RNAO applauds health minister's plans to reform the health system, calling them the biggest changes in 20 years

TORONTO | The healthy dose of change Minister Eric Hoskins is prescribing for the province's health system is being praised by members of the Registered Nurses' Association of Ontario (RNAO).The RNAO—which represents registered nurses (RN), nurse practitioners (NP) and nursing students—says legislation introduced at Queen's Park Thursday will fundamentally improve the system by expanding the mandate of Local Health Integration Networks (LHIN) to include the authority to plan and implement better integration of primary care, home and community care, and quality improvement initiatives."This is the kind of bold change we've been calling for," says RNAO CEO Doris Grinspun. "No one is served well by a system with disparate parts that doesn't bring providers together. Today's announcement makes it clear the ministry is serious about its commitment to patients.""Having one body accountable for whole system planning, funding allocation, and monitoring will result in stronger and healthier communities," Grinspun adds.Under the minister's plan, Community Care Access Centres (CCAC)—which currently oversee home and support care services—will cease to exist. Responsibility for these services will be transferred to the LHINs. "This is long overdue. We're pleased Minister Hoskins is acting on our advice," says Grinspun.RNAO first raised the issue of unnecessary duplication between the LHINs and CCACs in 2012 when it released its own blueprint for health system transformation titled, Enhancing Community Care for Ontarians (ECCO). "Bringing home care under the LHIN umbrella is the right thing to do, but we don't need another layer of bureaucracy to look after the provision of home care services," Grinspun says, cautioning Hoskins not to allow LHINs to assume the role of service provider.While RNAO welcomes the plan to do away with CCACs, the association wants to ensure the 3,500 care co-ordinators (mostly RNs) who will now be employed by the LHINs are located in primary care. There, they can work within interdisciplinary teams and co-ordinate care for patients with complex needs from cradle to grave.A report by Health Quality Ontario showed the province currently has one of the lowest rates of communication between its primary care and home care sectors. RNAO President Carol Timmings says the health minister must direct LHINs to locate care co- ordinators in primary care. "Only then will true integration between primary care and home care be achieved," she says. "People should be able to depend on care co-ordinators to facilitate access to care and health system navigation."RNAO says the legislation falls short in one area by not including the province's 36 public health units within the mandate of LHINs. "This is a big disappointment and a missed opportunity," says Timmings, adding that "nurses and other health professionals who work in this sector are experts in health promotion, disease prevention, population health and advancing health equity. Our association will continue to advocate that public health units be included to ensure the sector influences the whole system."RNAO looks forward to learning more about the critical implementation phase once the legislation passes. "Nurses are thrilled that our ideas on how to improve the system are taking root. We will continue to work on behalf of our patients and the public at large to ensure their experiences in our universal Medicare system are positive and deliver the outcomes and value they deserve," said Timmings.

RNAO applauds health minister's plans to reform the health system, calling them the biggest changes in 20 years

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