Ontario Reducing Wait Times for Surgeries and Procedures
The Ontario government is making it easier and faster for people to access the publicly-funded surgeries and procedures they need by further leveraging community surgical and diagnostic centres to eliminate surgical backlogs and reduce wait times. As the government significantly expands the number of surgeries being done through community surgical and diagnostic centres, it will do so with measures in place to protect the stability of health human resources at public hospitals, including requiring new facilities to provide detailed staffing plans as part of their application and requiring a number of physicians at these centres to have active privileges at their local hospital.
“When it comes to your health, the status quo is no longer acceptable,” said Premier Doug Ford. “Our government is taking bold action to reduce wait times for surgeries, all while ensuring Ontarians use their OHIP card to get the care they need, never their credit card.”
Community surgical and diagnostic centres have been valuable partners in responding to the pandemic and addressing the pandemic-related backlog in surgeries. Increasing community delivery of surgeries has proven to increase patient and provider satisfaction and reduces the risk of a rescheduled appointment. Surgeries performed at these centres will be publicly-funded.
Ontario has a three-step plan that better integrates and uses these state-of-the-art facilities to speed up how quickly people are able to get surgeries and procedures using their health card.
Step One: Ontario is urgently tackling the existing backlog for cataract surgeries, which has one of the longest waits for procedures. New partnerships with community surgical and diagnostic centres in Windsor, Kitchener-Waterloo and Ottawa will add 14,000 additional cataract surgeries that will be performed each year. This number represents up to 25% of the province’s current cataract waitlist, and accounts for the estimated COVID-related backlog of cataract surgeries. These centres will perform the 14,000 additional surgeries with existing health human resources.
Ontario is also investing more than $18 million in existing centres to cover care for thousands of patients, including more than 49,000 hours of MRI and CT scans, 4,800 cataract surgeries, 900 other ophthalmic surgeries, 1,000 minimally invasive gynecological surgeries and 2,845 plastic surgeries such as hand soft tissue repair. Surgical wait lists are anticipated to return to pre-pandemic levels by March 2023, barring operational issues.
Step Two: To further reduce wait times, Ontario is expanding the scope of community surgical and diagnostic centres to address regional needs with a continued focus on cataracts, as well as MRI and CT imaging and colonoscopy and endoscopy procedures. To start as early as 2023, these procedures will be non-urgent, low-risk and minimally invasive and, in addition to shortening wait times, will allow hospitals to focus their efforts and resources on more complex and high-risk surgeries.
Step Three: Early detection and diagnosis of a health issue has an immense benefit on a patient’s quality of life, prognosis and treatment path. As a next step, the government will introduce legislation in February that will, if passed, allow existing community diagnostic centres to conduct more MRI and CT scanning so that people can access publicly funded diagnostic services faster and closer to home. Starting in 2024, this next step will also expand surgeries for hip and knee replacements. Legislative changes will also, if passed, strengthen oversight of community surgical settings so that patients can continue to expect to receive the world class care they know and deserve and provide the province with more flexibility to continue to expand access to more surgeries and further reduce wait times. As the province expands the role of community surgical and diagnostic centres, Ontario Health and the Ministry of Health will continue to work with system partners and clinical experts to put in place the highest standards for quality and safety.
“Timely and convenient access to surgery and diagnostic imaging is critical to keeping people healthy,” said Sylvia Jones, Deputy Premier and Minister of Health. “This plan will boost the availability of publicly funded health services in Ontario, ensuring that Ontarians currently waiting for specialized surgeries will have greater access to the world class care they need, where and when they need it.”
As the government shortens wait times using community surgical and diagnostic centres, Ontario Health will ensure that these centres are included in regional health system planning. Funding agreements with new community surgical and diagnostic centres will require these facilities to work with local public hospitals to ensure health system integration and linkages, including connection and reporting into the province’s wait times information system and participation in regional central intakes, where available. Community surgical and diagnostic centres will also coordinate with local public hospitals to accept patients that are being referred, ensuring people get the surgery they need as quickly as possible.
- There are currently 206,000 people estimated to be waiting for surgical procedures. For reference, last fall, there were approximately 209,000 patients waiting for a hospital operating room-based surgical procedure in Ontario, and about 200,000 before the pandemic. Further information on surgical wait times is available here.
- Community surgical and diagnostic centres licensed under the Independent Health Facilities Act currently perform approximately 26,000 OHIP-insured surgeries and procedures annually.
- Ontario is investing $300 million in 2022/23 as part of the surgical recovery strategy to increase scheduled surgeries and procedures, as well as appropriate diagnostic imaging services with a focus on areas with the greatest reduction in services due to the COVID-19 pandemic.
- Ontario’s surgical recovery strategy prioritizes patients waiting longer than recommended in clinical guidelines. In 2022/23, the government continues to offer premiums to hospitals to support completion of over 200,000 surgeries and procedures.
- The government is also investing in digital tools to enhance coordination of surgical services between hospitals and enable better patient flow through the implementation of the Centralized Waitlist Management (CWM) program.
- Investments in the CWM program are providing funding for regionally led projects across the province that support a more equitable distribution of surgical cases and reductions in patient wait times, as well as for Ontario Health’s development of the technical infrastructure required to support centralized waitlist management at the provincial level.
“Ontario’s hospitals have a long history of leadership in clinical innovation and working collaboratively to implement new ways to reduce wait times and deliver exceptional patient-centred care in a safe and timely manner. The Ontario Hospital Association (OHA) welcomes the opportunity to work together with government and system partners to integrate Community Surgical Centres into Ontario’s health care system and establish new partnerships between hospitals and community-based surgical clinics to help ensure access to care for patients. Given the hugely disruptive impact of the COVID-19 pandemic on hospitals, health human resources and wait times for services, it is essential that the expanded use of Community Surgical Centres into new areas of clinical activity take place in a planned manner with appropriate change management and risk management measures in place. As always, by working together as Team Ontario, we can overcome any challenge and deliver on our shared commitment to strengthening our public healthcare system in service of the people of Ontario.”
– Anthony Dale
President and CEO, Ontario Hospital Association
“As a surgeon, I feel any measure that will allow for more surgeries and cut wait times should be considered. Expanding the scope of Community Surgical Centres is a measure that could potentially help reduce wait times across the province. With the proper safeguards that ensures staffing in hospitals won’t be impacted and IHFs are affiliated with existing hospitals to support patients throughout their care journey, this could benefit many patients and families in Ontario. We look forward to working with the Ontario government to develop this model to best serve Ontarians.”
– Dr. Amit Atrey
Assistant Professor of Orthopaedics University of Toronto Staff Trauma & Arthroplasty surgeon, St Michael’s Hospital
“Experience elsewhere has shown that providing outpatient surgeries and procedures in the community greatly improves the patient experience. Patients get their surgeries sooner, have lower rates of infection and get to go home the same day. We look forward to working with the government to develop a strategy to make sure these new centres do not take resources away from hospitals or exacerbate existing health human resources challenges.”
– Dr. Rose Zacharias
President, Ontario Medical Association
“This is an important solution that can help address wait times, one of the biggest structural problems in the health-care system. The OMA looks forward to working with the government to implement this model of care that will expand capacity throughout the health-care system. Integrating these new centres with hospitals and the broader health-care system will help ensure high-quality care and patient safety and free up beds and operating rooms for emergency, acute and complex cases.”
– Allan O’Dette
CEO, Ontario Medical Association
“Sunnybrook has had success in reducing patient wait times for both low risk and complex surgeries by partnering with health care organizations outside of the hospital to perform endoscopies, cataract procedures, and hearing loss treatments. We have also been able to achieve reductions in wait times by partnering on regional models of care with our fellow hospitals. Reducing wait times is a priority for everyone in health care and it is an issue that requires innovation and investment on a number of fronts. From embracing new models of care to ensuring our most important resource, our people, have the support they need to succeed, we are committed to improving the Ontario health care system in every way possible. We look forward to working with the government to ensure all Ontarians are able to access care in a timely and safe manner.”
– Dr. Andy Smith
President and CEO, Sunnybrook Health Sciences Centre
“Today’s announcement, focused on day surgeries which provide patients with improved quality of life, is an important step in helping to reduce the surgical backlog and getting people the surgeries they need in a timely manner, all while protecting universal access. I look forward to working with the government, system partners and the potential centre’s to develop the framework needed to maintain the integrity of our public system regarding staffing and quality assurance.”
– Dr. Kevin Smith
President and CEO, University Health Network
“Community-based surgical facilities can help ensure timely access to safe, high quality and personalized care. With the significant and growing backlog of surgical procedures, today’s announcement is a positive step forward for patients, communities and the Ontario health system. We look forward to working with government and partners to ensure an integrated and sustainable approach.”
– John Yip
President and CEO, SE Health
“We are committed to reducing wait times so that all Ontarians can get timely access to quality care. In partnership with health system providers, and informed by best practice, data and evidence, we will ensure system integration that supports provincial reporting, coordinated planning and equitable access for patients across the province.”
– Dr. Chris Simpson
Executive Vice President Medical, Ontario Health
“The Ontario Association of Radiologists welcomes the government’s plans to reduce wait times for surgical and diagnostic services. Ontario’s healthcare system was tested during the COVID-19 pandemic, and while it continues to recover, innovation is necessary to overcome systemic challenges. As the government moves forward with these investments and system improvements, protecting hospitals’ health human resources will be critical to the success of these initiatives. This will require continued investments in training and re-skilling programs, that will both support the ongoing surge in healthcare demands and lead to more rewarding careers for Ontarians. Diagnostic and Interventional Radiologists remain committed to working alongside the government and Ministry to provide high-quality diagnostic care to Ontario patients.”
– Dr. David Jacobs
President , Ontario Association of Radiologists