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Frequently Asked Questions

FAQ – Health System Transformation

1. Why are changes being made?
Manitoba families deserve to have access to the right care, at the right time, in the right place. That's why the Manitoba government and the regional health authorities are making significant changes to improve health care service delivery in Manitoba.

2. What will be the role of Manitoba Health Seniors and Active Living and the regional health authorities?
Manitoba Health will continue to lead the system in a number of areas, including policy support and planning, funding and performance requirements, oversight and accountability.

Regional health authorities and provincial health organizations, such as CancerCare Manitoba, will continue to be responsible for the delivery of health-care services. The delivery of mental health and addictions services across the province are expected to change as one provincial mental health and addictions system is developed, primarily within Shared Health.

3. How will the regions connect with Shared Health?
Regional representatives from across the province will take part in provincial service planning with clinical specialty leaders working at Shared Health.

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FAQ – Shared Health

1. Why is the province creating Shared Health?
Like every organization, the health system is always striving to be better. Across the province, there are talented, dedicated staff, ensuring Manitobans are getting the best health care possible.

For staff to be the best they can be, they need a system that supports them every step of the way. That's why we're embarking on a transformation of the health system, to integrate health-care services throughout the province, helping every health-care provider to be more effective and helping to optimize patient care, both now and in the future.

Shared Health, led by Dr. Brock Wright, will support a better-connected provincial planning process and develop a provincial clinical and preventive services plan. The organization will also provide coordinated clinical and business support to Manitoba's regional health authorities.

2. Why does the province need a provincial clinical and preventive services plan?
A coordinated provincial clinical and preventive services plan supports the best delivery of care and use of resources - including human, capital and financial - province-wide. Better-planned services will mean improved access to consistent, reliable quality health-care services, right across the province.

3. What will be the main components of the plan?
The provincial clinical services plan will be founded on the idea that health-care needs are always changing. It will be flexible and able to evolve while continuing to focus on accessible and sustainable patient care provided by skilled health-care professionals.

4. What is this plan based on?
In 2015, the province hired Dr. David Peachey to review the state of Manitoba's healthcare system and to make recommendations on what was needed to develop clinical service plans based on evidence, sustainability and equity. More than 250 interviews were conducted with key system stakeholders and leaders across the province.

5. What were the findings of this report?
Findings included that each region was providing quality care, but without a provincial plan to guide their work. Other findings included:

  • Care was not well-coordinated.
  • There were no provincial standards.
  • Rural care was fragmented.
  • Waiting lists were significant.

In particular, Dr. Peachey noted that "...we need to break away from the mindset that "more is better"."

6. What organizations will become a part of Shared Health?
Diagnostic Services Manitoba's corporate structure was used as the foundation for Shared Health.

Staff working in a number of departments, programs, service areas and sites across Manitoba’s health system will begin a phased transition to Shared Health in April 2019, setting the foundation for broad health system improvements to health-care offered across the province.

Affected areas included in the transition of staff include: Diagnostic Services in the Winnipeg Regional Health Authority (WRHA) and Prairie Mountain Health (PMH); Digital Health staff (in all Regional Health Authorities, Manitoba eHealth and CancerCare Manitoba); certain Mental Health Program services; Regional Emergency Medical Services and Patient Transport and WRHA Emergency and Continuity Management; Health Sciences Centre Winnipeg (HSC); and a number of corporate and administrative departments from within the WRHA.

Transition to Shared Health
The transition to Shared Health of staff identified through Wave One activities is now complete. More than 12,000 staff transitioned over the course of two phases in April 2019.

Provincial Diagnostic Services

Diagnostic Services are now consolidated within Shared Health. This includes:

  • Laboratory, diagnostic imaging services, and non-invasive cardiology services formerly provided by Diagnostic Services Manitoba (now Shared Health)
  • Diagnostic imaging services provided by Prairie Mountain Health (PMH) at the Brandon Regional Health Centre (BRHC)
  • Diagnostic imaging services provided by Winnipeg Regional Health Authority (WRHA) including fully-devolved hospital sites
  • Diagnostic imaging services provided at Health Sciences Centre Winnipeg
  • Cardiology services provided by PMH-BRHC
  • Non-invasive cardiac testing, shared in part with the WRHA Cardiac Sciences program, at publicly funded health-care facilities operated across Manitoba
  • Direct service delivery support services such as quality, radiation safety, billing, and central intake

Health Sciences Centre Winnipeg

Health Sciences Centre Winnipeg has transitioned to Shared Health.

A service management framework has been finalized that identifies both key transitioned services as well as those requiring ongoing collaboration by Shared Health and the WRHA. The framework will be in effect for the period of transition (anticipated to be up to one year in length) as legal agreements and assets are transferred.

Emergency Response Services

Emergency response services staff, including emergency medical services (EMS) and patient transport staff from Interlake-Eastern Regional Health Authority, Northern Regional Health Authority, Prairie Mountain Health, Southern Health-Santé Sud, the Medical Transportation Coordination Centre, Adult and Child Transport (Winnipeg Regional Health Authority), and Churchill (Winnipeg Regional Health Authority) have now joined Shared Health. Also included in the transition of more than 1000 staff from across the province are emergency and continuity management staff and patient flow and consultation support from the WRHA.

While staff from contracted or municipally-based organizations are not part of the transition, responsibility for the oversight of the services they provide now belongs with Shared Health. This includes: Brandon Fire Emergency Services, STARS, Stretcher Services of Manitoba, Thompson Fire Emergency Services and Winnipeg Fire Paremedic Services.

Digital Health

More than 700 information and communications technology (ICT) staff across Manitoba have joined Shared Health to form a provincial Digital Health service that will support the systems, services and technology needs of Manitoba's health organizations. This includes ICT staff from Manitoba's regional health authorities, the former Diagnostic Services Manitoba (DSM), CancerCare Manitoba and the former Manitoba eHealth.

Corporate Services

On April 5, 2019, administrative support services staff in a number of important areas (including human resources, finance, contracting and procurement, legal- corporate human resources, Digital Health, privacy, insurance and related risk, capital planning, facilities management and security, internal audit, provincial health labour and workforce, and regional staff scheduling) came together to create an expanded provincial corporate services team within Shared Health.

Health Services

Operations and staff within several programs that provide provincial health services, including medical assistance in dying (MAID), Tissue Bank Manitoba and Transplant Manitoba, transitioned to Shared Health.

Mental Health Programs

Some WRHA mental health program services also transitioned to Shared Health in April 2019 as an initial step in the alignment of critical mental health supports as part of an integrated provincial mental health and addictions system. These include: the Crisis Response Centre in Winnipeg, the Co-occurring Mental Health Substance Use Disorders Outreach Program, the Crisis Stabilization Unit, the Forensic Assertive Community Treatment Team, and Forensic Community Mental Health Services.

7. How much will this cost?
Detailed planning is underway and will continue over the next few months, including planning for costs associated with the creation of the provincial health organization and reducing the scope of the Winnipeg Regional Health Authority. It is expected that changes will be funded through existing budgets. As this work continues, we will share more information.

8. Who will Shared Health report to?
Shared Health will be operated by a board of directors with representation from Winnipeg as well as rural and northern Manitoba. Health will continue to take the lead on policy development, funding, performance monitoring and the oversight and accountability of the regions and the provincial health organization.

9. What about other corporations like CancerCare Manitoba?
CancerCare Manitoba is already a centralized organization, and there are no plans at this time to adjust the work of the organization.

CancerCare Manitoba will be designated as the provincial cancer authority under The Regional Health Authorities Act to ensure the organization is integrated into the health system governance structure and is subject to the same accountability framework as Shared Health and the regional health authorities.

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FAQ – Provincial Clinical and Preventive Services Plan (PCPSP)

1. Why is a Provincial Clinical and Preventive Services Plan necessary?
Our health system, built for the health care needs of a population 50+ years ago, is not equipped to support the integration and collaboration necessary to provide care to patients across geographic boundaries when it is required and as close to home as possible.

Numerous studies of Manitoba’s health system have recommended a provincial approach to health-care planning as a means to more effective and efficient delivery of services.

For more information on past studies of Manitoba’s health system visit: www.gov.mb.ca/health/hst/resources.html#reports.

2. What is the Provincial Clinical and Preventive Services Plan project?
Aided by data, public and population health information, evidence and leading practice, Manitoba clinical leaders are developing a provincial plan that will support the integration, collaboration and innovation necessary to support the health care needs of our population today and into the future.

This is a ground up process, exposing clinical leaders to models from elsewhere and inviting them to use their experience and clinical expertise to create something that will work in Manitoba.

For more information on who is involved in the planning visit: www.gov.mb.ca/health/hst/docs/membership_list.pdf.

3. What is informing the Plan?
Providers are identifying the challenges and gaps that exist in the current system including lack of access, lack of consistency and the absence of clearly defined service models or standards. Specific populations and regions where accessing services is particularly difficult are also being highlighted and clinicians are reviewing leading practices and new models of care from other jurisdictions to data-informed, evidence-based, locally-relevant and sustainable recommendations.

For more information on the phased approach to the development of the PCPSP visit: www.gov.mb.ca/health/hst/docs/faq_pcpsp.pdf.

4. What activities have been completed?
Provincial Clinical Teams have analyzed data compiled on Manitoba’s current state of health service delivery and reviewed models of care and leading practices used in other jurisdictions. Challenges and opportunities have been identified in each area of clinical focus, including key populations, differing needs across regions, enhancements required to system enablers such as diagnostics, digital health or emergency medical services.

For more information on the work done to date visit:

5. What are the next steps?
Early draft future state models of care are now being developed and recommendations shared across the specialty areas of focus. As future models continue to be refined, interdependencies will be addressed and areas of potential conflict identified and mitigated. Opportunities for broader input from health care providers and dialogue with the public will occur in early 2019. For more information on engagement opportunities or to submit your thoughts visit www.gov.mb.ca/health/hst/feedback.html.

6. When will the plan be complete?
Decisions and recommendations related to new or revised models of care and patient or clinical pathways have not been made. The final provincial plan will be presented to Manitoba Health in summer 2019.

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FAQ – Changes to Emergency Medical Services

1. How do people know which hospital to go to if they need help?
If your illness or injury is life threatening, call 911. Paramedics will provide care as they take you to an emergency department. You can also access care from your primary health care provider for less urgent health issues.

2. Why call 911? Won't it be faster if I drive?
Paramedics are trained and ambulances are equipped to provide vital health treatment as soon as they arrive and during transit - so in a life-threatening emergency, it is always best to call 911. For illnesses like strokes and heart attacks, this treatment can make a big difference.

3. Why aren't regions recruiting more doctors and other health care professionals?
As in many other jurisdictions, regional health authorities in Manitoba face a number of challenges when recruiting health care professionals to rural communities. Studies have shown some reasons include a heavier workload with a large number of patients to see and patients who require more care, difficulty taking time off and maintaining a work-life balance, fewer opportunities for continuing education, professional isolation, limited job opportunities for spouses and even a lack of afterschool programs and daycare for their children.

Regions continue their work to recruit and retain physicians and other health professionals in rural communities. However, changes need to be made now to ensure safe, quality care for Manitobans in rural communities while using their resources most efficiently and effectively.

4. Ambulance costs are high in my region. What if I can't afford to call an ambulance?
Costs for transportation by ambulance are not insured by provinces, including Manitoba. These costs are the responsibility of the patient, whether a resident of Manitoba or elsewhere.

Insurance can provide coverage for ambulance fees and can be affordable, even for those on a fixed income. In addition, a commitment has been made to reduce current average fees by 50 per cent by 2020. To date, fees have been reduced from an average of $500 to $340, which is 35 per cent towards goal of reducing fees by half.

5. What does this mean for EMS stations across the province? Why is the province closing EMS stations?
EMS planning is integrated with work to transition EMS and Patient Transport services to a provincial model within Shared Health as well as with the development of a provincial clinical and preventive services plan to ensure consistent and integrated service across the province.

As transformation project work continues, the day-to-day operations of EMS and Patient Transport have not changed and focus remains on building capacity, equipping staff and investing in a 24/7 workforce of skilled professionals.

A review of ambulances services in 2013 recommended the relocation or restructuring of a number of station locations across southern Manitoba. This will allow us to better locate the services and match resources with actual call volumes to achieve response time standards. Restructuring of station locations will not occur until the EMS and patient transport models are in place.

6. Won't this make response times longer?
The approved response time standard in Manitoba is a response of no more than 30 minutes for 90 per cent of the population, 90 per cent of the time. In 2015/16, 95.52 per cent of calls south of the 53rd parallel met this standard during daytime hours and 94.67 per cent during night time hours.

7. If response times are meeting the standards 95 per cent of the time, why are changes being made?
There is still more that can be done to improve services. Some sites are only open for limited hours, which means staff are only at the ambulance station for part of the time. This means that if a call is received outside of regular hours, on-call or standby staff have to return to the station before going out on the call. This increases response times and costs, and is not an efficient way to provide services.

8. Will the province need to hire more paramedics to provide 24/7 services?
Additional planning is underway and will continue over the next several months to ensure that all staffing needs are planned for and identified.

The province is already investing more than $1.7 million for enhanced paramedic staffing across three regional health authorities. The new 29.2 full-time equivalent, primary care paramedic positions will be located in Arborg, Ashern, Glenboro, Waterhen, Gladstone/Kinosota, Carman, and Morris. Four positions have already been filled with highly skilled candidates while hiring for the remaining positions will begin immediately.

9. What happens if the ambulance closest to my community is out on a call? Won't the response times be longer if it has to travel from further away to reach me?
When an ambulance is on a call, resources are shifted to ensure the ambulance can respond quickly when needed.

For example: Community A and Community B both have ambulance stations. When an ambulance in Community B is sent out on a call, the ambulance from Community A can be sent to a point in between the two communities. This ensures both communities have ambulance coverage in case a second call is received.

This work already happens in rural Manitoba to ensure coverage is available when people need it most. This is known as `flexible deployment'.

10. When are the changes going to be made?
Changes will be made gradually over the next few years. This will give us time to ensure new stations are built and 24/7 services are in place before stations are closed.

11. I'm a paramedic. What does this mean for my job?
Detailed planning is underway and will continue over the next several months. As work progresses, we will be working with staff and the unions to develop plans around staffing and the effects of planned changes. As this work continues and transition details are finalized, we will share more information.

12. I am a paramedic and often work on-call or standby shifts. How will these changes affect my work?
Detailed planning is underway and will continue over the next several months. As work progresses, we will be working with staff and the unions to develop plans around staffing and the effects of planned changes. As this work continues and transition details are finalized, we will share more information.

13. Won't it just be faster to just drive myself to the nearest hospital?
Paramedics provide a high level of care from the moment they reach a patient until they get to a health care facility. The fastest way to get help for a medical emergency is to call 911. For communities without 911 service, the front of the local phone book will list emergency numbers.

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