Health Bulletins

Update: Health System Integration

February 17, 2017

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.

How the new LHIN Organizational Structure will Deliver on the Patients First: Action Plan for Health Care

The Patients First Act, 2016 will help ensure patients are at the centre of the health care system. To do so, the Act expands the mandate of LHINs in home care, primary care and public health, and strengthens LHIN responsibilities in planning, health equity and engagement with patients, families and Indigenous and French-language health care partners.

To fulfill this expanded role, LHINs need an organizational structure that will provide strong, integrated leadership and ensure continuity of care for more than 640,000 home care clients through the seamless incorporation of the Community Care Access Centres (CCACs). This structure will also provide the platform for ongoing transformation to a more patient-centred health care system, producing high-quality, integrated care for Ontarians and their families and caregivers. 

The foundation of this strengthened organizational structure will be in place at transition, when the transfer of CCAC staff into the LHINs takes effect. That integrated structure will reflect the commitment to improve integration, planning, access and accountability.

At transition, the integrated organizational structure will also contribute to health system efficiency as a result of bringing together two organizations that have some similar corporate functions. The elimination of duplication will create the opportunity to find efficiencies outside of care delivery, and allow savings to be re-directed to patient care.

The importance of strong, integrated leadership, continuity of care and efficiency were key priorities that Ontarians and health care partners identified in our consultations about the Patients First proposal and the Patients First Act. It was also noted in the Ontario Auditor General’s 2015 report on CCACs, that funding should be shifted to direct patient care.

Supporting Strengthened LHIN Structures

To support the creation of integrated organizational structures, the ministry established a LHIN Management Work Stream, with LHIN co-leadership, CCAC membership and expert support. KPMG provided third party evaluation and expertise, which was retained through a competitive procurement process to engage with LHINs, CCACs and the ministry and provide advice.

Each LHIN was asked to develop a plan for its integrated structure, in consultation with its local CCAC, and to submit its plan to the ministry. That process is now complete.

Core Functions

Through this process, seven core functions for the integrated LHINs were identified:

seven core functions for the integrated LHINs: Home and Community Care, Clinical Leadership, Performance and Accountability, Human Resources, Health System Integration, Strategy and Planning, Communications and Engagement, Finance and Corporate Services

These functions represent both the new LHIN mandate and the integration of key corporate and functional operations of the CCACs and LHINs.

Streamlined Management

The design of the LHIN organizational structures has been standardized in key areas to strengthen consistency in system planning and service delivery across the province. The design combines the two previously separate management structures of the LHINs and CCACs to create a streamlined combined structure.

Local differences in the integrated structures will remain, so that LHINs will continue to benefit from effective local approaches, be responsive to local needs, and have the flexibility to support seamless home care delivery during and after transition.

Each LHIN has determined how the seven functions will be led within its organization and aligned these functions with five to seven positions, depending on local needs.

As part of local change management activities, LHINs will be sharing their structures with LHIN and CCAC employees in the coming weeks.

Efficiency and Re-Investment

As part of their planning for the amalgamation of the LHINs and CCACs, the ministry asked the LHINs to find efficiencies in management and administration costs without impacting the delivery of clinical care. Each LHIN has succeeded in planning for this goal, resulting in an anticipated combined annual savings of $10.7 million.

These savings come in part from a reduction in non-clinical management. The integrated organizational structures will have 59 fewer management positions, with no reductions in services as a result of the savings.

The $10.7 million in annual savings will be re-invested in client and patient care. Through the 2017-18 budget process, the ministry is determining how this funding can best be used to benefit patients.

Looking Ahead

LHINs are now working to confirm leadership of their integrated organizational structures in preparation for transition. Some positions mirror existing positions within the LHINs or CCACs, and are already filled by well qualified employees. Some positions will be filled through competitive recruitment processes.

As LHINs and CCACs do now, managers and staff in the integrated LHINs will share a common goal - putting patients first and delivering on the goals of the Patients First: Action Plan for Health Care.

The organizational structures now being integrated are the foundation for this work and they will continue to evolve as the LHINs support the transformation of the health system into one that puts the needs of patients at its centre.

Patients First Act, 2016: Implementation Milestones

More Updates Coming

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

Next Webinar February 27

You’ll hear from us soon about our next Webinar, which is planned for February 27, 2017, 2:00-3:00pm. 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