very co-ordinated set of services” and seamless care, from hospital to home, within a “clear, accountability framework.” One of the challenges is to provide care and meet needs in the interim.
The planning process includes a clinical services plan – outlining which services should be provided by the hospital or by community-based agencies – and a functional evaluation of the hospital facility, which was not designed for new technologies or treatments, has privacy issues, and is over-crowded.
A new hospital building is one of the options, Gowrie said, but in the interim, the big question is, “How are you going to address my needs today?”
At the open forum, participants were asked to identify health-care needs and gaps in the community.
“We need to hear from you. We need to hear from residents in the community,” said J.C. Kirk, executive director of the Southlake Academic Family Health Team in BWG.
Carolyn Donaldson, director of LOFT’s Bradford House residence for at-risk seniors, identified access issues. She suggested one solution is to provide more services in Bradford and other outlying communities.
“We’re ending hallway medicine if there’s access to services in Bradford,” Donaldson said.
She called Bradford West Gwillimbury, which receives some services from Simcoe County and York Region, a “Bermuda Triangle," as far as health care is concerned.
She also pointed out the current doctor-to-patient ratio is 1:3,000.
“That’s ridiculous,” Donaldson said. “I know that’s a big concern.”
Several items were identified as pieces of the puzzle, including access to primary health-care providers and specialists, prevention of illness, and the inclusion of municipalities, social services and “non-health-care organizations” in a partnership to provide more complete care.
Participants also took part in live polling, answering questions posed by Southlake.
Eighty-five percent said they received their health care primarily from their family doctor, eight per cent from walk-in clinics, and eight per cent from the hospital emergency room – based on convenience, access, and time of day.
Longest wait times were for appointments with specialists, followed by waits for necessary diagnostic imaging, including MRIs and emergency-room visits.
The biggest needs in BWG? More doctors, more mental health and addiction services, and more focus on the determinants of health, especially affordable housing and nutritious food.
There was a call for increased help in navigating and co-ordinating health-care services, and greater access to specialists locally, so ill patients don’t have to take “exhausting” trips to Toronto.
And there was a reference to transitional housing, for those on a waiting list for long-term care. At present, those patients can end up occupying acute-care beds in hospitals.
“Instead of living in hospital, how do we create that flow?” asked Donaldson, noting Bradford House has a resident who has been waiting 18 months for long-term-care accommodation.
Solutions proposed included more supportive housing in the community, temporary use of vacancies in retirement residences, and a change in mindset that would see young families take in an elderly parent or other relative.
Both Mayor Rob Keffer and Deputy Mayor James Leduc attended the session.
“What happens if you don’t become an Ontario Health Team (OHT)?” Leduc asked, noting there have been 108 applications to date for the 30 to 50 designations. “Where does that leave us?”
Heather McDonald, executive director of LOFT, agreed that only five to eight OHTs were likely to be certified in the first round but explained there will be no interruption of services for residents. If turned down now, the group can reapply, McDonald said, and it might expand its partnerships.
After a far-ranging discussion, Gowrie admitted, “I truly didn’t know what to expect tonight. One of the things I find astonishing, is some of the things you’ve shared with us tonight. What you’ve shared with us tonight impacts generations.”
There is still time for residents to provide input. Contact firstname.lastname@example.org to share your thoughts.