Last April, the Nova Scotia provincial government released its Action for Health plan, which was followed up with a website to show how the province is tracking and measuring progress.
The website tracks 125 actions that are divided amongst six key “solutions”:
- To become a magnet for health providers
- Provide the care Nova Scotians need and deserve
- Cultivate excellence on the front lines
- Build in accountability at every level
- Be responsive and resilient
- Address the factors affecting health and well being
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In addition to having status updates, the website also provides data to reflect progress for each of the six solutions, tracking things from the wait lists for long-term care and home care, to ambulance response and offload times, to the percentage of Nova Scotians seeking primary care.
Last week, after signing on to the bilateral health-care funding deals with Ottawa, the province added three new metrics: vacancy rates for health-care workers, the percentage of visits to emergency departments by people without a primary health-care provider and how often ambulances are meeting target response times.
According to the site’s indicator summary, of the 18 indicators with enough trackable data, over the last quarter nine have seen positive results, while six have been negative.
“I think it’s really important that we celebrate the successes that health care workers have accomplished,” said Health Minister Michelle Thompson.
Included among the positive results is an increase to the number of nurse practitioners and registered nurses.
The province has seen an annual net increase of 47 for nurse practitioners and 261 for registered nurses.
This allowed the vacancy rate for NS Health and IWK to drop in the last quarter. However, at 15 per cent it’s more than double the target of seven per cent and remains higher than the average for 2021-2022.
“The Action for Health plan is a strategy, it was sort of prefaced that it won’t be easy and it will take time,” said Colin Stevenson, Chief of System Integration with the Department of Health and Wellness.
“I think it’s important for all of us to reflect and remember that it is a multi-year health plan, it’s not really intended to demonstrate what our focus or accomplishment is intended to be with one single year.”
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The Progressive Conservatives are now a year and a half through their mandate. The party won a majority government in August 2021 after campaigning hard on a promise to fix health care.
Nova Scotia Liberal Leader Zach Churchill says it’s clear from the stats that that hasn’t happened.
“The situation is getting worse by the most important metrics ,” said Churchill.
“How many people have a family doctor, how many people are waiting in the ERs, how many ERs are open, how many staff are working in our system — it’s clear that plan is flawed.”
According to the Action for Health plan, the goal is to have just five per cent of the population seeking a primary care provider, but currently 13 per cent of Nova Scotians are without.
Nova Scotians unattached to a primary care provider are having an impact on other parts of the system.
In the third quarter of 2022-2023, nearly a quarter of emergency department visits were by patients without a primary health care provider. The target is 15 percent.
The province is also failing in ambulance wait times.
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In cities with a population of more than 15,000, urgent cases should be responded to within nine minutes, and non-urgent cases within 15 minutes. In areas with a population under 2,500, those targets are 30 minutes for urgent cases and 40 minutes for non-urgent.
The goal is to meet those targets 80 per cent of the time, but currently they’re being met only 53 per cent of the time.
Offload intervals are even worse, with only 27 per cent of patients being offloaded from ambulances within 30 minutes when it should be happening at least 90 per cent of the time.
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But Stevenson reiterated that the Action Plan itself itself is a long-term plan and that just the action of collecting and publicly displaying the data is helpful for moving forward.
“There was a desire to be more accountable and transparent within what’s happening with the health system,” he said.
“It’s helped people to build confidence that all players in the system are focused on this, that there’s a true commitment and dedication making change which actually builds enthusiasm and it helps to build momentum, so people want to see those measures shift or change.”
Health Minister Michelle Thompson said that there has been early progress in some areas and that things don’t change overnight.
“In the absence of a plan for the last 12 years, I think we really need to celebrate that we have a plan,” said Thompson.
“And that we’re measuring things for the first time and I want to thank health-care workers particularly for their commitment to making improvements in the health-care system.”
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