Ontario Ramping Up Efforts to Reduce Surgical Wait TimesPublished on July 28, 2021
Additional Funding Will Allow Province to Perform Thousands More Surgeries, Procedures and Diagnostic Imaging Hours
The government is investing up to $324 million in new funding to enable Ontario’s hospitals and community health sector to perform more surgeries, MRI and CT scans and procedures, including on evenings and weekends, as part of a wider, comprehensive surgical recovery plan to provide patients with the care they need. This plan will enable Ontario’s health care system to perform up to 67,000 additional surgeries and procedures as well as up to 135,000 more diagnostic imaging hours to address wait times for surgeries and procedures, improve access to care and support the government’s commitment to end hallway health care.
“Ontario’s hospitals have been unwavering in their commitment to provide exceptional care to Ontarians. While the pandemic has been challenging for hospitals, we have made significant progress in addressing wait times for surgeries and other procedures and are in a much better situation than was expected mere months ago,” said the Deputy Premier and Minister of Health. “As Ontario continues on the path to reopening and recovery, our government is committed to improving access and reducing wait times for scheduled surgeries and procedures across the province.”
The COVID-19 pandemic placed significant pressures on hospital and health care resources, requiring the government to take extraordinary measures to maximize capacity and ensure that Ontarians can continue to have access to safe, high-quality health care. Thanks to the ongoing efforts and dedication across the health care system as well as targeted government initiatives, 76 per cent of patients who were waitlisted for required surgery between March 1, 2020 and March 1, 2021 have received the care they need. Throughout the pandemic, urgent surgical patients were prioritized and 99.3 per cent of the most urgent patient surgeries were completed. As the province continues to safely and gradually lift public health measures, it is anticipated that referrals for surgeries, procedures and diagnostic imaging will increase similar to what has been seen in other provinces and jurisdictions.
To continue the progress made to date and meet future demand, Ontario has developed a comprehensive surgical recovery plan to enable hospitals and community providers to operate at 110 to 115 per cent capacity, bolstering the health system’s capacity to ensure patients’ surgical and recovery care needs are met at all stages, from primary care referrals, hospital discharge to recovery at home. The plan encompasses the entire continuum of care, including:
- Hospital care: A new investment of $300 million from the 2021 Budget dedicated to help the hospital sector recover and perform thousands more surgeries and diagnostic imaging hours, and help reduce wait times.
- $216 million for hospitals to extend operating room hours into evenings and weekends and perform up to 67,000 additional surgeries on top of the typical volume of 650,000 scheduled surgeries that happen in main operating rooms each year. New surgeries funded may include up to 33,000 new cataracts surgeries, up to 4,300 new orthopedics surgeries and up to 9,000 new paediatrics surgeries.
- $35 million for MRI and CT imaging, enabling over 75,000 additional hours of MRI scanning and over 60,000 additional hours of CT scanning, on top of the 577,000 hours and 550,000 hours that happen each year, respectively. This represents a 12 per cent overall increase in available hours.
- $18 million investment in centralized surgical waitlist management to increase use of electronic referrals and support work to enable efficient tracking of surgical information, making better use of specialist and hospital resources and reducing patient wait times.
- $1 million for surgical smoothing coaching from an expert team of experienced surgeons and administrators to support knowledge sharing and best practices to optimize the use of operating rooms at key high-volume hospitals.
- $30 million for the new Surgical Innovation Fund to help hospitals in each region of the province to address barriers and increase their surgical output. Approval for funding will be released in September 2021 for immediate implementation this year.
- Increase health system capacity through community alternatives to hospital care: A new investment of up to $24 million to increase volumes of low-risk, publicly funded surgical and diagnostic services in independent health facilities and to support the licensing of new independent health facilities for existing services.
This funding builds on investments currently underway that support integrated care across the continuum, including $1.2 million for cancer prevention and screening initiatives and $143 million to support post-hospital care with ongoing programs such as rehab hospitals, use of virtual care, home care and transitional care.
The government and Ontario Health will work with hospitals to determine which hospitals can increase their surgical activity based on the local situation. Funding allocations for additional surgeries will be communicated to hospitals in early fall as they continue to ramp up to increase their surgical output.
Building on initiatives to increase health human resources capacity in hospitals during the pandemic, Ontario’s surgical recovery plan also includes initiatives that support health human resources capacity for increased surgical volumes in hospitals, including expanding existing initiatives and developing additional programs.
“Ontario patients should feel safe and confident in accessing the health system and getting the care they need,” said Matthew Anderson, President and CEO of Ontario Health. “With funding provided by the government, we will work with partners across the system to deliver expanded care and service to patients needing preventative, primary, surgical and specialist care.”
The government will work with its health system partners to closely monitor both surgical output in hospitals and patient wait times and implement additional measures if needed to ensure patients and their families have access to the safe, high-quality care they need.
- At the height of the third wave in April 2021, the Chief Medical Officer of Health reissued the directive to request all hospitals to temporarily pause non-emergent clinical activity in order to preserve capacity to respond to COVID-19.
- The government took action to preserve access to urgent surgeries during the COVID-19 pandemic, such as funding supports for weekend and evening surgeries. Over 465,000 scheduled surgeries took place in main operating rooms in Ontario’s hospitals in 2020-2021.
- As part of the province’s $2.8 billion fall preparedness plan, the government has invested $283.7 million to support additional priority surgeries and procedures, and $457.5 million to increase community capacity, including home and community care, to help build more capacity in the health care system to effectively manage the COVID-19 pandemic in the province.
- Under the 2021 Budget, Ontario is investing an additional $1.8 billion in the hospital sector in 2021-2022, bringing the total additional investment in hospitals since the start of the pandemic to over $5.1 billion. This includes temporarily adding more than 3,100 additional hospital beds - the equivalent of six new large community hospitals in the province - to increase capacity and reduce occupancy pressures caused by COVID-19. Many of these beds were used during the pandemic and will continue to be used as part of the province’s health system recovery until at least March 2022.
- Ontario’s surgical recovery plan will improve the pre- and post-hospital experience for patients by building on ongoing partnerships with Ontario Health Teams and efforts, such as the Digital First for Health strategy and home and community care modernization, with innovative solutions, including centralized surgical waitlist management and funding for home care and transitional care.
- As part of its plan to end hallway health care, the Ontario government has increased the overall funding for the hospital sector by 3.4 per cent in 2021-22. This represents an increase of $778 million in funding to ensure all publicly funded hospitals will receive a minimum one per cent increase to help them keep pace with patient needs and to increase access to high-quality care.
"Though the worst of the crisis is likely behind us, the effects of the COVID-19 pandemic will be felt throughout the health care system for some time to come. In hospitals, this includes a backlog of postponed surgeries and procedures. The Ontario Hospital Association welcomes the government's investments to encourage innovation and increase access to surgeries and diagnostic imaging as an important first step towards recovery. Hospitals remain committed to doing everything they can to provide timely and high-quality care to Ontarians, and we look forward to working closely with government to support this effort going forward."
- Ontario Hospital Association
"This plan is an important and positive step forward, and represents a comprehensive approach to surgical, diagnostic and procedure recovery. Ontario’s doctors are proud to be part of a patient-centred COVID recovery and initiatives to improve our health-care system."
- Dr. Adam Kassam
President, Ontario Medical Association
"Today's announcement offers good news for people with arthritis who are waiting for joint replacement surgery. These innovative solutions align with recent recommendations by Arthritis Society experts. Reducing the agonizing wait for hip and knee replacement surgeries is one of our top priorities and we’re pleased to work with the Ontario government to ensure the plan improves care for patients."
- Trish Barbato
President and CEO, Arthritis Society
"As advocates for shortening orthopaedic wait times, we’re encouraged by this important step in the right direction for getting patients the surgeries they need, and for addressing connected pain points in the system. We’re committed to supporting the Government of Ontario however we can as they implement these new measures, and to continuing to work towards making even further progress."
- Dr. Jeremy Hall
Member of the Mobilize Canada Coalition, Chair of the board of the Ontario Orthopaedic Association, and a Toronto-based orthopaedic surgeon