MOHLTC’s priorities and plans for primary care

This message presents what the Deputy and Associate Deputy Ministers of Health and Long-Term Care said recently about the ministry’s key priorities for health system transformation, the role of primary care in this transformation, and some of the key steps ahead. While the media have asked if government “has pressed the pause button on team-based primary care” (Globe and Mail, TVOntario), the information below indicates significant movement ahead. The content of this email comes from Associate Deputy Minister Susan Fitzpatrick’s meeting with the AFHTO board on Feb. 25 (click here to access her slide presentation). Many of the same points were reiterated the next day in addresses made by Deputy Minister Bob Bell and by Susan Fitzpatrick at the Feb. 26 HealthLinks conference. Highlights:

• “Primary care must be the strong foundation for our health system.” Both DM Bob Bell and Associate DM Susan Fitzpatrick clearly stated this view. The key question – what does this look like and how will we get there?

• “Comprehensive regionally governed, population-based primary health services for Ontarians.” Slide 10 is a specific look at how the ministry sees primary care teams in advancing transformation, from 2005 and into the future. On several occasions the Deputy has called for movement toward “population-based risk-adjusted primary care”; this slide confirms the intent.

• Ministry’s key priorities for primary care teams. Slide 12 lists them as follows:
  • Population health based programs and services with focus on access, integration and patient experience
  • Collect community-specific data to improve performance and quality of primary care for its population
  • Continue progress in expanding availability of same day/next day appointments and after-hours
  • Continue to provide access to integrated health care teams for Ontarians who need it
  • Establish policies to improve Quality Improvement indicators ( e.g. post-hospital discharge visits, readmission rates, ED visits)
  • Participation in HealthLinks and other local initiatives (e.g. Physiotherapy reform)
  • Leveraging full scope of practice and improving team functioning
  • Strengthening and expanding local partnerships and care coordination

• “Sector Leadership and Excellence are Critical.” Slide 6 depicts the adoption curve; AFHTO members are clearly identified in the “Early Adopter” group. Our individual and collective work to engage patients, advance measurement, spread best practice and improve quality is recognized by the ministry, and in the results of the recent Conference Board of Canada FHT evaluation report. Team-based primary care is rich with strong leaders and champions to lead the way for this sector as the ministry and stakeholders work to transform the health system.

• Review of interprofessional primary care models. On both occasions Susan Fitzpatrick stated it was time to review the team-based models from the perspectives of performance and accountability, funding, and use of interprofessional teams (recruitment and retention, ratios of team members, opportunity to leverage these resources). FHTs and CHCs will be included in the review. The ministry is developing terms of reference for this review, and is considering the range of team-based models to be included.

• Physician Services Agreement. Susan Fitzpatrick summarized the current status – click here for the ministry update.

AFHTO continues to work with and on behalf of members to show the way forward. We are ready with clear direction from the leaders of our member-organizations on the necessary principles – for the governance of primary care organizations; for accountability and reporting to funders; for determining accountability measures; for funding allocation; and for the support teams need to deliver timely, high-quality, comprehensive team-based care. Collectively we continue to advance measurement capacity to give solid evidence of the value of team-based care, and develop governance and leadership capacity to lead the way. We will ensure our members’ successes are seen and voices heard by the ministry and stakeholders. We look forward to showcasing and further invigorating this work at the AFHTO 2015 Conference in October — Team-Based Primary Care: The Foundation of a Sustainable Health System.