The province has released an update on its response to a report last fall of B.C.’s handling of the second COVID-19 wave in the long-term care sector, noting a number of steps have already been put in place.
The October 2020 report by Ernst & Young pointed to the lack of centralized oversight as a major hurdle facing the province, highlighting a number of areas that B.C. should improve on in terms of governance, policy and operations in long-term care.
On Monday, the province said it has already released its Fall/Winter plan for COVID-19 management, adding that the Ministry of Health introduced streamlined pandemic response through a new agency (CRHEM) to replace the embattled Health and Emergency Coordination Centre (HECC).
The province is also stepping up efforts to get a better idea of what’s happening on the ground in the front lines of B.C. long-term care homes with regards to COVID, officials said.
“Starting in late-November, [COVID-19 operational] leads began to meet daily with the Ministry... to enhance coordination, collaboration, and data-sharing to strengthen decision-making, communication with the LTC sector,” the province said in a statement. “The Ministry is using a weekly check-in with industry associations as a vehicle for increased communication, coordination, and policy discussions.”
Chief among the concerns in the October Ernst & Young report was the repeated comments from more than 40 stakeholders interviewed – including health authorities, the BC Centre of Disease Control, seniors’ associations, care homes and front-line workers unions – that a more consistent oversight for all regions and public/private operators is needed.
“The Health Emergency Coordination Centre [HECC] could have been better integrated into provincial decision-making and accountability frameworks, resulting in decisions being better coordinated, and addressing the decision-making powers and accountabilities of the HECC,” the report said.
It also noted that the “oversight, management, and support available to providers depended on whether a facility was health authority owned and operated or operated by a private or not-for-profit provider.”
“Policy challenges were communicated to contracted and private care providers through different means, and private operators reported feeling they were given less implementation support,” the report said. “The above was made more difficult by the Ministry and Health Authorities having limited visibility into operations, and challenges in collecting some human resource and financial data.”
According to the report, there were also complaints from stakeholders that there was some confusion over who had the primary authority when orders from the Ministry of Health and local authorities conflicted with one another – and that conflicts arose because guidelines and directions “didn't always consider operational constraints.”
“The rationale for collecting personal health and other data was not well understood and contributed to a perception of the ministry's lack of trust in operator's ability to report outbreaks,” the report said. “Real time supply chain data was not readily available, leading to reduced oversight and inefficient management of supplies.”
Provincial officials noted all of those items have begun to be addressed, including a new data-reporting structure and a centralize supply chain coordination system for items such as PPEs.
“The Ministry had begun work on several new data reporting structures to assist with both short-term and long-term collection of health human resource and financial data to better inform policy directives,” the provincial statement said. “These actions align with issues identified in the report.”
The October report did find some strengths in the province’s response, including “a united and consistent presence” by B.C. Health Minister Adrian Dix and Provincial Health Officer Bonnie Henry in the public – which contributed to people following public health orders in larger numbers.
Ernst & Young also found that a significant part of the problems that arose came from the fact that government mobilized emergency response mechanism so quickly across sectors, a positive point considering how quickly COVID-19 could have potentially spread in the community.
The province added that B.C.’s COVID response as resulted in lower infection and mortality rates when compared to places like Ontario, Quebec and Alberta.
The full report can be read here.
