New ER for addictions, mental health a possibility as LHSC drafts long-term master plan

London Health Sciences Centre is considering several major changes as part of a work-in-progress plan for the future, including creating an addiction and mental health-focused emergency department, and an adult acute specialized care centre, officials said.

Details of the possible changes, which could also see the opening of a child and obstetrical care centre with a specialized pediatric ER, come as LHSC works to finalize a master plan blueprinting how it will deliver care over the coming decades as the area’s population changes and grows.

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LHSC says it has consulted with hundreds of its staff members, along with nearly 3,000 community members and officials from 36 partner agencies in developing the plan, while also utilizing local economic forecasts, national and international trends, population projections, and other datasets.

“There were lots of inputs, and a clear message that came out is people want the best health care possible,” said Brad Campbell, corporate hospital administrative executive at LHSC, on Thursday.

“We really are now going forward with an idea that we need an adult acute specialized care centre which will fulfill all of our needs in those acute areas like surgery, cancer, cardiac, emergency room, etc. to serve the adult population.”

The consultations have also seen several key themes emerge, including calls for improvements to accessibility and inclusivity, wait times and staffing, and mental health and addictions care.

“We are looking at mental health and… how do we better serve populations that aren’t currently well served in buildings that were built 20 years ago and designed 30 years ago. And that would include a mental health and addictions emergency department,” Campbell said.

LHSC officials are also considering the creation of a child and obstetrical care centre containing a specialized pediatric ER, and are also examining how it can better support patients in end-of-life and palliative care, he said.

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The three-phase master plan process is a routine one undertaken with the Ministry of Health when an organization, like LHSC, is eying significant infrastructure refurbishments. LHSC last submitted a master plan in 2013, however, it was rejected by the province.

“Feedback was that it was not innovative enough, it didn’t look to leading examples from international and national trends,” Campbell said.

Development on the new master plan began in 2017, a process that was delayed by the COVID-19 pandemic and other factors. Officials are currently in the early stages of phase one, and a finalized master plan is expected to be sent to the ministry and Ontario Health in July for approval.

“They then review it. They give us feedback. They approve. They don’t approve. Assuming they approve, we then go formally into (the) next stages,” Campbell said. Altogether, the process takes approximately three to four years.

While there is no formal cost estimate yet, Campbell says they believe it could cost upwards of $2 billion based on other projects in Ontario, and what they’ve heard from other hospital CEOs who are drafting their own master plans.

“We put that number out there, not because we’ve come up with a final budget, but when people ask us… we’re trying to sense the order of magnitude. This is not a small change, is really the message.”

If approved, the new master plan would succeed one put in place in the 1990s when the current Victoria Hospital campus was built.

Between now and July, Campbell says LHSC will engage with the community to gather more feedback and to gain clarity on what some options might look like, including whether some services currently provided by LHSC would be better served by community partners.

Campbell says LHSC will also consult with local hospital partners, including its five top referring hospitals and St. Joseph’s Health Care London, which operates St. Joseph’s Hospital, Parkwood Institute, and Southwest Centre for Forensic Mental Health Care in Elgin County. Other partners include Fanshawe College and Western University, which both have students learning within LHSC.

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The new master plan‘s development comes as LHSC, like other hospitals across Ontario, grapples with staffing shortages, overwhelmed ERs, significant patient volumes, and long wait times.

LHSC’s adult and pediatric emergency departments have reported hours-long wait times in recent weeks for non-urgent matters. On Thursday, wait times clocked in at roughly eight hours at University and Victoria hospital’s adult ERs.

“Not all of the solutions have to wait until the master plan is finalized. If there (are) new buildings to come from that… there’s things that you can then do to start down that path, to start to solve some of these problems now,” Campbell said.

“Our goal is to solve some of our congestion in the emerge… or the pressure that we’re currently experiencing with Children’s Hospital, in addition to the other children’s hospitals. Our goal is to figure out what we can do now, but it has to be in the context of that long-term plan, because it has to align.”

On Tuesday, Children’s Hospital announced that it would be cancelling some surgeries in a bid to ease capacity pressures, citing a 115 per cent occupancy rate. Daily visits to the ER were 80 per cent higher than normal, with wait times averaging six to eight hours, officials said at the time.

— With files from Amy Simon

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