Letters going out this month to invite community members to participate in new Citizens’ Advisory Panel
NHH will be moving forward with the creation of a Citizens’ Advisory Panel (CAP) this fall following unanimous approval of a plan by the Board at its August 27 meeting. The CAP will provide advice to the Board in developing a contingency plan for balancing the budget through changes in services in the event the Hospital is unable to balance through other means.
Financial Outlook
“Despite our best efforts, and the efficiencies gained as a result of our Shared Challenge, Shared Solution collaborative budget strategy launched last December, NHH continues to forecast an operating deficit,” said President and CEO Robert Biron, at the August 27 meeting. Operating costs continue to rise, the demand for the Hospital’s services continues to grow, and revenues are not keeping pace with inflation. By the end of this fiscal year, NHH will have run three consecutive years of operating deficits in order to maintain the level of services our community has come to expect and value.
“Simply put, this approach is not sustainable in the long run,” said Board Chair John Hudson.
“Like any business or household, we simply cannot keep spending more money than we receive.”
Despite the financial challenges facing hospitals today, there will be no bailouts. In the words of Health Minister David Caplan, published in a Toronto Star article earlier this year: “We want hospitals to fund their operation with the existing resources and we do not want them to run a deficit.”
In August, the Local Health Integration Networks (LHINs) introduced the “Framework for Making Choices” as part of its Guidelines to assist hospitals in developing their service and budget plans for the next two fiscal years, 2010/11 and 2011/12. Work is now underway at NHH to prepare these plans.
Hospital boards cannot make the decisions referenced in the Framework for Making Choices on their own. Any planned changes in hospital services must be approved by the respective LHIN board. In addition, the Local Health System Integration Act, 2006, requires health service providers to “engage the community of diverse persons and entities in the area where it provides health services when developing plans and setting priorities for the delivery of health services.”
Added John Hudson: “Regardless of the requirements of the Act, we strongly believe that it is not only prudent, but of significant value, to engage our community when making these types of decisions. While these are difficult times that require difficult choices, the best outcome can be achieved by having a two-way dialogue with our community.”
The NHH Board has mapped out a plan to facilitate public input in such a way that representatives from the community have a meaningful opportunity to participate in the decisions shaping our Hospital’s future. The approach has been developed using the public input received from the Hospital’s April telephone survey regarding community engagement preferences.
“Collaborative” of Experts to Oversee the Citizens’ Advisory Panel
NHH’s approach involves the establishment of a “collaborative” among four parties:
- the Hospital Board providing governance oversight;
- external consultants from MASS LBP with expertise in public engagement;
- researchers from Queen’s School of Business with expertise in resource allocation decisionmaking and program evaluation; and
- funding partner the Northumberland Community Futures Development Corporation
Together, these four parties will support and oversee NHH’s first Citizens’ Advisory Panel (CAP).
CAP Terms of Reference
The membership of the Citizens’ Advisory Panel shall consist of 28 volunteer residents from within NHH’s west Northumberland catchment area. NHH Board Director Lynda Kay shall serve as Moderator, in a non-voting capacity, and as such provide a vital link between the Board and the CAP.
The responsibilities of the CAP shall include the following:
- develop a Decision Making Framework for Service Prioritization (“Framework”); the Framework will guide the decision making process by identifying principles, values and considerations that should be applied when prioritizing Hospital services that are provided to the community;
- apply the Framework in determining which services are “core” and “non-core” for purposes of providing strategic direction to the Hospital;
- apply the Framework to develop contingency plan models/scenarios;
- provide advice on potential service integration strategies for Hospital services with other health service providers; and
- provide a formal report to the Board of Directors outlining the Panel’s advice and recommendations.
Added Biron: “We are very pleased to announce that The Monieson Centre at Queen’s School of Business will provide an independent and objective third party evaluation of NHH’s CAP process, which will help us improve the process for future initiatives. Queen’s will also be assisting the Board by researching decision-making frameworks used in health care and other industries for service prioritization. We are grateful to the Northumberland CFDC for their financial support for this undertaking, and their assistance in facilitating our relationship with The Monieson Centre.”
Selection of CAP Members
Similar to the method used for selecting a jury for a court of law, members will be drawn, at random, from the community at large. Later this month, MASS LBP, the consulting firm retained to assist in the facilitation of the CAP, will use a civic lottery process to mail invitations to 5,000 households in west Northumberland. The letters will invite one eligible member of each household selected to put his or her name forward for consideration as a Panelist. No specialized knowledge about the Hospital or the health care system is required. Panelists must be 18 years of age or older, and be available to participate in the CAP meetings. Staff, volunteers and physicians with privileges at the Hospital are not eligible to participate in the CAP.
In early October, MASS will randomly select 28 citizens from among the applications received to serve as CAP members. Steps will be taken to ensure a balance of participants by age, sex and geography. No fewer than fifty per cent of the Panel’s members will be recent patients or family members of recent patients of the Hospital. A considerable commitment will be required by candidates who decide to put their name forward for participation. The CAP will meet from 9:00 AM to 4:30 PM on five Saturdays planned from late October to early December. In addition, the public will be invited to participate in a “Public Roundtable" meeting that will be facilitated by CAP members, which will further expand the reach of this community engagement. The public will also be invited to follow the progress of the CAP, and read the same background information shared with the CAP, through updates that will be posted on the Hospital website.
Said John Hudson: “It is the Board’s intention to facilitate community input into our budget balancing options in a manner that is proactive, transparent and inclusive. As the LHIN sets out in the HAPS Guidelines referenced above: ‘Health needs and priorities are best addressed when the community providers, health service providers and the people they serve had input that informs the making of decisions.’”
West Northumberland residents are encouraged to watch their mailbox this month for further information, and an invitation to put their name forward to participate in NHH’s first Citizen’s Advisory Panel. Letters will arrive the week of September 9. Acceptance of the invitation to participate is due no later than October 1, with the first meetings of the CAP scheduled to begin on October 24.
For more information, please contact Jennifer Gillard at 905-377-7757 or
at jgillard@nhh.ca.
About Northumberland Hills Hospital
The Northumberland Hills Hospital (NHH) is located approximately 100 kilometres east of Toronto. The 137-bed acute care hospital delivers a broad range of services, including emergency and intensive care, medical/surgical care, complex/long-term care, rehabilitation, palliative care and obstetrical care. A variety of ambulatory care clinics are also offered at NHH. In addition to these, NHH also sponsors a Community Mental Health Centre and an Assertive Community Treatment Team.
The hospital serves the catchment area of west Northumberland County. A mixed urban and rural population of approximately 60,000 residents, west Northumberland comprises the Town of Cobourg, the Municipality of Port Hope and the townships of Hamilton, Cramahe and Alnwick/Haldimand. NHH employs close to 600 people and relies on the additional support provided by physicians and volunteers. NHH is an active member of the Central East LHIN.
For more information, please visit www.nhh.ca.
About MASS LBP
MASS LBP is a new kind of company that is reinventing public consultation. MASS LBP works with visionary governments, corporations and organizations to deepen and improve their efforts to engage citizens and solve complex issues. For more information, please visit www.masslbp.com.
About The Monieson Centre, Queen’s School of Business
Established in 1998, The Monieson Centre brings leading academic research to business, government, and community audiences to create value through knowledge. The Centre focuses on research related to the knowledge economy - how best to use the expertise of individuals, organizations and communities to create knowledge capital. For more information, please visit the Monieson Centre website.
About the Northumberland Community Futures Development Corporation
The Northumberland CFDC is a not for profit organization governed by a local Board of Directors and staffed with business professionals. Northumberland CFDC works closely with the community to foster new partnerships, assess challenges and create new opportunities that will strengthen our economy. This project is funded in part by the Government if Canada's Eastern Ontario Development Program, which is administered locally by the Northumberland CFDC. For more information, please visit www.northumberlandcfdc.ca.