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A paramedic closes the doors on his ambulance at a hospital in Toronto on April 6, 2021.Frank Gunn/The Canadian Press

The Ontario government announced new measures today that it says will bolster the province’s strained health-care system, including hiring more staff, transferring elderly patients who don’t require hospital care to long-term care homes, allowing paramedics to treat more patients on scene, and increasing the number of surgeries performed in private clinics.

Introduced by Health Minister Sylvia Jones and Long-Term Care Minister Paul Calandra, these new measures are part of the second phase of the province’s “Plan to Stay Open” plan, which was initially released in March. Here are the highlights of the plan.

Hiring more health care workers

To address the critical staff shortages in Ontario’s health-care system, which has forced the temporary closure of emergency rooms in recent weeks, the plan aims to attract 6,000 more health-care workers. The province will temporarily waive exam and registration fees for internationally trained nurses to speed up recruitment, which the government says will save each person $1,500. The province also plans to invest up to $57 million over three years to increase the number of nurse practitioners working in long-term care homes. It also announced a new program for internationally educated personal support workers, which will bring 500 new LTC workers into the system.

The Ontario Nurses’ Association estimated that about 25 hospitals across the province had to close parts of their operations over the August long weekend because of a shortage of workers. Meanwhile, nurses have been calling on the province to repeal Bill 124, which caps increases to their salaries, to help alleviate the staffing crisis.

The province also said it will add 400 physician residents to support the workforce in northern and rural Ontario and is working to expedite the registration of doctors who may want to work in emergency departments in those regions.

New powers to move elderly patients into long-term care homes

Under new legislation to be introduced later today, Ontario plans to assign hospital patients who are deemed by their doctors to no longer need treatment a temporary placement in a long-term care home to free up beds. The province believes this will allow for an increase of at least 250 free hospital beds in the first six months. While patients wait for their preferred home choice, this could mean those awaiting long-term care will move to a home outside of their community.

If the legislation passes, the province’s “Plan to Stay Open” states there will be “mandatory guidelines…to ensure patients continue to stay close to a partner, spouse, loved ones or friends.” The second phase also ensures patients won’t be “out of pocket for any cost difference” between their placement and their preferred home.

Mr. Calandra said that patients won’t be forced out of hospitals against their wishes, “but the changes do allow us to continue that conversation.”

One of the main factors exasperating understaffed hospitals is patients waiting for an alternate level of care (ALC). In Ontario alone, there were about 5,000 ALC patients in hospitals, accounting for about a quarter of the province’s total hospital beds.

Increasing the number of surgeries in private-sector clinics

The province plans to increase the number of publicly funded surgeries in its pediatric hospitals and “existing private clinics” covered by OHIP in an effort to improve timely access to surgeries. The plan does not provide specific details on what types of surgeries would be included or what private facilities would be expanded.

The government has previously said it would boost the number of surgeries performed at private clinics outside of hospitals to tackle the backlog created by COVID-19, while stating that all procedures would still be covered by OHIP.

Expanding program allowing paramedics to treat more patients on scene

Ontario also plans to implement an expansion of their 911 pilot program for paramedics. Paramedics across Canada have been struggling to answer 911 calls and respond in a timely way because of staff shortages and overcrowded hospitals. Ontario’s paramedicine expansion will allow paramedics to provide care to patients without taking them to an emergency room, which the province says will help seniors and recovering patients stay in their homes and preserve hospital capacity for those who need it most. Some of these patient calls may include palliative care, mental health and addiction.

“Ontario is also investing in specialized nursing teams within the emergency departments to identify at-risk individuals earlier and connect them with community supports,” the plan states.

The province believes these efforts will free up to 400 hospital beds.

Advocates for community paramedicine say a system where calls deemed low-acuity can be treated outside a hospital setting also better serves under-represented populations, such as new immigrants and rural communities.

With reports from Jeff Gray, Dustin Cook, Karen Howlett, Carly Weeks and Jake Kivanc

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