While there is a now a full staff of nurses at the Sackville Memorial Hospital, a return to 24/7 service at the hospital’s emergency department is still months out, Horizon CEO Margaret Melanson told Tantramar council on Monday.
“We have the nursing staff,” said Melanson, “that’s not the issue. The issue is the medical staff coverage.” At least two more full time emergency department doctors are needed to fully staff the Sackville ER.
“I really don’t want to reintroduce additional hours and then have to retreat again from that,” said Melanson. “And so our next leap would hopefully be that we will be able to be open until at least midnight, and then from there look at what will be the model for an overnight service availability at this point in time.”
Melanson said physician recruitment efforts are underway, and Horizon is exploring other options to staff the Sackville ER, such as making it possible for Moncton ER doctors to take shifts in Sackville, and the introduction of physician assistants to the Moncton ER to help free up doctors.
A policy change with Horizon last year meant that local primary care doctors no longer needed to commit to working shifts in the ER, which resulted in the immediate loss of two ER physicians who chose to focus on their family practices. Melanson said that was aligned with a culture shift in medicine, making primary care and emergency medicine their own specialties.
The practice of a family doctor working shifts in an ER is, “becoming a thing of the past,” said Melanson. “Primary Care is its own specialty, and physicians that have a residency in primary care, wish to carry out primary care… They don’t want to be working in the hospital, and they don’t feel they have the training for the emergency department.”
On the other side of the coin, there are doctors specializing in emergency care. The only trouble is the Sackville Memorial Hospital might not be attractive to emergentologists. “They likely want to be associated with a major trauma centre,” said Melanson. That’s why she believes the Sackville ER will benefit from being staffed alongside the Moncton ER.
“It may be that it’s a combination of physicians that are recruited that would live [and work] in Sackville… with people from the Moncton hospital that would be coming out to cover shifts,” said Melanson.
Community group report and recommendations remain confidential
Melanson was in Sackville Monday partly to celebrate the accomplishments of Horizon’s collaboration with local volunteer group, the Rural Health Action Group (RHAG). Much has been said publicly about the volunteer group’s work on recruitment and retention, including the design of a website geared towards attracting health care workers to the area.
Less has been said about the RHAG’s Service Design Working Group, a group of volunteers who produced a report and recommendations for Horizon which Melanson says the health network is using to inform its plans.
“There was an in depth review of the current health care services in the Sackville area, and an analysis of those gaps and opportunities,” said Melanson. “They presented a very fine report to myself and other members of our executive team back in the late fall of 2022. And so as a result of these recommendations having been brought forward to Horizon, we have a plan now that we would like to outline for implementation.”
Unfortunately, the report Melanson refers to is not available to anyone outside of Horizon or the Rural Health Action Group. Though RHAG volunteers submitted the report and recommendations on behalf of the community, the group has yet to release it publicly.
Melanson shared an outline of some of the recommendations that the health network is considering for implementation:
• Prioritize addiction and mental health addiction resources
• Improve access to primary care
• Enhance existing team-based practice – health clinic and Nursing Home Without Walls
• Enhance prevention, wellness, and education
• Improve transportation
• Improve long-term care – part of the continuum of primary care to end of life care
‘Not an easy transition’
Rural Health Action Group co-chair (and former Sackville mayor) John Higham also presented on Monday, and asked council to consider the future of community engagement with Horizon.
“We now have to think about collaboration 2.0, how are we going to do this? We need different people. We need to actually do things now,” said Higham. “Last time, we could just tell Horizon, well, you should probably try this or this. But now we actually have to find places for clinics, and find residences, and go out and recruit and attend some of the sessions where we could recruit.”
“And so that’s where we’re at,” Higham told council. “Which is a positive, but it’s not an easy transition that we’re going to go through in the next little while.”
