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Next steps for Niagara Health System

Posted Jan 14th, 2014

Niagara Health System ends Supervision and Board assumes full responsibility; Minister announces planning for new South Niagara Hospital is going ahead; Dr. Kevin Smith ends role as Supervisor, will stay on as NHS CEO in addition to his role as President and CEO at St. Joseph's Health System; local NHS President will be recruited

The Honourable Deb Matthews, Minister of Health and Long Term Care, made these announcements today at 3:00pm, noting NHS will receive a $ 26.2 million planning grant as the next important step toward a new South Niagara hospital

Niagara Health System is pleased to inform you that as of today the Minister of Health and Long Term Care has announced that our community-based Board of Directors for NHS has taken on its full responsibilities. The Board has also recommended that Dr. Smith continue in a leadership capacity to finish the job he started, and NHS has entered into a management services agreement with St. Joseph’s Health System, keeping Dr. Smith on as CEO.

Dr. Barry Wright, Chair of the NHS Board of Directors indicated “I am thrilled to announce that Dr. Kevin Smith has agreed to serve as CEO of the Niagara Health System, now that supervision has ended, in addition to his current role at St. Joseph’s Health System. This news, along with the government’s commitment to a new hospital and two new urgent care centres in the region, means that the future of health care in our community has never been brighter.”

Dr. Kevin Smith noted the exciting challenges ahead. “There are still a great many hurdles in Niagara, and taking on the CEO job I am committed to continue to work on bettering our culture of caring and our commitment to academics, working with the leadership teams of both St. Joseph’s Health System and NHS. I also know a great deal of energy will be focused on the next important phases of planning for the new South Niagara hospital, which will become a hub for high quality, patient-centred care. I want to express my appreciation to our staff, physicians and volunteers as well as our partners in health care delivery for all their efforts to ensure our community receives high quality care.”

The plan announced today will also see a President for NHS recruited whose responsibilities will include working with the Board and Dr. Smith on strategic planning and culture renewal. Recruitment for this role is commencing immediately. In the interim, following Dr. Sue Matthews' final day, commencing February 7, 2014, Angela Zangari, Chief Financial Officer, will assume the role of Interim President until such time as a candidate is found to fill the role permanently.

More information will follow in the coming weeks.


Questions and Answers

What does this mean for Niagara’s hospitals?

Primarily this announcement means that the plan put forward by Dr. Smith in his role as Supervisor is moving forward, and that Dr. Smith has agreed to stay on as CEO to finish the job in terms of building community confidence and improving the patient experience in Niagara. It also means the proposed new South Niagara hospital has passed an important marker, and that NHS will move forward with planning toward construction of a new site.

Does this mean Niagara is losing its autonomy?

The Board of Directors for Niagara Health System will retain its authority, and has contracted Dr. Kevin Smith to work as the most senior leader for the organization, overseeing important activities like strategic planning, while also advancing our plans, in particular those for the new site, working with government and other partners. Most major decision-making, like divesting of assets or the content of the strategic plan, will be done in collaboration between the Board, Dr. Smith, and the NHS leadership team.

NHS will also recruit a President who will assume on-site operational responsibilities for NHS hospitals on the day-to-day basis, reporting to Dr. Smith and the Board. There may also be opportunities for further collaboration between St. Joseph’s Health System and NHS that are mutually beneficial and these will be explored in future.

Is this arrangement taking healthcare dollars out of Niagara?

Dr. Smith is not receiving any additional personal compensation as a result of the management services agreement, and the costs incurred will only be related to project-based expenses. St. Joseph’s Health System will recuperate appropriate costs related to the fulfillment of the terms of this agreement.

Does this mean Niagara Health System is merging with St. Joseph's Health System?

This is not an amalgamation, but a management services agreement. Niagara Health System will retain its Board, and will have decision-making ability on important matters.

What are the differences between a President and a CEO?

Looking at how the model works at St. Joseph's Health System (SJHS), the President is the on-site, local leader who is accountable for the operations of the hospital, and is the primary face of the hospital to the local community, local media and local politicians. The CEO's role is more external, involving advancing our plans with the Provincial government, and looking at longer-term strategic opportunities for the organization. The President, CEO, and Board will work together on important matters like the strategic plan and cultural renewal.

What is the term of the agreement making Dr. Smith our CEO?

The agreement has been finalized and we will post it on our website very shortly. The agreement states that the initial term is for three years and is automatically renewed for a further term of two years unless at least six months prior to the expiry of the initial term St. Joseph’s Health System or Niagara Health System gives the other notice that they do not wish the agreement to be renewed. It can then be renewed again after that initial five-year term. The Boards have entered this agreement in good faith, with the intention that it be long-standing, leading to benefit and opportunity for both NHS and SJHS.

Did the Minister approve a new hospital, or just the grant to plan for a new hospital?

Technically the Minister approved us to move to a new phase of planning for the new hospital. That said, the government's announcement used language that indicated the proposed South Niagara hospital is 'moving forward.' We also received a large sum of planning funding that will take us through to the end of the planning cycle.

What is involved in the planning grant? $ 26M seems like a lot of money?

The planning grant will involve many phases including analyzing the proposed site and the land including servicing, soil samples, and other elements. It will also include an exercise to determine what clinical services will be required at the site, and the projected number of beds. This process will involve a lot of work with Infrastructure Ontario, the government's capital planning branch. The process could take up to 18 months.

Can we use the plans from the St. Catharines Site that was just built?

Although there are definitely things that we have learned from the St. Catharines Site build that will translate to the new site, the planning for this site involves analyzing consolidation of activity from the legacy sites and new needs in our communities. It will also address the two new urgent cares that have been approved, whose activity is currently at Douglas Memorial and Port Colborne hospitals’ urgent care centres. There are also ever evolving construction standards, and other changes that have taken place since we did the planning for the St. Catharines Site.

How long until a new hospital is built?

This is to some degree uncertain, but it is probably realistic to speculate it will be a minimum of 6 to 10 years.

Has the new hospital location been chosen?

Much work went into the recommendation to plan for a new hospital near Lyons Creek and QEW in St. Catharines. Dr. Smith received input and analysis from municipal leaders, the region's planners, Niagara EMS, and a geo-location expert at McMaster University before suggesting that area. Also a generous donor has offered to donate land in that area. Through the planning grant, that site will be subject to further analysis, but in general we expect that Lyons Creek and QEW will be the area in which the new hospital is built.

Where will the two approved Urgent Care Centres be located?

This will be determined through the planning grant process.

Are the small sites closing?

Any closure of small sites will be planned with a number of things in mind, including the date for the new site opening, the financial situation of the NHS and the ability to ensure services are available. As always, our financial planning will attempt to minimize job loss wherever possible.

What is the status of the search for a permanent Chief of Staff?

The search for a permanent Chief of Staff is ongoing, and we hope to conclude it and announce the successful candidate within a few short months.

Will the Minister's announcements this week impact my job?

The Minister's announcements are not about job loss in any way. Longer term, when a new hospital is built, there may be new opportunities and some of us may be serving patients in different environments than we are now.

Niagara Health System