Health Bulletins

Update: Health System Integration

February 3, 2017

Hello colleagues,

We are pleased to share this update on the work supported by the Patients First Act, 2016. You will also find this update archived at this link. You may also be interested in the answers to some Frequently Asked Questions at this link.

You can count on regular emails like this as your source of ongoing information and updates, which can also be shared with staff members, local stakeholders and other stakeholders and colleagues.

LHIN Sub-Regions

Ontario is home to nearly 14 million people spread across a vast geography, representing different walks of life. As the province continues to focus on transforming the health care sector, an emerging priority is to ensure that health care planning is supported through mechanisms that take into account the diverse geographic, population and demographic needs to deliver quality care in an effective and efficient manner.

LHIN sub-regions are local planning regions that will serve as the focal point for improved health system planning, performance improvement and service integration. Sub-regions have been in place informally in LHINs for many years and they are now being formalized. They will be the avenue for local improvement and innovation with the common objective of improving the patient experience.

The rationale for sub-regions is based on a significant body of research, experience and advice. LHINs range in population size from about one to two million residents; although the development of LHINs enabled a more community-focused lens for health care planning and improvement, we know there remains significant diversity within LHIN boundaries. For example, in the North East LHIN the needs of the James and Hudson Bay Coasts sub-region, with a population size of 7,100, significantly differ from the needs of the Sudbury-Manitoulin-Parry Sound sub-region, with a population size of 229,900.

North East LHIN Sub-Region Map

North East LHIN Sub-Region Map

We also know through our Health Links initiative that targeting health care improvement efforts at a smaller scale can enable better identification of population health needs, can foster improved patient and family engagement and can improve collaboration among providers within the circle of care. Further, advice from the Expert Advisory Committee on Strengthening Primary Health Care in Ontario recommended smaller geographies as a means of structuring our primary care sector around the needs of populations.

Sub-regions are not another layer of bureaucracy. They are instead simply a better way for LHINs to plan and improve health services in a manner that is more in line with the diverse needs of communities across the province.

For each sub-region, the LHIN will ensure there is a person responsible as the administrative lead on planning, plus a clinical lead - a doctor or nurse practitioner who already provides primary care in the community and will provide their clinical expertise to the LHIN. This clinical lead will work with other local doctors and health service providers to inform the LHIN’s planning and help ensure that health service providers address local clinical trends and needs. The sub-region planning lens will also help ensure better equity of health services, with opportunities to address issues like communities where there might currently be higher rates of chronic disease and challenges in access to health resources.

LHIN sub-regions do not mean that people need to change the way they access care. They will not have to find a new primary care provider, choose a different hospital nor seek out home and community care services differently. In fact, LHIN sub-regions are based in part on existing care patterns, not creating new ones.

To arrive at the sub-regions, LHINs spent the summer and fall engaging patients, families, providers and other community partners locally. The ministry also consulted with our Indigenous partners, French language stakeholders, municipal sector and others. Based on consultation and looking at existing care patterns, each LHIN recommended between 4 and 7 sub-regions. In total, there are 76 sub-regions, a number that reflects the diversity of Ontario and its local needs. The median population size of LHIN sub-regions is about 140,000 and each LHIN sub-region typically has at least one acute care hospital, on average 150 primary care practices as well as home and community care service providers. We may see LHIN sub-region geographies evolve over time as we gather more experience, as LHINs continue to engage their communities and as improvement efforts take hold.

The Number and Size of Sub-Regions in Ontario

The Number  and Size of Sub-Regions in Ontario

What’s next? The formalization of sub-regions is the platform upon which system improvements will take hold. From a planning perspective, LHINs and partners can expect detailed, local analysis of population health, service utilization patterns, capacity considerations and other data points. From an improvement and integration perspective, sub-regions will be the locus for local innovations, be they focused on improving connections between primary care and home care, access to specialists or ensuring newcomers receive the care they need.

We invite you to take a look at LHIN websites to see these sub-regions. We value your input going forward on how we can use these new geographies to put patients first.

Patients First Act, 2016: Implementation Milestones

More Updates Coming

You can expect regular updates like this as we move forward together.

And you’ll hear from us soon about our next Webinar, which is planned for February. That will provide another opportunity to share updates and ask questions.

If you have questions or comments, please send an email to patientsfirst@ontario.ca.

To join our email list and receive these updates, please send an email to patientsfirst@ontario.ca.

For More Information
Email: patientsfirst@ontario.ca