In an effort to meet provincial budget targets, the NBRHC will undergo structural changes over the next six months—ranging from staff reductions to a new physician leadership model

The North Bay Regional Health Centre is making what it calls ‘difficult but necessary’ decisions as it looks to trim millions from its operating budget without affecting healthcare delivery.

It expects to implement the changes over the next six months. Staff were told yesterday that they will see changes to how some services are accessed, and staff layoffs.

Adjustments to its budget and operations are expected to save $5.6 million.

Forty full and part-time positions will be affected, but Director of Communications Kim McElroy says it is anticipated that the number of employees impacted could be much lower based on 14 new positions, offers of early exit, retirements, attrition, and movement to other positions.  

See: Hospital layoffs to impact 40 positions

North Bay Regional Health Centre president Paul Heinrich tells BayToday that the changes to their financial approach are being made with an eye to making sure there’ll be zero impact on service.

“We’ve announced no changes that would impact service. We’ve kind of gotten to the end of the opportunities now. So, these are the changes we can make without impacting any services negatively.”

To accomplish that,  Heinrich says, one of the things they’ve done is reach out to other hospitals.

“It’s a responsibility of all hospitals, and we’ve always done this for years; we do peer benchmarking. We reached out to many hospitals across the province that are similar to us, and we found different practices. Some of the changes we’re making are skill mix changes.”

For example, in practical terms, that means the hospital might investigate Department X. and find that another organization is doing similar work with RPNs as opposed to RNs. That’s an example of a skill mix the local hospital could modify to fit its needs.

“We are constantly looking for efficiency improvements, and this is what we were able to find. I will make the point that we’re pretty close to the end of the road. There’s nothing further that we’re going to be able to find that would not impact services.”

What Heinrich means by that is the hospital board and administration are unwilling to make any further reductions in the budget. He says he doesn’t want to speculate on what the future is, but admits there’s still a certain degree of uncertainty about what the budget will be,

“I just want to tell you at this point in history, we’ve reached out and found best practices and efficiencies, and we’re applying them. And by the way, we recognize this has a real negative impact on morale in the short term. And we don’t take any of these changes lightly. They have a negative impact on individuals, and we’re going to do our best to minimize that impact by trying to manage this primarily through attrition.”

Heinrich points to what he calls “an incredible increase” in the demand for services, plus the complexity of patients has gone way up, citing multiple reasons.

“You’ve got poor access to primary care. You’ve got so many factors. People are delaying care that actually creates a more complex patient, so when they arrive, now our workload is higher, there’s more patients, and they’re more complex.”

Heinrich says the hospital is going to soon embark upon a planning exercise to help define what its future growth and pressure is going to look like.

“We have to be proactive and start planning for the future because there’s a huge increase in the demand for service coming at us over the next 14 years. In fact, it’s going to be something like 72 per cent growth in the burden of chronic disease over the next 14 years. So the health system’s got to get ready.”

 

PHYSICIAN LEADERSHIP MODEL CHANGE

·reducing the number of physician leadership positions effective January 1, 2026: reduction of 20% with no change in physician numbers. 

“We have done everything in our power to meet our financial target and find savings equal to 2% of our budget,” says Paul Heinrich, President and CEO.

“Hospitals face a number of complex challenges, including operational pressures, financial constraints, and an increased demand for services,” Heinrich says. “Our priority is always to protect and maintain access to health care.”

Heinrich says it is important to openly acknowledge the stress this causes for our staff, physicians, volunteers, and patients. “NBRHC is focused on working collaboratively with the Government of Ontario to find both funding and operational solutions to create a more innovative and sustainable future for the communities we serve.”

Among the announced changes is a physician leadership model change.

“These are all practicing physicians that we asked to do leadership roles. So we have right now department chiefs, we have five departments, emergency, primary care, psychiatry, surgery, and medicine. And each of those departments has a medical director and a chief of department. What we’ve decided to do is to combine those 10 roles into five by combining those positions to make one incumbent do that administrative work. And yes, that will add to the burden for those physician leaders, but it’s actually an opportunity for people to reconsider their role, and we’ll be saving money. So big credit goes to our chief of staff and our medical advisory committee for showing leadership here and doing their part.”

Heinrich admits not everybody is happy with these changes,

“As with any change, there is some concern at the beginning. I know there’s not universal happiness about the change, but I would say that there’s better than average positive reaction once you start working through it and consider it, and talk to people. We were very iterative and inclusive about the discussion. And like I said, not everyone’s happy, but I think most people are comfortable with the decision that was taken.”