The Esquimalt Treatment Centre at 918 Esquimalt Rd. closed at the end of 2018, leaving Esquimalt with just one walk-in clinic (Nicole Crescenzi/News Staff)

Experts suggest Esquimalt explores hub-and-spoke medical clinic model

Dr. Eileen Pepler says Esquimalt is in a ‘dire’ situation for medical care accessibility

There’s a dire need for better access to medical services in Esquimalt and its surrounding area.

That’s what council heard on Monday from Dr. Eileen Pepler whose consulting firm, Pepler Group, has been conducting needs assessment research in the area for six months, thanks to funding from the Fraternal Order of Eagles. She gave an updated presentation on her research to preview an upcoming final report.

Pepler and her staff canvassed the area, interviewing over 75 people and analyzing over 300 surveys after scouting out people near grocery stores and daycares in the area.

ALSO READ: Township of Esquimalt explores options amidst doctor shortage crisis

Data showed that Esquimalt holds a unique population of both aging and growing families, all in a complex geography surrounded by water, bridges and highways that make it difficult to travel for care.

“Some of our data says that 86 per cent of patients would like closer care to home. They want longer consultation hours,” Pepler said. “[Many] people had more than two conditions, and also 79 per cent of patients said they do not have a family doctor.”

Researchers asked people where they go to seek medical care, and the resulting map was something Pepler called “a spaghetti chart” thanks to the recent closure of Esquimalt’s second-to-last walk in clinic in December. The only remaining walk-in clinic in the Esquimalt Plaza is almost always at capacity.

READ MORE: Esquimalt needs urgent health care facility, mayor says

“If you’re like me and you use MediMap to see which clinic has the shortest waiting time, you can begin to travel to any one of these 23 clinics only to be told to come back in three hours, if you’re lucky,” Pepler said.

Researchers found that in 2018 there were over 31,000 encounters in general practitioner visits, and over 8,500 visits to emergency services. The average wait time for an emergency bed was 48 hours, while wait time for services was 24 hours.

All these factors prompted Pepler to pose the question, “What if?” to council.

What if there were more dial-in options available? What if there is a hub-and-spoke clinic model?

Pepler suggested combining the efforts of several clinics in the Greater Victoria area to create an integrated system. She’s been looking at the hub-and-spoke model, which is used in the United Kingdom and Australia. She has also been speaking with Dr. James Houston, whose clinic the Yates and Quadra Integrated Health Centre is facing closure due to a physician shortage.

READ MORE: Downtown Victoria medical clinic faces closure because of doctor shortage

“We need to look at bringing together some resources from across the bridge, and working with Dr. Houston in exploring what new models of care,” Pepler said.

This model would have a central clinic, and a coordinated system to help people find the resources they might need outside of that clinic.

Along with this model, Pepler also suggested hiring a business consultant to argue the case for health care options in the area, to work with the Ministry of Health on developing more family models for health and wellness, and developing ideas for short term solutions.

“You have an immediate need of health care,” Pepler said. “There’s a sense of urgency here, there’s a short window and we’re competing with other municipalities, we’re competing for funding and physician resources.”

Recently the province also acknowledged the area’s need; Pepler said the Ministry of Health and the South Island Division of Family Practitioners decided to move Esquimalt from the secondary wave of primary care clinics to the first wave, though no dates have been publicly set.

More details will come out when Pepler’s final report is presented to council in late April or early May.

nicole.crescenzi@vicnews.com

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