A Zoom webinar hosted by South Bruce Grey Health Centre about a planned reduction in services at the Durham Hospital offered stats about staffing issues, but left some other questions unanswered.
Those include questions about alternative options, and why leadership and the board were not at a public meeting on the matter last week.
The 45 minute webinar was held Tuesday morning.
It was billed by the South Bruce Grey Health Centre as an opportunity for the community to have their questions answered about the unpopular decision to move the inpatient beds from the Durham hospital to Kincardine and Walkerton.
SBGHC CEO Nancy Shaw and Chair of the SBGHC Board of Directors Jim Bagshaw, as well as Director of Clinical Support and Ambulatory Care Services Mandy Dobson addressed questions from a prepared list of frequent questions, followed by 10 minutes for questions submitted ‘live’ by the community which the SBGHC chose from.
CEO Nancy Shaw said, “We have heard loud and clear that keeping emergency services open at the Durham site is a priority for our patients as this is primarily how you access healthcare, as many patients in Durham do not have access to a family doctor.” Shaw repeated what she has said before, that there are no plans to close the emergency department completely. She also stated the ‘H’ would remain on the Durham hospital.
Shaw argued the decision to move beds protects access to emergency care, saying, “We truly wish we were not in a situation where we had to make such decisions, but the safety of our patients and staff come first. ”
She says the decision has nothing to do with cutting costs, stating, “Relocating these beds is what will allow us to keep the Durham site open with the staff that we have.”
When asked why the SBGHC didn’t engage with community partners before making the decision, Shaw says she wishes she could have had more time to do more engagement, adding, “But unfortunately, we just didn’t have a choice, due to the severe staffing shortages which are anticipated to get worse, we had to act swiftly.”
She says they had an obligation to finalize their summer staffing schedule by May, according to collective agreements.
When asked about consultation with community partners, Shaw said over the last year, SBGHC has been in, “Frequent communication with our health system partners, including Brightshores Health System, Hanover and District Hospital and others.” Shaw says she’s also met regularly with municipal partners to discuss the challenges the hospital is facing and how SBGHC plans to address them. She says municipal partners were informed of the decision to move the beds in advance of the announcement, though Shaw didn’t say how far in advance.
Municipal representatives have said they were informed of the plan to move beds at the same time as the rest of the community.
Grey County and the Municipality of West Grey have both publicly lamented their perceived lack of consultation on the decision to move the beds.
When asked why the board and CEO did not attend a public meeting held May 7th in Durham, CEO Nancy Shaw did not offer an explanation about the specific date. Instead, she said, “Hearing from the community is really important to us. That’s why we are hosting this webinar today. We understand that the Durham community is really engaged and passionate about the hospital and healthcare services, and over the last two weeks we’ve received many questions and we are actively working to respond to all the questions and concerns as best and as quickly as possible. So we wanted to provide an opportunity for everyone in our community to hear from us directly and be able to ask questions and that’s why we’re hosting this today, to share information and respond to your questions.”
The webinar did provide some information about staffing numbers at the hospital.
Shaw says from April 1st, 2023 to March 5th, 2024 there were 96 short notice and emergency department closures in Durham due to insufficient staffing. “This is partially due to the 2,303 hours of short-notice nursing staff vacancies at the site over the same time period,” says Shaw.
She says to help fill some of those vacancies, the registered nurses at the Durham site worked 3,119 hours of overtime, noting, “We expect all of these numbers to increase if changes are not made at the Durham site.”
Shaw added, “The current registered nurse vacancy rate at the Durham site is 48 per cent.” She says that’s up from 19 per cent last year. Shaw says, “We cannot continue to ask them to work the long shifts and extra hours that they have been completing. They deserve vacation time. They deserve consistency in their schedules.”
She says SBGHC has been struggling with a shortage of staff for the last five years, adding, the human resources team has been “tirelessly working to recruit more staff,” saying they have had 16 applicants in the past six months, 12 of whom were from out of the country or region, and once they were told where Durham is, did not want to relocate or do an interview. Of the four others, Shaw says one didn’t meet the requirements for the position and two are in the interview process, while one has been hired.
Back at the May 7th meeting, people expressed a desire to know what kind of alternate options the board had considered before choosing the present course of action.
The question was posed in the webinar. Board Chair Jim Bagshaw answered, “The board carefully reviewed and discussed several options around staffing, use of agency nurses and different program reviews as well. But after reviewing all the options that we had, the board came to the conclusion that transitioning the beds from the Durham site was the only option to preserve emergency services at Durham.”
He didn’t describe those options he says were discussed, other than to add, they’ve been undertaking recruitment initiatives for several years and have been using agency nurses to address some vacancies but he says it’s not sustainable for the long-term.
“We know that many people in Durham don’t have family doctors, so they rely on emergency services and we wanted to preserve that as much as we could,” said Bagshaw.
Meanwhile, Shaw notes the beds will move to Walkerton and Kincardine as of June 3rd ‘indefinitely,’ and in answer to a question about what happens to equipment that was donated specifically for the Durham site, Shaw expressed gratitude for the donations and said all the equipment will be used for patient care, and some will be moved, while some will stay in Durham.
She says “While we do not anticipate having a solution for our staffing shortages any time soon, the leadership team is always open to reevaluate the situation should more qualified registered nurses come back to work.”
When asked in a submitted question, “Who set all of this in motion, the leadership, board or government?” Shaw replied, “The reality is, we’re facing a severe shortage of nurses at the Durham site and because of this shortage, swift action needed to be taken to preserve access to care at Durham. It’s really important that we maintain that access to healthcare for everyone within the Durham community. The leadership team and the board reviewed several options and came to the conclusion that transitioning the beds from the Durham site was the only option to preserve emergency services in Durham and provide ongoing access to care for the community.”
Another question that was raised both at the public meeting May 7th and again during the webinar about COVID-19 vaccination policies for staff was answered.
South Bruce Grey Health Centre still requires vaccination for staff. Shaw said, “We want to remove as many barriers as possible so we can have more staff caring for our patients. However, South Bruce Grey Health Centre also remains committed to providing high quality patient care services. And with that, we depend on evidence based practice and certainly following infection control practices that are supported by experts in the area. So right now we are continuing to follow those guidelines that support vaccination.”
Brightshores Health System, which runs the majority of the other hospitals in Grey Bruce also still requires staff vaccination at its hospitals.
Director of Clinical Support and Ambulatory Care Services Mandy Dobson answered a question about the whereabouts of agency nurses that are being funded. Dobson said they’ve been using agency nurses for several years across their sites, sometimes heavily, noting, “It’s not a sustainable long-term solution. An agency is really helpful to fill in gaps as needed, but we’ve experienced a lot of challenges as far as they don’t adhere to the same collective agreement as our staff, so from a scheduling standpoint it’s challenging when availability changes frequently and we have struggled to fully stabilize with agency.” She says it’s the short-term vacancies that they struggle to get agency nurses to fill, and it’s the short-term vacancies that lead to closures. “We are currently using some agency nurses right now but we need to have something sustainable.”
This was the first of several community engagement sessions SBGHC hopes to have over the coming months, Shaw says, “As we discuss stabilizing our operation across all four sites.”
Shaw added, “We are also actively advocating to bring new healthcare services to the Durham site. If Durham cannot support inpatient beds at this time, what other services can we bring to Durham that will help the Durham community but also the broader region?”
A bus of people from Grey Bruce are heading to Queen’s Park in Toronto Wednesday morning to represent the Save the Durham Hospital Group and try to raise awareness and voice opposition to the planned changes.
A statement from the Ontario Nurses Association was also released Tuesday. It blamed management for staffing issues and claimed they aren’t recruiting aggressively enough. You can read that statement HERE