Alberta’s government continues to lead the way in reducing surgical backlogs, with Alberta Health Services (AHS) exceeding 100 percent of monthly pre-pandemic surgical volumes.
Surgical wait times have been impacted by the pandemic, with the total surgical backlog in Alberta estimated at approximately 40,000. Approximately 95 percent of the 15,000 surgeries delayed by the second and third wave of COVID-19 have since been rebooked.
Currently, the province and AHS are expanding contracts with four chartered surgical facilities (CSF) to increase the number of cataracts and other ophthalmological procedures available for Albertans. Out of 13 proposals submitted, two have been identified as preferred proponents in the Calgary Zone, and two were identified in the Edmonton Zone. "These privately run, publicly funded facilities will increase surgical access while maintaining high-quality care for Albertans," said health spokesperson Steve Buick.
AHS spokesperson James Wood said they are entering into negotiations with the four CSFs following a public request for proposal (RFP) process launched in April 2021. They expect the CSFs to be ready to provide additional ophthalmological surgeries in Edmonton and Calgary no later than January 2022. AHS will also continue to perform more complex ophthalmology surgeries in Calgary and Edmonton hospitals as well as these community settings.
The contracts in Edmonton and Calgary allocate funding for "established facilities" experienced in performing a high volume of procedures. With increased capacity for surgeries, the province hopes to decrease the surgical waitlist and save costs per procedure.
As of July 7, there are 13,432 patients waiting for cataract surgeries in the province, with 56 percent of those waiting outside of the clinically appropriate target wait time. The target is within six to 16 weeks, depending on the severity of illness or injury.
The final cost per procedure will be determined through contract negotiations. AHS will go through a due diligence exercise prior to initiating negotiations and finalizing the award. Alberta’s government claims costs will be less than historical costs in-hospital, and volume increases will allow better pricing per procedure. The total spending for in-hospital ophthalmological surgeries and CSF facility fees in 2019-2020 was approximately $34 million.
The savings incurred will be re-invested into additional surgeries.
Health Minister Tyler Shandro said the province is able to secure "high-quality ophthalmology care for Albertans at excellent pricing" compared with other jurisdictions across Canada. "This expansion will allow for an increase in safe ophthalmology procedures while delivering savings that can be reinvested to continue expanding surgical access for Albertans," he said.
Ophthalmology surgeries will also continue to be provided in regional sites such as the Queen Elizabeth Hospital in Grande Prairie, Red Deer Regional Hospital and Chinook Regional Hospital in Lethbridge.
This work is part of the Alberta Surgical Initiative (ASI) to ensure all Albertans receive scheduled surgeries within clinically appropriate targets. The initiative also improves and standardizes the entire surgical system from the time patients seek advice from their family doctor, to when they are referred to a specialist, to their surgery and rehabilitation.
"Patients are at the heart of all our decision-making, and these independent facilities provide safe, low-risk surgeries without cost to patients," said Verna Yiu, president and CEO at AHS. "These changes will improve access, reduce wait times for surgery for patients and provide capacity for procedures that require hospital care."
The province also invested $120 million in capital funding over three years in AHS-owned facilities under the Alberta Surgical Initiative to reduce wait times for more complex surgeries that cannot be performed in CSFs.
To continue to expand surgical access for Albertans, an orthopedic CSF RFP is expected to be issued shortly. Additional RFP opportunities for CSF providers in other regional centres and for different types of surgeries are expected in the fall.
No emergency or urgent surgeries were delayed or postponed during the pandemic. Most cancer surgeries continued during Alberta’s pandemic response.
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