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Socio-Economic
Montage
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The Health Service
Delivery Plan
Of the West Kootenay Boundary Health Planning Committee
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Authored by:
HMRG - A Division of KPMG Consulting
Commissioned by:
West Kootenay Boundary Health Planning Committee
May 1999
Location of Publication:
"Columbia Basin Trust Collection"
Regional District of Kootenay Boundary.
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A practical health services delivery
plan for the West Kootenay-Boundary region was developed which balances
equity of access to services with cost-effective delivery of services.
The focus was on creating a model of service delivery which responds
to the needs of the people in the region over the next five to ten
years. The recommendations take into account the essential concerns
of each health authority while creating a delivery model to benefit
the whole region.
Participants in the planning process
were:
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The Kootenay Boundary Community
Health Services Society (KBCHSS) |
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The Arrow Lakes/Upper Slocan
Valley Health Council (ALUSVHC) |
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The Boundary Health Council
(BHC) |
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The Castlegar and District
Health Council (CDHC) |
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The Greater Trail Community
Health Council (CTCHC) |
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The Nelson and Area Health
Council (NAHC) |
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The West Kootenay Boundary
Regional Hospital District (RHD) |
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The Ministry of Heath (attending
in observer status) |
The programs and services which
were considered include:
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primary and secondary acute
care provided in hospitals |
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mental health
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residential care (extended
and intermediate care) plus continuing care |
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diagnostic services in the
region provided in hospitals |
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public health services
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The report provides a regional overview
of the geography, population size and distribution, population growth,
health services, facility assessment, systems size (future workloads),
and mental health workloads in 2003/4. As well, key issues and opportunities
are explored.
The recommendations below are directed
at the six health councils. The Health Planning Committee was able
to reach consensus support for the majority of them. The issue of
acute referral, which has been a thorny one, continues to elude
a consensus solution by regional players. As a result, this recommendation
is the opinion of the consulting team. Conclusions and recommendations
fall under two broad categories:
1. Structures
to Support Regional Planning
The health authorities
in the region face significant challenges currently, and over the
next 5 to 10 years. It is apparent that:
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current utilization rates
for most health programs in the region are higher than provincial
averages; |
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projected population for growth
in the region is less than the provincial average; and,
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in general, funding of health
programs (and other public social programs) is likely to be
constrained for the foreseeable future. |
Recommendations are as follows:
1) The six health authorities commit
to establishing effective regional integrating structures at the
governance and senior management levels, building on recent initiatives.
2) The six health authorities commit
to re-establishing an effective Regional Medical Advisory Committee
(RMAC). Specifically, the Management Council, in collaboration with
current RMAC members, recommend an appropriate mandate, and terms
of reference, for a revitalized RMAC (taking into account the suggestions
put forward in this report, and other input from medical staff representation).
2. Regional
Service Models For Priority Clinical & Support Services
Regionalization
and integration of health care services have been the underlying
"themes" of health care restructuring in BC.
Recommendations are as follows:
3) The six health authorities agree
on a shared planning process and framework for future health care
services in the region, based on the following assumptions:
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Formally recognize that new
funding for health care in the region will be constrained
for the foreseeable future, and that improvement/enhancements
will have to be achieved primarily through improved efficiency,
and reallocation of resources throughout the region.
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Jointly agree that the main
planning focus for the next 5-10 years will be based on maintaining
the level and quality of acute care service, while improving
cost-effectiveness and efficiency, and enhancing access to
required community-based services and long term care facilities.
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Endorse the utilization and
resource targets identified in the planning process.
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Agree that recommendation/decision
with respect to all regional program initiatives and/or major
capital expenditures will be based upon consultation and recommendations
by the regional Leadership and Management Councils and the
Regional Medical Advisory Committee. |
4) The six health authorities:
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Jointly agree, in principle,
to the establishment (and shared governance) of regional integrated
programs/services, where it is identified that a single service/program
for the region would improve quality and/or cost effectiveness.
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Delegate to the Regional Leadership
Council appropriate authority, within a defined framework,
to oversee the management and operation of approved regional
programs. This should be undertaken in consultation with Ministry
of Health officials to ensure such delegation is consistent
with the legislative mandate(s) of health authorities. |
5) The Arrow Lakes/Upper Slocan
Valley CHC, supported by other health authorities, establish a plan
for discontinuing the provision of acute inpatient care at Slocan
Community Hospital. It is also recommended that the discontinuation
of acute inpatient care at Victoria Hospital, Kaslo, be endorsed
by this planning process.
6) The Castlegar and District CHC,
supported by other health authorities, discontinue surgery at the
Castlegar and District Hospital at the time of retirement of its
surgeon, or at an earlier date if mutually agreeable. As well, the
Boundary CHC, supported by other health authorities, establish a
task force to determine whether surgery should be discontinued at
the time of retirement of its surgeon, or, if because of distance,
surgical capacity should be continued.
7) The six health authorities:
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Agree that the major acute
care referral centre for the region be located at Trail Regional
Hospital.
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Agree to continue to support,
as a minimum, the internal medicine, general surgery, and
maternity services at Kootenay Lake District Hospital. |
8) The six health authorities assign
to the RMAC the task of consulting with specialists and others,
and bringing forward specific recommendations on the proposed configuration
of individual specialty and subspecialty services.
9) The six health authorities actively
pursue opportunities to plan, redesign, and evaluate continuing
care service and residential facility resources, using the regional
CC/LTC working group or an equivalent task group.
10) The Regional Leadership Council:
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Prepare (with input from RMAC
and Regional CEOs) a detailed plan for the implementation
of the Regional Health Services Delivery Plan.
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Seek approval for the implementation
plan from each of the six Health Authorities.
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At least annually, review
progress that has been made, and modify and upgrade the implementation
plan, based on experience gained, and on identified goals
and objectives. |
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