NIAGARA HEALTH STRATEGIC PLAN A SOURCE OF CONCERN

FUTURE OF HEALTH SYSTEM MODEL WILL BE TWO ACUTE CARE HOSPITALS, ONE AMBULATORY SITE

Niagara-Centre MPP Jeff Burch and Welland Mayor Frank Campion remain concerned about changes planned for the Welland hospital, as Niagara Health released a new five-year strategic plan.

In a joint public letter sent Friday to Niagara Health president and chief executive officer Lynn Guerriero, Burch and Campion said comments they heard from medical professionals working at the hospital system were "extremely serious and deeply concerning."

In addition to concerns about the ongoing redirection of patients requiring emergency surgery from Welland to other sites on evenings and weekends, primarily due to a shortage of anesthesiologists, the elected officials said the hospital system's long-term plans will permanently remove additional services from the site.

Niagara Health posted a document on its website, last Thursday, outlining the objectives of its 20232028 strategic plan.

"By 2028, Niagara Health will ... fully transition to a regional model with two acute care sites, including the opening of the new South Niagara Site hospital, and one ambulatory care site," the document said.

In a written response, Niagara Heath addressed concerns over surgical changes: "Niagara Health is working to address the immediate challenge of the anesthesiologist shortage to ensure we can maintain critical services. This shortage of anesthesiologists and other healthcare professionals is not unique to Niagara, Ontario or even Canada. There is a global shortage impacting the entire sector, making recruiting incredibly difficult.

"We are working with our physicians to find a surgical model that allows us to safely deliver care across our sites. No changes have been made, and we have continually let our local politicians know that we are working to develop a plan and will share more information once we determine how to operationalize it."

Niagara Heath currently operates five medical facilities including full-service hospitals in Welland, Niagara Falls and St. Catharines, while sites in Port Colborne and Fort Erie offer urgent care centres and a limited number of additional services such as ambulatory care.

The posting makes no mention of specific changes or hospital sites, other than the new hospital planned for Niagara Falls expected to be open by 2028.

Niagara Health was to provide more details on Tuesday.

In their letter, Burch and Campion said they continue to oppose the longterm plans for the Welland site, and reminded Guerriero that a motion calling for the preservation of services at the hospital received unanimous support in the provincial legislature in April.

"We want to be clear that it is our position that sufficient communication and engagement has not occurred to support a longterm decision to reduce emergency operations at the Welland Hospital, nor is it our belief that such a decision is supported by the facts," they wrote.

Niagara Health's document said input for the strategic plan was collected through more than 20 focus groups at all sites, dozens of one-on-one interviews, more than 600 surveys, drop-in sessions, round-table conversations and more than 10 leadership meetings, reaching "more than 1,000 members of the Niagara Health team."

"A plan to move Niagara Health to a two-site and ambulatory model was approved in 2018. At that time, the model took into account the needs of Niagara as a growing community, one which has a larger than average seniors population who have chronic conditions, and the clinical needs of the population. This will allow us to provide highly

specialized services and attract skilled healthcare workers. Transitioning the Welland Site to an ambulatory model is planned to follow the opening of the new South Niagara Site in 2028. There will be many opportunities for discussion with our elected officials and the community in the future," said Niagara Health in its written response to strategic plan concerns."

Nevertheless, Burch and Campion said they remain concerned.

"It's our understanding that effective Feb. 27, 2023, there will no longer be surgeries in Welland after hours and no surgeons will be on call," they wrote. "We have heard from doctors at Niagara Health who tell us they are gravely concerned, and express concern that these changes will result in avoidable patient deaths."

Burch said the doctors who spoke with him asked to remain anonymous, fearing reprisal for speaking out.

He said medical staff told him, for instance there is about 60 minutes to operate on a critically ill patient suffering a ruptured appendix and "the drive alone from the Welland site to the Niagara Falls site is 26 minutes."

"Adding to the gravity of the situation, Niagara is experiencing an unprecedented ambulance offload delay, which is expected to only get worse," the elected officials wrote. "Niagara Emergency Medical Services paramedics are expecting to spend at least 52,000 hours waiting to deliver patients to hospitals in 2023, an increase from 33,000 hours spent waiting in 2022, and 21,000 hours spent waiting in 2021."

In response to anonymous staff concerns, Niagara Health's written response said "These changes are aimed at saving lives and improving the care we're able to provide for the people of Niagara, given the health human resources challenges we're facing. We have had surgical redirects in place over the past year and ensured patients continue to receive high quality care."

Burch and Campion asked for an immediate meeting with hospital officials and board representatives to discuss the situation.

"The appropriate time for engagement with the community is now and meetings with elected representatives should have already occurred and should be occurring now, not when a plan has already been put in place," they wrote.