To: EDs, Lead MDs/NPs and Board Chairs of all AFHTO member organizations AFHTO’s Executive Director Advisory Council (EDAC) met on April 22^nd. This email provides an overview and highlights key items discussed:

• Ministry-FHT Contract Renewal: Update from PHC Branch Meeting on April 8^th
• The Commitment to Recruitment & Retention Efforts
• What’s Ahead for Primary Care: Preparing for Change
• AFHTO Program Updates

Ministry-FHT Contract Renewal: Update from PHC Branch Meeting on April 8^th

Following from the principles and priorities that emerged from the AFHTO membership last fall, AFHTO has been pursuing next steps for contract renewal with the ministry. This renewal provides opportunity to demonstrate the evolution of FHTs (and NPLCs since the same principles will most likely apply to all team-based models), and to develop more meaningful contracts that will support teams to continue to deliver high-quality primary care. Its content will be informed by the ministry’s plans to review team-based primary care models from the perspectives of performance and accountability, funding, and use of interprofessional teams (as reported to members on March 3). During the April 8^th meeting with senior officials in the PHC branch, AFHTO reached provisional agreement on the following:

• Leverage work of D2D and aim for 6-10 meaningful measures to be included in the next contract agreement;
• Ensure performance measures support and align with ministry priorities;
• Reduce the current reporting burden by eliminating that which is not meaningful, including removal of the current Schedule E;
• Retain Schedule A as a document that encourages and gives evidence of program planning and enables an inventory of programs across LHINs/Province (with improvements to Schedule A as a planning and reporting tool).

Over the next few weeks, members of an EDAC work group will begin the process of reviewing the contract, identifying issues that need to be addressed, and begin strategizing the approach to the renewal process.  Work will evolve over the coming months in collaboration with the members of the leadership triad (EDs, Board Chairs, and Physician Leads) and the Ministry.

The Commitment to Recruitment & Retention Efforts

AFHTO continues to give top priority to advocacy for increased funding to enable our members to recruit and retain the staff needed to deliver comprehensive team-based primary care. EDAC members reconfirmed the significance and urgency of dealing with recruitment and retention efforts and spoke about the desire to explore alternative actions and strategies if no further movement is seen on behalf of the Ministry. As reported to the AFHTO membership on April 24, the 2015 Ontario Budget included no formal commitments; however, political staff confirmed the Minister is committed to making progress in the next few months.

What’s ahead for Primary Care: Preparing for Change

EDAC members reviewed recent Ministry announcements and key messages, including: – An email summarizing Associate Deputy Minister Susan Fitzpatrick’s meeting with the AFHTO board on March 3 and the intent to move to “comprehensive regionally governed, population-based primary health services for Ontarians.” To this end, members are encouraged to build upon current relationships and strengthen partnerships with their local LHINs and regional health service providers. –  A summary of what’s ahead for primary care in Ontario based on a March 5th meeting between AFHTO’s representatives and the PHC Branch. The Ministry’s emphasis on providing “solid evidence of the value of FHTS/NPLCs and team-based care” will be a strong influencing factor in the development of new MOHLTC-FHT contracts. EDAC commented on the need to showcase the matured state of FHT/NPLCs, demonstrate the impact of team-based care through manageable, meaningful measurement and to focus on strengthening the development of high performing teams.

Governance & Leadership Program Update

Members of EDAC reviewed excerpts from AFHTO’s Year Two Report and Year Three Proposal (2015-16) to the Ministry.  A number of achievements were acknowledged from the 2014-15 plan (most of which could not have been done without the support and contribution of EDs!), including:

• Executive Director Resource Toolkit (members were pleased to support the formal launch of the toolkit  – this is a terrific achievement and an extremely useful tool for use by all EDs!)
• Launch of the Physician Leadership Council, NPLC Community of Practice (CoP) and re-launch of the Health Links CoP –  communiques released after every meeting to keep all leadership informed

o   Governance Webinars o   Governing for Quality Workshops o   Case Studies (to be completed early May – stay tuned!) Visit Governance and Management  on AFHTO website for access to tools/resources achieved. Focus for 2015- 2016 Together with our members and in collaboration with the ministry and other partners, AFHTO is striving to advance the objectives listed below by March 31, 2016.

• Measuring and improving
• Demonstrating and assuring value
• Strengthening governance and leadership practice
• Optimizing team capacity
• Supporting and strengthening collaborations and partnerships
• Maintaining and strengthening the foundation of AFHTO membership and leadership

To support these objectives, AFHTO is proposing to conduct a series of one-day leadership sessions in each of the LHINs beginning in the fall. EDAC members reflected on their role in supporting the outcomes and deliverables to be achieved and the role of EDs as facilitators in bringing leadership together. There are a number of work items that EDAC will focus on over the coming few weeks including: establishing a mentor/buddy system for new EDs, establishing/strengthening the development of regional ED networks; and developing case studies that will illustrate FHTs that have transitioned human resources such that physician-funded and FHT-funded staff all come under one entity as a mechanism to harmonize working relationships.

QIDS Program Update

The QIDS program has reached their goal to grow member participation in D2D from 30% in the first iteration to, so far, 55% for the second iteration. As of today, 104 out of 187 AFHTO members have signed up to submit data for D2D 2.0! Members can continue to sign up until the data submission deadline of May 28. For members who are considering whether to participate, this new 4 minute video tells a story about why D2D matters from the perspective of a family doctor. See Data to Decisions eBulletin #9 for further information and updates.