Government announcements are anticipated in early September. This email summarizes priorities for AFHTO, set through the ED Advisory Council (interview results and July 28^th meeting), Physician Leadership Council (July 30^th meeting) and AFHTO Board (August 12^th). In light of government’s communications to date, the 5 priorities identified for AFHTO were:

1. Developing and strengthening relationships with (and education for) LHINs, in anticipation of a tighter relationship between LHINs and primary care.
2. Addressing the province’s intent to broaden access to teams while ensuring teams can continue to deliver quality care.
3. Determining how to measure “Capacity” – a fundamental component in assuring quality care.
4. Shaping what it means to take a “Population-Based Approach to Primary Care”.
5. Strengthening governance of teams – a critical requirement for leading this next stage in primary care’s evolution.

Scroll down to read more about these priorities.

Stay Tuned:

• Sept. 17 — The ED Advisory and Physician Leadership Councils will meet together to review further developments from government and plan next steps.
• Oct. 28 — Leadership session at the AFHTO conference is open to leaders of all member organizations.
• November through February — AFHTO is organizing “Regional Leadership Sessions” – to include AFHTO leadership, FHT/NPLC EDs, Lead Physicians, Board Chairs, LHIN leadership, and other stakeholders deemed appropriate within each LHIN region.

What can you do now? Relationships are fundamental…start getting to know the FHTs/NPLCs in your region, think about how you could strengthen partnerships with the LHIN or how AFHTO might assist! Moving Forward – AFHTO will continue to engage our membership and keep everyone informed as soon as formal announcements are made or direction is received.  Working together we will identify and provide the necessary education, training and guidance needed to lead the way for comprehensive, high-quality, team-based primary care.

1.    Relationship with/Education for LHINs

All members – EDAC, PLC and the AFHTO board – as a priority to be addressed immediately, to prepare for the evolution ahead. Next Steps:

• To build profile for FHTs and NPLCs with each LHIN CEO, ED Advisory Council reps have been invited to join with AFHTO’s ED (and one or two other EDs/Lead MDs) in meeting with their respective LHIN CEOs.
• To foster greater understanding about primary care across LHIN staff, AFHTO has initiated development of educational material together with the LHIN Collaborative.
• These two activities will help set the stage for Regional Leadership Sessions in each LHIN (November through February).

2.   Broadening Access to Teams

The Ministry has been clear on a shift toward improving “Access to team-based primary care for all Ontarians who would most benefit” – currently only a quarter of the population is served by FHTs/NPLCs and have access to IHPs within team based care. HOW this is done, lends itself to a number of challenges and potential opportunities. How primary care is organized going forward, the possible role of the LHIN, and expectations of FHTs/NPLCs will be key factors in determining how we can broaden access to team based care. Next Steps:

• AFHTO’s paper on optimizing value of and access to team-based primary care presents evidence-informed advice on how to spread access to high-quality team-based primary care in a way that achieves the best value, and provides a number of recommendations to the Ministry.
• The joint EDAC/PLC in-person meeting on September 17^th will identify areas for further recommendations for the Ministry and members on approaches to broadening access to teams (including addressing challenges such as liability).

3.   Advancing Capacity Measurement

Team capacity has been the core issue for FHTs and NPLCs seeking Ministry funding to meet patient needs. As the province calls for broader access to teams, this will be THE number one issue – what can teams take on while assuring quality of care? Quality, capacity and total cost of care are the core concepts for measurement in the “Starfield Principles”, adopted by AFHTO. Through D2D 2.0, we have progressed in measuring cost and quality. AFHTO members, staff and other stakeholders are working to find meaningful ways to measure capacity. Expanding access to teams only makes sense where capacity is sufficiently developed. Next Steps:

• In-depth clinical consultations are underway on capacity measurement (and other strategic indicators). Click here to participate.
• Aiming to include a capacity measure in D2D 3.0 (launching January 2016).

4.   Population-based Approach to Primary Care

MOHLTC leaders have consistently used the term “population-based primary health services for Ontarians”. Working collaboratively to plan and offer programs and services that are designed to meet the specific needs of the patient population will be central to implementing a population based approach. Next Steps

• AFHTO will continue to work with the Ministry and other stakeholders to establish a clear definition and principles of a population-based approach to primary care.
• AFHTO is establishing a joint Work Group with MOHLTC PHC Branch to improve the approach to program planning and the ministry’s template for reporting on program plans (Schedule A in FHT contracts/Schedule E in NPLC contracts). A workshop will be provided at the AFHTO 2015 conference with a focus on: what constitutes a program; key elements of a well-designed population-based approach to program planning; how to conduct a needs assessment; goal setting; performance measurement principles and evaluation; and how to use the reporting tool effectively.
• Members are encouraged to start looking at their own communities, to get to know the teams in the same geographic region, and to begin to explore ways that teams can reach out to larger segments of the population that are not formally rostered patients.

5.    Governance of Teams

Given the Ministry’s anticipated announcement, strong governance and leadership practices will be even more paramount for FHTs/NPLCs to successfully navigate the upcoming transition and change. Next Steps:

• AFHTO is offering the Effective Governance for Quality in Primary Care workshop to AFHTO member board members, executive directors and lead clinicians on October 27^th (one day prior to the AFHTO conference).
• AFHTO will work with the Ministry to target FHTs/NPLCs who may benefit from individualized plans to develop effective governance practices and leadership capabilities.
• Through the work of D2D, AFHTO will begin looking at the correlation between high performing teams and associated governance structures.

AFHTO is supporting the development of an ‘ED Mentorship Program’ as a way to provide support and encourage knowledge translation for new EDs and EDs requiring additional guidance.