Environmental Scan Driving the need for a south campus Thank you for the opportunity to speak with you today as RVH continues its long-range planning exercise which includes determining how to best use the space still available within its current Georgian Drive facility, as well as planning for a state-of-the-art satellite campus to meet evolving healthcare needs in rapidly-growing south Barrie, Innisfil and Bradford West Gwillimbury The initiative is called Plan our Future. Together and it requires broad and genuine engagement with our staff, physicians, volunteers, patients, partners and the community. Charting RVH’s course for the future – including a South campus and the services provided there – will be a complex and lengthy process. It will take 15 to 20 years. But given the growth in the area, and the pressures on our current health centre, we need to start now. RVH already provides exceptional specialized and inpatient care at its Georgian Drive facility. However, we need to develop a graduated plan to developing a state-of-the-art facility that will bring outpatient, urgent care, and additional care space closer to where are population is growing the fastest. Before I get into the plans for the RVH of the future, I want to orient you to the RVH of today.   Environmental Scan Driving the need for a south campus

$325 million annual budget Our people – Our patients 15,000 Surgeries 455,000 Patient visits 2,500 Employees 750 Volunteers 83,000 ED visits 430 Physicians As you can see from our numbers, RVH is a large, complex, very busy regional health centre, logging 455,00 patient visits each year.  RVH is the largest hospital between Newmarket and Sudbury, with a team of over 350 skilled physicians, 2,500 caring staff members and 800 dedicated volunteers. The health centre has many academic partnerships and affiliations including an official partnership with the University of Toronto Department of Family and Community Medicine. The Health Centre’s Family Medicine Teaching Unit trains family physicians in their final two years of residency. In fact, we train over 1,300 students every year – from doctors, to nurses to physiotherapists. RVH has also received Exemplary Standing from Accreditation Canada, the highest level of compliance possible. As well as the award of Distinction in both acute and rehab stroke services. This is all to say RVH has the expertise, technology and capacity as a large regional health centre to expand services to a satellite campus 117,000 Cancer centre visits $325 million annual budget 1,350 Students / medical residents 2,000 Births 2016-2017

Outside North Simcoe Muskoka Rest of North Simcoe Muskoka Where RVH’s patients come from Outside North Simcoe Muskoka 9% As our regional role has expanded, now half of RVH’s patients come from outside the city of Barrie The rest live in the surrounding area, with a fair number coming from outside the region; places like Parry Sound. Seasonal residents – cottagers and skiers -- would also be included in that percentage. As you can see, RVH is NOT “Barrie’s health centre” and we need a plan that will enable us to meet the healthcare needs of South Simcoe County for the next 10 years, 20 years and beyond. City of Barrie 50% Rest of North Simcoe Muskoka 41% 2016/17

Population in North Simcoe Muskoka

Population Projections 2017-2040 Ontario’s population is projected to increase by 13% by 2025 and 59% by 2040 NSM LHIN’s Population is projected to increase by 18% by 2025 and 82% by 2040

Population growth Population of Bradford-West Gwillimbury, Innisfil & Barrie will increase by 109,000 by 2031 Simcoe County remains one of the fastest growing populations in Ontario, growing almost twice as fast as the rest of the province (7.5% vs. provincial average of 4.6%) Pink line is being driven by growth in Innisfil and Bradford West Gwillimbury. The combined population of Bradford-West Gwillimbury, Town of Innisfil and Barrie is expected to increase by 109,000 by 2031 for a total population of almost 300,000. Population of Innisfil alone will double to 70,000 over next 20 years Innisfil and Bradford West Gwillimbury has a unique population of younger residents/families, retirees (Sandy Cove Acres) and newcomers to Canada whose first language is not English. The exploding population has resulted in traffic congestion that makes it difficult to RVH quickly.

Population growth In fact, if we look a bit further into the future, the population of Bradford West Gwillimbury, Innisfil and Barrie will exceed 415,000 by 2041

Age projections in North Simcoe Muskoka 45% of North Simcoe Muskoka will be over 60 by 2037

Population in Barrie/ Innisfil / Bradford City of Barrie 141,000 residents (4% growth 2011-’16) Average age is 38.5 (Simcoe County average is 43) 14% are over the age of 65 10.3% of residents’ first language is not English or French (Simcoe County = 10%) Innisfil 24,000 residents (17.8% growth 2011-’16) Average is 40.4 (Simcoe County average is 43) 14.8% are over the age of 65 13.7% of residents’ first language is not English or French (Simcoe County = 10%) Bradford West Gwillibmury 35,000 residents (25.8% growth 2011--2016) Average age is 37 (Simcoe County average is 43) 11.6% are over the age of 65 28.3% of residents’ first language was not English or French (Simcoe County = 10%)

Population Health – Risk Factors North Simcoe Muskoka Ontario Eat 5+ servings of fruits/vegetables a day Are physically active Are overweight Heavy drinker Smoker An important consideration when planning for the future of healthcare is, what is called, population health This takes into account many factors that contribute to a person’s health, including: education, income, housing stability, social supports, and risk factors. Unfortunately, residents of North Simcoe Muskoka have a lot of risk factors that impact the kind of healthcare they’ll need in the future. As a whole, we don’t exercise or eat enough fruits and vegetables. More of us are overweight, and many people drink and smoke. 9

Population Health – Chronic Conditions North Simcoe Muskoka Ontario Arthritis High blood pressure Asthma Diabetes Heart disease COPD Cancer 45% of North Simcoe Muskoka residents have 1 chronic disease 20% have multiple chronic diseases As well, many area residents suffer from chronic diseases that may require them to use hospital services more frequently. North Simcoe Muskoka residents have more chronic conditions that make them less healthy than those living in other parts of Ontario. In fact, almost 45 per cent of adults have a chronic condition like diabetes, heart disease, cancer and respiratory illnesses. We need to help at-risk people better manage their health will reduce and even prevent hospitalization, so a focus of RVH’s future must be on wellness and prevention

Projected beds needs 2017-2037 Estimated acute inpatient beds needed by North Simcoe Muskoka hospitals It is expected that RVH will need to double its bed capacity over the next 20 years

Ambulatory Care Projections – Cancer

Ambulatory Care Projections – Day Surgery

Ambulatory Care Projections – Emergency

Mental Health Projections