Thames Valley District Health Council Services Review

MANDATE AND PROCESS

In June 1994, the Ministry of Health approved a grant for the Thames Valley District Health Council (TVDHC) to "determine the appropriate configuration of hospital services and to address the findings through rationalization or realignment of services".

THE TVDHC formed a 12-member committee called the London Acute Care Teaching Hospitals Restructuring Committee (LACTHRC) to make recommendations on the scope and location of clinical and academic services provided by the acute care teaching hospital system in London. LACTHRC members represented a wide range of groups, including the public, health care, business, research and education.

LACTHRC formed nine Task Teams and received feedback through 12 regional consultation sessions with community groups, clinical specialists and other district and regional restructuring groups in the following areas:

Communications/Consultations	Facilities & Support Services
Economic Model	Human Resources
Governance	Teaching & Research
Patient Service Groupings	Vision
Data Advisory

The Final LACTHRC Report was released February 29, 1996 and outlined the Committee's work and analysis in the following major areas:

• Profile of the Thames Valley Health District, including socio-demographics, health status indicators and health service utilization
• Health Services framework in southwestern Ontario
• Review of acute care services in London
• Results of broad consultation and analysis of feedback
• Restructuring recommendations for the acute hospitals

OPTION DEVELOPMENT AND ANALYSIS

As part of its decision-making process, LACTHRC used five criteria: quality of care, affordability, teaching & research, research and future service needs, partnership & coordination.

These criteria were applied to three models for the London acute care hospitals:

• Consolidation of 32 services onto one or two sites
• Continuation of three tertiary/quaternary hospitals
• Differentiated roles based on recognized excellence

• Two comprehensive adult tertiary care centres: Victoria campus & University campus
• St. Joseph's Grosvenor site to become child/maternal, family medicine, mental health and rehabilitation centre with onsite medicine and surgery to support these roles

• Consolidation of most tertiary and quaternary care on two sites: University Campus and Victoria Campus
• New role for St. Joseph's on Grosvenor site to combine community hospital services with specialty services in a teaching environment
• Westminster Tower would be leased from LHSC to create the child/maternal continuum under St. Joseph's leadership on the site of a network of adult and children's services

1. Link care through a directory system and common information systems
2. Enhance primary care services in east London with community health centres as a preferred model
3. Redesign emergency care by reducing the number of emergency departments from four to three and reducing deferrable emergency visits by 33 - 40%
4. Restructure hospital patient care services using Model 3. The impact of this option is as follows:
   • South Street site would close
   • a new tower would be required on the Victoria campus to consolidate tertiary fetal/maternal program from St. Joseph's with paediatrics at Victoria
   • the role of the St. Joseph's Health Care London would change to community teaching with some tertiary
   • all major clinical programs would be consolidated, with two hospitals operating collaboratively at three sites (Perth, Commissioners, Grosvenor)
   • a capital investment of $188 million would be required
   • operating annual savings of $79 million would be achieved
5. Design the facilities to meet the newly recommended roles.

Go To The LHSRR Table of Contents
Proceed To Section #4 - Analysis and Evaluation of Restructuring Options
Return To The Thames Valley District Health Council Health Services Review