Amid a wave of changes hitting Manitoba health care, the province and the Winnipeg Regional Health Authority announced another shift on Tuesday: the closure of four of Winnipeg's five remaining QuickCare clinics, to be replaced by expanded Access centres throughout the city.
The health authority says the move will save around $900,000 — just a portion of the roughly $83 million it hopes to cut in order to balance its budget.
To help you figure out how the change will affect you, here's a breakdown of what you might want to know about QuickCare clinics and Access centres, starting with the basics.
What's a QuickCare clinic?
A QuickCare clinic is a care centre staffed primarily by nurse practitioners and designed to treat minor ailments in order to free up family doctors.
The clinics offer walk-in services and operate on extended hours, including during weekends, evenings and holidays.
According to a 2014 report on "innovative practices" by the now-defunct Health Council of Canada, the first four Manitoba clinics — opened in 2012 and 2013 — saw more than 45,000 patients by the fall of 2013.
The clinics are funded by regional health authorities. They can diagnose and treat non-urgent care needs such as:
- Bumps, bruises or sprains.
- Rashes, eczema, infected cuts or minor sores.
- Sore throats, earaches, colds and flu, coughs, hay fever or nosebleeds.
- Immunizations (including this season's flu vaccine).
- Stomach pain, diarrhea and vomiting.
- Headache, back or neck pain.
- Breast feeding issues.
- Sexual health-related issues, including birth control.
- Stress or anxiety.
- Minor medical issues in children.
If you're wondering, nurse practitioners are registered nurses who have advanced education and experience that allows them to make diagnoses, order and interpret diagnostic tests, and prescribe pharmaceuticals, according to the Nurse Practitioner Association of Manitoba.
How is it different from an Access centre?
Access centres offer a variety of services, and each one has a different menu.
Services on offer at different centres range from front-line health care from physicians or nurse practitioners to assistance with mental health, home care, employment and income assistance programs.
Until now, the centres have not offered walk-in services. But going forward, a spokesperson for the WRHA says that will change, in order to accommodate services previously offered by QuickCare clinics.
There are seven Access centres in Winnipeg, located in seven different neighbourhoods:
- Access Downtown: 640 Main St.
- Access Norwest: 785 Keewatin St.
- Access River East: 975 Henderson Hwy.
- Access Transcona: 845 Regent Ave. W.
- Access Winnipeg West: 280 Booth Dr.
- Access Fort Garry: 135 Plaza Dr.
- Access St. Boniface: 170 Goulet St.
There is also an Access centre in Brandon at 20 Seventh St.
Why were QuickCare clinics introduced?
According to the 2014 Health Council of Canada report, the model is unique to Manitoba.
It was introduced by the NDP back in 2012, touted at the time as a convenient, cost-effective and more efficient alternative to emergency room visits for common health concerns.
They came as an answer to the promise the party made in its 2010 throne speech to ensure every Manitoban had access to a family doctor by 2015.
The theory was that by relying heavily on nurse practitioners at the clinics, doctors would be freed up to see more patients.
"We think by organizing services better we can give more access to existing doctors for people that don't have access now. That's why we talked about the role of rapid access," then-premier Greg Selinger told CBC News in 2010.
The move was praised at the time by the union representing Manitoba nurses as recognition of the role specialized nurses play in health care.
"If you talk to patients in the city who have had the opportunity to be seen by nurse practitioners, they are very satisfied with the care they receive," Manitoba Nurses Union president Sandi Mowat said in 2010.
Manitoba Health Minister Kelvin Goertzen has more recently described them as an "experiment" to improve wait times.
"QuickCare clinics have been somewhat controversial, in my view, from the outset," said Winnipeg Dr. Allan Katz.
"They were an add-on to the system which duplicated services that should be provided by regular providers, providing ongoing, continuous care as opposed to the QuickCare clinics, which provide episodic care."
How will this transition work?
So far, it's a little unclear. At a press conference on Tuesday, the WRHA provided little detail.
The health authority says staff and resources from QuickCare clinics will be moved to existing Access centres around the region.
According to the announcement, the WRHA is adjusting patient-to-staff ratios and changing staff rotations at various units across the region.
The closures are supposed to be completed by the end of January 2018, and services will be redirected to other primary-care options in surrounding areas.