Rollout for new acute care agency delayed as Alberta's health system overhaul continues 

As Alberta continues major surgery on its health-care system, work to establish a new agency in charge of acute care services has fallen months behind schedule. 

During a news conference Monday, Alberta Health Minister Adriana LaGrange announced that more time is needed to get Acute Care Alberta up and running.

The new provincial health agency is now expected to be operational by the spring of 2025. The provincial government had hoped to get the organization fully operational by this fall.

"We made this deliberate decision to be flexible with timelines to ensure we get this incredibly complex and incredibly important work done right," LaGrange said Monday. 

"The acute care system is complex and making sure we set the system up for success now and into the future is critical.

The province is hoping to have Acute Care Alberta operational by April 1, LaGrange said. 

No disruptions to patient services, LaGrange says

Hospitals now run by Alberta Health Services and Covenant Health will answer to the new agency which will manage hospitals, emergency services and surgery care. 

The agency will be introduced with a phased approach. The province is establishing a working group to help ease the transition and former AHS president Dr. Chris Eagle has been brought on as an adviser.

There will be no disruption to patient services during the delay in operations or the coming transition in care, LaGrange said.

"While this is an adjustment to our initial timelines, providing Albertans with a health-care system that is sustainable and effective remains our top priority," LaGrange said. 

The new agency is part of the provincial government's ongoing work to dismantle AHS, the centralized body that oversees health delivery on everything from acute care to community care.

Under the new structure, AHS is to be replaced by four distinct agencies — primary care, acute care, continuing care, and mental health and addiction — and be relegated strictly to the role of hospital care. 

The sweeping overhaul has prompted concerns that the new model will create unnecessary upheaval in the health-care system by creating a disconnected patchwork of services that could put care at risk, some critics say.

Critics including doctors and nurses have said upending the system will not address delays in care, a lack of patient beds or a rising demand for new doctors amid an ongoing pay squabble with physicians. 

The province has said the changes are necessary to streamline patient care, improve operational oversight and cut wait times. 

On Monday, LaGrange said the changes have already helped Alberta patients and streamlined the system. Around 500 AHS management positions have been eliminated to date, she said. 

Recovery Alberta was the first of four provincial health agencies proposed by Alberta's government to begin operations. In September, about 10,000 staff and physicians were transferred to the agency from AHS. 

Primary Care Alberta has now been established as a legal entity and work has begun to establish operations, LaGrange said Monday.

Kim Simmonds, an epidemiologist and assistant deputy minister of strategic planning and performance for Alberta Health, was previously announced to oversee operations. 

New health corridors

The overhaul will also scrap Alberta's current health zone system.

AHS divided the province into five delivery zones: Calgary, Edmonton, south, north and central. The new health system will include seven regional health corridors that better account for travel patterns among patients.

Health corridors will ensure Alberta's government will be better able to determine current gaps and make it easier for Albertans to access procedures, La Grange said.

The new corridors will be developed based on data related to where Albertans access services and facilities, as well as feedback received during upcoming public engagement sessions.

She encouraged Albertans to provide feedback on the new model at a series of government townhalls this month. Another round of in-person public engagement will be held next year.

"We have committed to continuing our refocusing work and reaching the finish line," LaGrange said.

"We don't want to make any missteps." 

It's those missteps that Dr. Shelley Duggan, a critical care specialist in Edmonton and president of the Alberta Medical Association, fears. She said she remains concerned about the unintended consequences of breaking the system into separate parts with distinct chains of command. 

She fears that, without a centralized management structure, critical co-operation within the system will be lost. For instance, under the previous AHS oversight, when an acute care wing became overwhelmed during flu season, patients were diverted elsewhere. 

Duggan said she is concerned patients will slip through the cracks of the new system. 

"It's hard to imagine that it's going to be less problematic to move patients through it. It's also hard to imagine that there's going to be less bureaucracy when you have four CEOs instead of one." 

There will be unintended consequences and the restructuring must be done in close collaboration with frontline workers who know the system best, she said. 

"It's very difficult to see through the noise right now," she said.

"If we could do it all over again, I think perhaps tweaking what AHS was wouldn't have been a bad way to go."

She said AMA has been attempting to advise the province on the "potential pitfalls" of its new model. But Duggan said she isn't convinced the overhaul will succeed in making the system better. 

Alberta is scrambling for doctors and nurses and is not in a strong position to withstand a wholesale change, she said. 

"We need to really get a handle on that before we create even more upheaval in the system," she said.

"There's a lot of things that could go wrong."