Thursday, 07 December 2017 10:11

Single provincial health authority starts work of transformation in Sask.

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The transition process from 12 regional health authorities to a single provincial health authority was completed in less than a year, but the transformation of Saskatchewan’s health system will take much longer.


Saskatchewan Health Authority (SHA) CEO Scott Livingstone spoke about the long road ahead during a media briefing on Dec. 4, which took place shortly after the new health authority’s 10-member board of directors held their first meeting.
“I want to emphasize that today is truly the beginning,” he said. “It is truly day one and we’ve just started this multi-year journey towards transforming the Saskatchewan health care system. All the work that’s been done to date is really accumulating in making sure that the organization was as prepared as possible for day one, ensuring that we would be able to not just legally operate, but also to ensure that transition was as smooth as possible to ensure the safety and quality of our patients and the staff that take care of them.”
The launch of the new health authority took place on the date of the official proclamation of the Provincial Health Authority Act, which resulted in the legal transfer of the operations and employees of the 12 former regional health authorities to the new organization. The SHA is the largest organization in the province with over 44,000 employees.
Saskatchewan residents will for the moment not see any difference if they visit a health facility. This is done intentionally to ensure the transition to the new health authority will be as smooth as possible.
Patients will still use the same phone numbers as before to access the health care system, and people can still access information through the websites of the 12 former regional health authorities. At the same time the new SHA website has been launched to provide information about the transition and other details about services.
“We will continue to engage patients, families, stakeholders, First Nations, Métis people and other health care partners as we start to work towards redesigning our system over the next few years,” he mentioned. “As I said before, there’s a difference between transition and transformation, and the transformation work is about to begin.”
The work to fill the most senior jobs in the new organization has almost been completed. The senior leadership team consists of 18 individuals, and only two positions still need to be filled.
Most of these jobs are located in Saskatoon and Regina, but some of them will be in other centres such as Prince Albert.
“The next phase will be recruiting the next level of leadership across the SHA, and that’s going to take some time over the next few months,” he said. “We’ll be filling those positions and then we’ll be moving down to the director level. So it’s going to be a period of months before we actually have the Saskatchewan Health Authority out of scope management team in place.”
These executive roles on the executive director and director levels will be responsible for services such as nutrition and facility management.
“They’ll be distributed across the province,” he noted. “They will have provincial responsibilities, but we’ll be locating them closer to home, really to be true to that provincial oversight with local presence and local management for the health care system to be able to liaise with both the staff, patients and the communities.”
The most visible difference at the moment between the SHA and the previous regional health authorities is that there is only a single provincial board of directors and one senior leadership team, instead of 12 board of directors and 12 leadership teams.
“The single biggest change will be to finally be able to have the system operating under a single strategic direction and a single authority,” he said. “As we continue to build and evolve you’ll start seeing a more provincial focus and provincial policies and programs being put together. So you’ll see a lot more similarities across the province, but also programs that are responsive to community needs.”
The creation of the SHA will result in an 86 per cent reduction in senior administrative staff positions, which will mean an 80 per cent reduction in senior administrative staff salaries or an annual saving of $9 million.
Severance of $4.1 million has already been paid to former CEOs and senior executives, and that amount will still increase as the process continues to fill available positions.
“That number will change as more people get opportunities to apply for roles within the organization, but for those folks that are currently in roles that don’t land a position, there may be severance down the road,” he said. “We expect that the cost of severance of other folks within the system is going to take a few months. ... So we don’t know what the ultimate severance number is going to be, but it will evolve as we start filling positions and people choose to exit the system because there’s not meaningful work for them."
Livingstone believes it will take at least three years to implement the changes to give patients more seamless access to health care services across the province, but some of those improvements will take even longer to achieve.
“We’ve been very conscious about including physician leadership in the new organization structure because we know every high performing health care system in the world has physicians in leadership roles,” he said. “That’s new to our province and it’s going to take us some time to ensure that we support that work, but part of that is how do we better collaborate and incorporate health care services outside of a family physician’s office with physicians, because it’s a big gap for patients with respect to accessing specialist care and other services, and I think that’s going to be a longer-term challenge for the system.”
The SHA will be responsible for decisions on the availability and roll-out of services across the province, including the need to close some facilities, but for the moment this is not a consideration and any such decisions will be taken in a consultative manner.
“Once the new Saskatchewan Health Authority creates a strategic plan and has approval for that plan and direction from government with respect to what the opportunities are to integrate health services across the province, that will include what we do with existing facilities, but there’s no preconceived notion of that today,” he said.
One of the challenges for the SHA will be to find a balance between decision-making as close as possible to the patient care level and the need for direction on a provincial level.
“There will be a significant amount of local area decision making, particularly around how it supports primary health care networks and what services are required, given the community need, but there will be a significant amount of direction provided at the provincial level, because that’s also part of the intent of creating a new authority,” he said.
The SHA head office is located in Saskatoon, but a distributed leadership model will be implemented to keep the organization and management connected to communities around the province.
“The other thing that we’ll be doing very shortly as we continue to broaden the engagement around how we transform the system is the creation of community advisory networks and other ways in which we’ll actually engage with communities across the province and other stakeholders to help redesign the system,” Livingstone said. “That work hasn’t been completed, it’s just about to begin. So it’s going to be one of the ways in which we’re going to ensure that services are designed to meet the needs of the community.”

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Matthew Liebenberg

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