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The South West Local Health Integration Network (LHIN)
instituted an external review of the St. Joseph’s
Health Care London and London HealthSciences Centre Emergency Departments as a result of a challenge to clinical coverage in Urgent Care.On May 24
, 2011 a series of meetings were held in London with representatives of the Board, Executive Management Teams and MedicalLeadership
of St. Joseph’s Health C
are London (SJHC) and London Health Sciences Centre (LHSC) as well as the South West LHIN.On June 6, 2011 meetings were held at SJHC and the University and Victoria campuses of LHSC with both the nursing and physician staff whowork in the Urgent Care Centre (UCC) and Emergency Departments (ED). In addition, we were fortunate to receive numerous emails fromstaff who were unable to meet with us during our on-site meetings.
While the inability to staff the UCC with qualified ED physician support over the past year has resulted in a gradual erosion of hours of service to thecommunity and most recently the plan to close the UCC for both weekend days commencing in June 2011, the underlying pathology appears to berelated to flow issues in the ED. As a result of the inability to offer what physicians and nurses perceive to be high-quality clinical care, the numberof those choosing to practice as full time ED physicians has declined and the capacity to cover additional shifts as well as UCC coverage eroded.Though much is being done to address flow issues by both hospital corporations, the sooner planned bed openings might be realized and expandedcapacity for Long Term Care created, the more likely the hospitals will be successful in recruiting an adequate complement of physicians to ensurefull coverage of all sites. While this review has focused on the London hospitals, the issue of access to urgent and emergent care must increasinglybe viewed across the entire LHIN and consideration of how limited human resources may most effectively be deployed to serve the broaderpopulation of the South West LHIN.