January 2017

It is hard to believe that 2016 is already behind us. It feels like just yesterday that I started off the year with an introduction to a discussion paper called Patients First: A Proposal to Strengthen Patient-Centred Care in Ontario. How time flies! Fast forward 12 months and the Patients First Act is now law (I hope you had an opportunity to review the special edition blog issued in December).

Each January, we take time to reflect on our accomplishments and set goals for the upcoming year. As a LHIN, our resolution this year is the same resolution we’ve had since we began more than 10 years ago – to help make our communities and the people who live in them healthier. This year an important step forward in the evolution of our organization is the creation of LHIN sub-regions. While the establishment of sub-regions was one of the few changes that did not require the new legislation to be enacted, there remain conflicting reports as to what they are, so I wanted to clear up a few misconceptions and make sure we are on the same page.

Sub-regions are smaller geographic planning regions within each LHIN that will serve as the focal point for population-based planning, performance improvement and service integration. By looking at care patterns through a smaller lens, we can better identify, understand and respond to community needs at the local level. This concept is not new and has been used effectively for a number of years in managing the care of patients with complex and chronic conditions through initiatives like Health Links and Integrated Comprehensive Care.

Contrary to what some have claimed, sub-regions ARE NOT an “added layer of bureaucracy”. Sub-regions ARE NOT separate organizations nor will sub-regions have their own boards or administration. Sub-regions ARE NOT boundaries and they WILL NOT restrict where patients can receive care.

We know that health care is most effective when services are tailored to the specific needs of a community. Within our LHIN, which has a large and diverse geography and a population of nearly 1.5 million people, we know that different communities are facing different health challenges. The goal of sub-regions is to support improved local planning and collaboration and to provide more integrated care so that patients across the entire region are able to access the care they need, when and where they need it.

To that end, we consulted with the local communities and analyzed the data, including population characteristics, health service use patterns, availability of core services and existing relationships between providers, to identify six distinct regions within the LHIN: Brant, Burlington, Haldimand Norfolk, Hamilton, Niagara and Niagara North West.

During November and December of last year, the LHIN staff facilitated six sub-region engagement sessions (one in each of the proposed regions) in order to provide further detail on the regions put forward and to engage with health service providers. The sessions were very well attended, with 226 system partners participating representing 120 organizations. We welcomed physicians and partners from hospitals, Community Care Access Centre (CCAC) and contracted service providers, Community Health Centres, Family Health Teams, mental health and addictions agencies, Health Links, community support services, municipalities, Public Health, French Language Service Providers, and Indigenous Heath Care as well as other provincial Ministries and partners from the South West and Mississauga Halton LHINs.

Those participating in the sessions were tasked with helping to identify strengths within the current system, gaps that present opportunities for improvement and strategies that are working well in certain communities and can be scaled or spread to other regions.

Some of the areas of strength identified included:

  • Existing relationships and partnerships among service providers
  • Learning from and building on well-functioning programs/models (such as Health Links and Integrated Comprehensive Care)
  • High-performing primary care models
  • A strong focus on patient and families

Among the gaps requiring specific attention:

  • The need to shift from a system culture that remains too provider-centred to one where patients are at the centre of care
  • Aligning programs and services around community needs
  • The ability to more easily share information across providers and agencies
  • Improved access to primary care
  • Better integration of services to ease system navigation by patients and caregivers
  • Earlier intervention for mental health & addictions and palliative care

One very encouraging takeaway from the sessions was that there is a real understanding that a focus on addressing the social determinants of health (including access to transportation, food security, affordable housing, and education) and aligning our efforts with other Ministries and funding sources, is essential. It was wonderful to hear about how our partners are committed to ensuring equity in the health system.

As it is for the LHIN, implementing sub-regions must continue to be a priority for health service providers. A summary of the proposed next steps and ‘quick wins’ based on engagement session feedback has been compiled and shared with participants. Only by continuing to work together will we maintain momentum and ensure sub-region progress - essential for the patients we serve.

There is much ongoing work as it relates to development of sub-regions in the HNHB LHIN. We are committed to keeping you informed of any developments, updates and changes and look forward to your feedback, input and participation.

For more information about sub-regions in the HNHB LHIN or to learn about a specific sub-region, CLICK HERE.

To learn more about the Patients First Act and how we are preparing for the coming changes, CLICK HERE.

If you or your organization would like to be featured in a future blog or share a patient story in one of our Voices in the Community videos you can reach us through our office, or if you’re on social media via our Twitter handle -@HNHB_LHINgage. Your feedback and questions are always welcome.