Answers to common questions on health care system refocusing

The Health Care System Refocus is guided by an emphasis on strong integration and collaboration across all provincial health agencies to support appropriate transitions of care, prevent silos, and ensure Albertans receive the health care they need today and for generations to come.

The refocused system will be a fully integrated health care delivery system that centres around four priority sectors each supported by its own provincial health agency: primary care, acute care, continuing care and mental health and addiction.

The goals and outcomes of Primary Care Alberta include:

• Provide provincial oversight and coordination of primary care service delivery
• Ensure every Albertan is attached to a family physician, nurse practitioner, or primary care provider
• Ensure Albertans have timely access to high-quality primary care services, including after hours, no matter where they live

The goals and outcomes of the acute care provincial health agency include:

• Provide provincial oversight of acute care service delivery and clinical operations, and Emergency Medical Services operations
• Hold AHS, Covenant Health, and other entities accountable
• Incentivize regional innovation and enhance local decision-making, as appropriate
• Reduce wait times and improve quality of care while improving integration
• Higher-quality care across the province and enhancing access to care in rural areas

The goals and outcomes of the continuing care provincial health agency include:

• Provide provincial oversight and coordination of continuing care service delivery
• Manage contracts for service delivery
• Ensure equitable, consistent, and timely access to continuing care services and increase the number and distribution of beds to reflect the projected demographic shifts
• Improved team-based care leveraging other health and social services

The goals and outcomes of Recovery Alberta (the new mental health and addiction provincial health agency) include:

• Provide provincial oversight, including setting system-level objectives, performance standards, and system-level planning
• Focus on planning and service delivery of mental health and addiction services in higher tiered/acuity services (hospital-based) and community outpatient clinics

Both the Ministry of Mental Health and Addiction and Recovery Alberta will be able to hold contracts with third-party service providers.

We are at a critical juncture when it comes to health care in Alberta; the current health system is uncoordinated, and Albertans often do not know where to get the medical attention they need, nor can they access it in a timely manner. We can either keep doing what we have always done and hope for better outcomes, or we can refocus how the system is structured, amend our legislation accordingly, and create a path forward that will get us the outcomes Albertans deserve.

The government heard what Albertans had to say about their experiences with the current health care system and carefully looked at what did and did not work in Alberta’s previous health care system models. The government has considered a wide range of options and identified that this is the best path to achieve the goal of improving access to, and quality of, health care.

Overall, the key changes are at the governance and structural level, addressing areas of accountability and separating the roles of oversight and health service delivery to make sure all Albertans are getting the care they need. Changes to local decision-making and regional advice will empower local communities, including rural, remote, and Indigenous communities, to have a greater say.

Involvement of local communities in decision-making can lead to health care services that better meet specific needs, ensuring that citizens have a voice in shaping their health care system.

The Government of Alberta is committed to engaging with health care workers and listening to the input of patients, families, and caregivers across Alberta. Health care workers know the most about the system, gaps, and needs that exist. Collaboration is crucial to creating a health care system that serves the current and future needs of Albertans.

Future engagement opportunities will be posted at alberta.ca/lead-the-way 

A guiding principle of the health care system refocusing is the commitment to ensure a seamless health care journey for each patient through strong integration, information sharing, and collaboration across all provincial health agencies to support appropriate transitions of care and prevent silos.

The new Integration Council, chaired by the Minister of Health, will include participation from all parts of the new health care system. This council will ensure patients experience a seamless health care journey. This Council will have improved provincial oversight to achieve system-wide health planning and policies.

• The Integration Council will ensure alignment and integration of different health sectors, advice, and information at the highest levels of health care system organizational governance. Further, it will ensure that the health care system is working efficiently to deliver better health outcomes for Albertans.
• The Integration Council will be responsible for ensuring there is a unified health care system, delivered by providers who are accountable to the sector-specific provincial health agencies.

The government is committed to enabling collaboration between the new provincial health agencies to ensure continuity of care and mitigate any gaps during and after the refocusing.

Each new health care provincial health agency will participate in the Integration Council to ensure the system achieves the intentional integration and seamless patient journey Albertans want.

The Integration Council will be chaired by the Minister of Health, with support from the Minister of Mental Health and Addiction, the Minister of Seniors, Community and Social Services, and will have members from each new sector-specific health provincial health agency.

Albertans will continue to access health care services where they are used to getting their care during the system’s transition period and beyond. In some instances, AHS will continue to operate services such as primary or continuing care where they are currently co-located in rural hospitals.

Rural communities will have stronger voices in the new system through regional advisory councils.

In addition, the establishment of the Rural Health Branch within the Public and Rural Health Division of Alberta Health, the first of its kind in Canada, will provide an added opportunity to coordinate activities to enhance health outcomes in rural and remote communities.

Finally, in an effort to improve health care in rural and remote communities across the province by launching a Rural Health Action Plan, which will help guide actions, address challenges and improve outcomes in rural and remote health care. The action plan recognizes Albertans living in rural and remote communities face unique challenges that require tailored supports and approaches to deliver safe, high-quality and sustainable health care services.

Establishing greater accountability for service delivery in each provincial health agency is one of the key drivers for Health Care System Refocusing.

Each provincial health agency will be expected to measure and report against priorities set by the oversight minister and sector minister. 

The role of the Health Quality Council of Alberta (HQCA) will be enhanced to support Alberta Health in setting performance standards and measurement.

The government stands by the Public Health Guarantee that no Albertan will have to pay out-of-pocket to visit a family doctor or receive care at the hospital, and health services that are currently covered will not be delisted. AHS currently contracts some services, which is not a new practice in Alberta or Canada within a publicly funded system.

The Government of Alberta’s goal is to build a strong public health care system and empower health care workers to continue delivering world class care to Albertans. Refocusing the system is a push towards more equitable access for Albertans regardless of where they live.

The Government of Alberta continues to be committed to maintaining a publicly funded provincial health care system that provides quality services to all Albertans.

The government is committed to enabling a smooth transition during the shift from AHS to the new provincial health agencies.

There will be an intense focus on planning and preparing for the stand up of the new provincial health agencies over the next several months, including appointing new leaders and transitioning staff.

The workforce is the backbone of the health care system, and we will minimize the disruption to their daily activities.

For most AHS frontline workers, there will be no changes to their day-to-day roles.

Some staff not in frontline delivery roles have already transitioned to similar roles within Alberta Health. More similar shifts are possible.

As the four new provincial health agencies are established, appropriate resources and staff will transition from AHS to the new provincial health agencies. Planning for the transfer of AHS staff (both frontline and non-frontline) to the new provincial health agencies is ongoing.

The Mental Health and Addiction provincial health agency, Recovery Alberta, is expected to be created in early summer and the first wave of staff transfer is anticipated to begin following its establishment.

The remaining provincial health agencies will be established in Fall 2024. Staff transfer details for the remaining three provincial health agencies will be determined as we get closer to those entities being created.

As information becomes available, Alberta Health and AHS are committed to transparent communication throughout the process.

Corporate and shared services are important to the health care system. These services will be integrated across the four provincial health agencies to prevent silos and in the health care system and improve patient outcomes and continuity of care, which will be explored over the coming months with input from AHS.

The health care system refocus will prioritize advancing Alberta’s health care information systems to improve integration of the various health information technology (IT) systems involved in the patient care journey.

At this time, the changes will not have an impact on the Connect Care rollout.

Connect Care remains an important initiative for patients and health care professionals in Alberta, and its rollout will progress as planned.

Sharing patient information across providers to support continuity of care, while still maintaining Albertans’ privacy rights, remains a critical priority.

As part of ongoing public engagement, Alberta Health is listening to health care workers about their experiences with Connect Care to better understand how best to deploy this important tool.

AHS will continue to deliver Public Health programming in the immediate term. 

Alberta Health is reviewing Public Health functions to determine any future shifts that may be appropriate. If shifts are considered, Alberta Health and AHS will work together to ensure a seamless transition for patients and the workforce.

The Chief Medical Officer of Health and public health professionals at Alberta Health will continue to perform their role of providing public health expertise to support health surveillance, population health, and disease control initiatives on issues of public health importance.

The Acute Care provincial health agency will be responsible for Emergency Medical Services.

Alberta Health created an Indigenous Health division to build more meaningful connections with Indigenous leaders and communities to identify health care system improvements that reflect the unique needs of their communities.

Between April and June 2024, Alberta Health hosted four public, in-person Indigenous Information Gathering Sessions in communities located in alignment with the Medicine Wheel, in the north, south, east, and west of the province. Additionally, it held 14 virtual Information Gathering Sessions with Indigenous leadership and organizations. These leaders and organizations were identified with the support of the Indigenous Health Division, who were embedded in each of the conversations. These insights and perspectives are being used to help guide the design and implementation of the refocused health care system. 

As part of our effort to improve local decision-making and representation, a provincial Indigenous Advisory Council will incorporate feedback from community representatives, including those in First Nations, Métis, and Inuit communities. Additionally, each Regional Advisory Council will have Indigenous representation.

Refocusing our health care system will ensure its improved responsiveness to the needs of Indigenous communities and the ability to provide equitable access and culturally appropriate health services for First Nations, Métis, and Inuit people in Alberta.

Recruiting and retaining health care workers remains a top priority for the Government of Alberta.

The four new provincial health agencies will be able to focus on health care shortages in their specific sector. This means more targeted recruiting and retention campaigns can be leveraged moving forward.

The Ministry of Health will continue to focus on staffing challenges across the province and will leverage the new Regional Advisory Councils to amplify community voices and advise on local issues, including health care worker shortages.

The health care system refocus is guided by an emphasis on strong integration and collaboration across all provincial health agencies to support appropriate transitions of care, prevent silos, and ensure Albertans receive the health care they need today and for generations to come.

In alignment with recommendations from the Modernizing Alberta’s Primary Health Care System Initiative, integrated teams of health professionals will be supported to provide comprehensive primary care. These teams will include family physicians, nurse practitioners, pharmacists, and other providers, all of whom will have appropriate access to patient health information.

To further support improved access and a holistic and integrated health care system, the government is enabling nurse practitioners to open their own clinics, take on patients and offer services based on their scope of practice, training, and expertise to support and stabilize primary health care.

Counsellors provide an important service to many Albertans seeking mental health services. To further improve and define the standards of care, the government is working with counsellors and the College of Alberta Psychologists (CAP) to regulate and license the profession.

As regulated health professionals, counsellors will be held to professional standards including education, safety standards and a code of ethics. Unprofessional or unethical conduct can also be investigated. These are important safeguards that will protect Albertans receiving counselling and improve mental health services for those in need. These regulations are expected to be put in place in 2025.

Given the close alignment of mental health service delivery between psychologists and counsellors, CAP is well-positioned to oversee and provide regulation for this profession. This path will improve the standard of care and ensure consistent delivery of services across the province without the need for a new regulatory body. As part of this, CAP and Alberta’s government will work to minimize red tape by ensuring those who work in the counselling profession and meet requirements are grandfathered into regulation and licensing.

Alberta is taking a transformative role in creating a health care system where the benefits of central administration are balanced against local needs and sector-specific governance to increase accountability for health outcomes. Learnings and successful approaches from other jurisdictions in Canada and around the world were considered in the development.

Some other provinces have demonstrated moves towards more focused service delivery models. Ontario, for example, has created a new provincial health agency called Ontario Health that will do service planning for acute care and other sectors. Ontario Health atHome provides consolidated contracting and service planning for home care and long-term care across the province.

Other provinces have health authority models that allow for more focused service delivery, planning, and oversight, including the Provincial Health Services Authority in BC, 3sHealth Saskatchewan, and Shared Health Manitoba.