As Alberta continues a major overhaul of its health care system, work to establish a new agency responsible for acute care services has fallen months behind schedule.

At a news conference Monday, Alberta Health Minister Adriana LaGrange announced more time is needed to get Acute Care Alberta up and running.

The new provincial health agency is now expected to be operational by spring 2025. The provincial government hoped the organization would be fully operational by the fall.

“We made this deliberate decision to be flexible with respect to deadlines to ensure that this incredibly complex and incredibly important work is done well,” LaGrange said Monday.

“The acute care system is complex and it is critical to ensure we set it up for success, now and in the future.

The province hopes to have Acute Care Alberta up and running by April 1, LaGrange said.

No disruption to patient services, says LaGrange

Hospitals now managed by Alberta Health Services and Covenant Health will answer to the new agency which will manage hospitals, emergency services and surgical care.

The agency will be introduced in a phased approach. The province is creating a task force to ease the transition and former AHS president Dr. Chris Eagle has been named an advisor.

There will be no interruption to patient services during the delay in surgeries or the upcoming transition of care, LaGrange said.

“While this is an adjustment from our initial timelines, providing Albertans with a sustainable and efficient health care system remains our top priority,” LaGrange said.

The new agency is part of the provincial government’s ongoing work to dismantle the AHS, the centralized body that oversees health care delivery in everything from acute care to community care.

Under the new structure, AHS is to be replaced by four separate agencies – primary care, acute care, continuing care and mental health and substance abuse – and relegated strictly to the role of hospital care.

The radical overhaul has raised fears that the new model will create unnecessary upheaval in the health care system by creating a patchwork of disconnected services that could put care at risk, some critics say.

Critics, including doctors and nurses, said the system shake-up would not solve delays in care, a lack of beds for patients or the growing demand for new doctors amid ongoing pay squabbles with doctors.

The province said the changes are necessary to streamline patient care, improve operational oversight and reduce wait times.

On Monday, LaGrange said the changes have already helped Alberta patients and streamlined the system. About 500 AHS management positions have been eliminated to date, she said.

Recovery Alberta was the first of four provincial health agencies proposed by the Alberta government to begin operations. In September, approximately 10,000 staff members and physicians were transferred from AHS to the agency.

Primary Care Alberta has now been created as a legal entity and work has begun to establish its operations, LaGrange said Monday.

Kim Simmonds, epidemiologist and assistant deputy minister of strategic planning and performance for Alberta Health, had previously been announced to oversee operations.

New health corridors

The overhaul will also remove Alberta’s current health zone system.

AHS has divided the province into five delivery zones: Calgary, Edmonton, South, North and Central. The new health system will include seven regional health corridors that will better take into account patient travel habits.

The health corridors will allow the Alberta government to be better able to identify current gaps and make it easier for Albertans to access procedures, La Grange said.

The new corridors will be developed based on data about where Albertans access services and facilities, as well as feedback received at upcoming public engagement sessions.

She encouraged Albertans to provide feedback on the new model during a series of government town halls this month. Another round of in-person public consultations will take place next year.

“We are committed to continuing our work of refocusing and getting to the finish line,” LaGrange said.

“We don’t want to make any missteps.”

These are the missteps that Dr. Shelley Duggan, a critical care specialist in Edmonton and president of the Alberta Medical Association, fears. She said she remained concerned about the unintended consequences of dividing the system into separate parts with separate chains of command.

She fears that without a centralized management structure, essential cooperation within the system will be lost. For example, under previous AHS oversight, when an acute care wing became overwhelmed during flu season, patients were redirected to another location.

Duggan said she was concerned that patients would fall through the cracks in the new system.

“It’s hard to imagine that moving patients forward will be less of a problem. It’s also hard to imagine that there will be less bureaucracy when you have four CEOs instead of one.”

There will be unintended consequences and restructuring must be done in close collaboration with the front-line workers who know the system best, she said.

“It’s very difficult to see through the noise right now,” she said.

“If we could have started all over again, I think changing what AHS was might not have been a bad way to go.”

She said the AMA attempted to advise the province on the “potential pitfalls” of its new model. But Duggan said she wasn’t convinced the overhaul would succeed in improving the system.

Alberta is in need of doctors and nurses and is not in a strong position to resist radical change, she said.

“We really need to get a handle on this before we create even more upheaval in the system,” she said.

“A lot of things could go wrong.”