North West LHIN releases Health Services Blueprint

The North West Local Health Integration Network (LHIN) has been working overtime planning the transformation of health care. All 14 LHINs in the province are required to produce an Integrated Health Services Plan every three years, but the North West LHIN is the only LHIN in the province to also release a 10-year plan called a Health Services Blueprint.

“The Health Services Blueprint contains extensive qualitative and quantitative research,” said North West LHIN program director Heather Murchison. “We did a lot of community engagement. We conducted surveys and there was a jurisdictional scan looking at best practices internationally and in Canada.

“The Blueprint is a framework, a model of care that we want to see introduced over the next decade. It will guide how resources will be allocated and how care will be delivered.”

The longer-range Blueprint was required because of the North West LHIN’s unique circumstances and challenges, said Murchison.

“Our health-care costs are 39 per cent higher than the provincial average. We have a high burden of preventable disease. We have the highest rate of hospital use in the province, the highest number of repeat visits and the highest administration costs in the province.

Vast geography

The region’s vast geography (458,0120 square kilometres) and sparse population (222,100) are part of the problem.

Patients often wait in hospital too long for home care or long-term care to become available and don’t receive the post-discharge care they require to speed recovery. All too often, they end up back in hospital.

“We also have lower acuity use of long-term care which means we have people defaulting to more expensive components of our health-care system because we don’t always have the lower level supports like home care or meals-on-wheels that they need to stay in the community,” said Murchison.

A high rate of youth outmigration compounds the problem by depriving the elderly of informal caregivers.

“Because of all this, our discharge practices deviate from the provincial norms as well, meaning we keep people in hospital longer. All of this contributes to our higher health-care costs,” she noted.

In the province as a whole, health-care spending currently accounts for 42 per cent of the government’s budget, and unless we do things differently, it will consume 70 per cent of spending, said Murchison.

In order to develop a sustainable health-care system that meets the needs of an aging population, the Blueprint advocates an integrated health service model to organize services and the delivery of care at the local, district and regional levels.

Health hubs

The plan calls for the identification of 14 local health hubs, which will be responsible for planning and providing health services for the local community. These include home care services provided through the Community Care Access Centre, acute care, long-term care, primary care, post acute care including physiotherapy and rehabilitation following surgery, mental health and addiction services, meals-on-wheels and respite care.

The Blueprint also divides up the region into five Integrated District Networks (IDNs), each of which will have a hospital site designated as a district health campus. The IDNs will co-ordinate services to the district population and offer more specialized care, including certain surgeries.

Higher-cost specialized care for complex patients will be offered at the regional level.

Kellie Hudson, the LHIN’s director of communications, describes the strategy as one of “collaboration and integration,” not decentralization.

There is no intention of adding to costs or creating more bureaucracy.

Health-care organizations and agencies at the local hub level are already meeting, “so we’re not expecting them to do anything radically different,” said Murchison. “We’re just expanding who’s at the table because what we see now is more of a silo approach.

Funding that has been based on historic allocations inherited by the LHIN will be reassessed and standardized costing will be applied, resulting in a reallocation of health-care dollars and potentially less funding for some components of the system, said Murchison.

The four priorities for the 2013-2016 Integrated Health Service Plan are to build an integrated health-care system and an integrated eHealth framework, improve access to care and enhance chronic disease prevention and management.

www.northwestlhin.on.ca

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