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Rapid Recap: Ontario Government Unveils Health System Strategy

Thursday, February 2, 2023 – Ontario’s Minister of Health Sylvia Jones, Minister of Long-Term Care Paul Calandra and Minister of Colleges and Universities Jill Dunlop released Your Health: A Plan for Connected and Convenient Care this morning. The document serves as Ontario’s new health system strategy, outlining the government’s vision and direction for the next several years.

The new strategy is focused on the core priority of developing system capacity through increasing the health workforce, expanding the ways people in Ontario can access care and investing directly in health infrastructure. The three pillars of the plan: The Right Care in the Right Place, Faster Access to Care and Hiring More Health Care Workers clearly articulate the government’s major priorities.

Although the plan includes many previously announced investments, there are significant new commitments to tackling the health human resources crisis through health education and training. New training spots are being created for a range of health care professionals including nurses, physician assistants and medical lab technologists. The government is also continuing its commitment to faster licensure for internationally trained health care professionals with new “As of Right” rules.

The government is also outlining that it sees increased collaboration between health professionals and expanded scope of practice as opportunities to increase efficiency in the health care system. Building on the recently announced expansion for pharmacists, the plan flags the possibility of greater scope for many regulated health professionals. The continued investments in community-based care, including home and community care, interprofessional Family Health Teams, as well as digital and virtual health options, also seek to relieve capacity on hospitals by encouraging people in Ontario to access care closer to home.

The plan offers a roadmap to health care providers, professional associations and industry associations on the government’s health care priorities. It also invites proposals on innovative new models of care and expanded scopes which will deliver a more efficient and effective health care system.

Legislation to enact any necessary changes is expected to be introduced when Ontario’s legislature resumes on February 21.

The Details

Pillar One: The Right Care in the Right Place

Expanding care at local pharmacies:

Improving access to care at home

  • Previously announced $1 billion to expand home care services over three years.
  • Working with Ontario Health Teams (OHTs) and home and community care providers to establish new programs.
  • Continuation of the Community Paramedicine for Long-Term Care Program.

Improving access to mental health and addictions services

  • Continuation of the Roadmap to Wellness: A Plan to Build Ontario’s Mental Health and Addictions System.
  • Previously announced eight new youth wellness hubs, bringing the total to 22.
  • Previously announced development of the Mental Health and Addictions Centre of Excellence within Ontario Health.
  • Previously announced development of the Ontario Structured Psychotherapy Program.
  • Previously announced expansion of virtual walk-in counselling service pilot One Stop Talk.

Digital health

  • Rebranding Health Connect Ontario as Health811.
  • Reiterating the government’s intention to “Axe the Fax” in health care and providing a firm target for achieving this in 5 years.

Expanding Ontario Health Teams

  • Reviewing applications for four additional Ontario Health Teams to bring the total to 58.
  • Previously announced $106 million investment in digital and virtual care options.

Bringing together primary care

  • Ensuring primary care providers are integrated into Ontario Health Teams.
  • Investing $30 million to create up to 18 new interprofessional primary care teams.
  • Allowing an additional 1,200 physicians to work in team models, 720 in 2022/23 and 480 in 2023/24.

Pillar Two: Faster Access to Care

Reducing wait times for surgeries and procedures

Faster access to care

  • Expanded 9-1-1 models that make paramedics able to treat certain patients at home or on-scene in community.
  • Working to expand treat-and-release models to people with diabetes and epilepsy.
  • Continuing investments to support dedicated offload nurses in emergency departments.

Building new hospitals and adding more beds

Relieving paediatric pressures on hospitals

  • Previously announced investment of $8.5M at Children’s Hospital of Eastern Ontario (CHEO) to double critical care beds to 12 as well as investments to permanently increase the number of critical care beds at McMaster Children’s Hospital, Hospital for Sick Children (SickKids) and London Health Sciences Centre Children’s Hospital.

Improving long-term care, reducing wait times

  • New investment of $40M for specialized services in long-term care for residents with complex care needs, which will also support transport from acute care to long-term care.
  • Previously announced $6.4 billion plan to build 30,000 new long-term care beds, and upgrade 28,000 existing beds to modern standards.
  • Previously announced investment of $4.9 billion over four years for each patient to have an average 4 hours of hands-on care by nurses and personal support workers.

Enhancing diagnostic services for long-term care residents

Supporting end-of-life care

  • Expanding palliative care services in local hospitals, adding 23 new hospice beds.

Expanding access to mental health and addiction treatment in your communities

  • Previously announced investment of $90 million over three years through the Addictions Recovery Fund.
  • Previously announced investment of $10.5 million for children and youth with complex mental health needs to expand the child and youth mental health Secure Treatment Program, adding up to 24 new beds to serve vulnerable children and youth, develop two new step-up, step-down live-in treatment programs and addition up to 16 new beds to meet the needs of youth who don’t require the highly intensive care.

Pillar Three: Hiring More Health Care Workers

Training more health professions every year

  • Creating several new training places for health care professionals including:
    • 455 new spots for physicians in training
    • 52 new physician assistant training spots
    • 150 new nurse practitioner spots
    • 1,500 additional nursing spots

Expand the Ontario Learn and Stay Grant

  • Recently announced expansion of the Ontario Learn and Stay Grant beginning in 2023, to include approximately 2,500 eligible postsecondary students who enroll in high-priority programs, including nursing, paramedic, and medical laboratory technology/medical laboratory science at the diploma, advanced diploma, undergraduate, masters and postgraduate levels.

New “As of Right” rules

  • Recently announced “As of Right” rules allowing health care workers registered in other provinces and territories to work without having to first register with one of Ontario’s health regulatory colleges.
  • Allow hospitals and other health organizations temporarily increase staffing and allow health care professionals to work outside of their regular responsibilities or settings as long as they have the knowledge, skill, and judgement to do so.

Portable benefits

  • Previously announced portable benefits program that will include a package of workplace health benefits that move with workers as they change jobs.
  • In 2023 the Portable Benefits Advisory Panel will provide their recommendations on portable benefits to the Ministry of Labour, Immigration, Training and Skills Development.

Reducing fees for nurses

  • Investing an additional $15 million to temporarily cover the costs of examination, application and registration fees for internationally trained and retired nurses looking to receive accreditation from the College of Nurses of Ontario.
  • Developing a centralized site for all internationally educated health professionals to streamline their access to supports such as education, registration and employment in their profession or an alternative career.

Investing in education and training

  • Developing a strategy to train more medical lab technologists by working with education partners to establish bridging programs and create additional educational seats for more students.
  • Previously announced commitment to expand medical school education by adding 160 undergraduate seats and 295 postgraduate positions over the next five years. Of the 295 new postgraduate positions, 60 per cent will be dedicated to family medicine and 40 per cent will be dedicated to specialty programs.
  • Launching the physician practice ready assessment program in 2023 to help internationally educated physicians, with previous medical practice abroad to undergo screening and assessment to determine if they are ready to enter practice in Ontario with the goal of adding at least 50 new physicians by 2024.
  • Permanently increase training spots for physician assistants by adding 52 new educational seats.
  • The College of Physicians and Surgeons of Ontario will be delivering a framework for regulating physician assistants as a class of members in late 2023 and physician assistants will be regulated in 2024.
  • Expanding access to training for nurses over the next two years by adding up to 500 registered practical nurse and 1,000 registered nurse training spots.
  • Previously announced investment of $100 million to add an additional 2,000 nurses to the long-term care sector by 2024-25 and provide tuition support for current PSWs to become registered practical nurses, and for current registered practical nurses to advance their education to become registered nurses.
  • Add 150 more education seats for nurse practitioners starting in 2023-24 to bring the total number of seats to 350 annually.
  • Scale up the Enhanced Extern Program and Supervised Practice Experience Partnership Program for an additional year.
  • Providing additional funding to hire over 3,100 internationally educated nurses to work under the supervision of regulated health professionals in order to give them an opportunity to meet the experience requirements and language proficiency requirements they need to become fully licensed to work in Ontario with new funding for the home and community care sector to extend the reach of the program this year.
  • Continuing commitment to funding the training of 24,000 personal support workers by the end of 2023.
  • Engaging education and health sector partners to look for other innovative ways to accelerate health provider training, so students move into practice and providing care to people sooner.
  • Funding and supporting the new Health and Supportive Care Providers Oversight Authority to become fully operational by December 2023, initially ensuring quality care, and consistency of education and training of personal support workers before expanding to other health care provider groups.

Maximizing the expertise of health care workers

  • Creating a Models of Care Innovation Fund for individual hospitals, long-term care homes, home care providers and Ontario Health Teams to find innovative ways to maximize the skills and expertise of their current health care workers.
  • Considering further scope of practice changes for regulated health professionals.