Physician Leadership Council input on issues for Ministry-FHT Contract Renewal

To the leaders of AFHTO’s member organizations,

Ministry-FHT Contract Renewal: Guidance from PLC

As the next MOHLTC-FHT contracts are set to expire on March 31^st 2017, AFHTO has been working diligently on identifying and pursuing next steps in the contract renewal process. An important step was to obtain input from the Physician Leadership Council (PLC) on key areas of focus for the MOHTLC-FHT contract within the overall context of Patients First and the state of the tentative Physician Services Agreement (tPSA). (Note: PLC meeting took place before the Aug. 14 vote that ultimately turned down the tPSA.) PLC members were provided with a discussion document & poll questions to guide the conversation – to read the full report of items discussed and input received, click here. Top 3 points:

• Harmonization between FHT and physician group(s) is an evolutionary process; strengthening team relations and dynamics should remain a central focus of AFHTO-led efforts. Learning what has worked well in other teams, sharing experiences, developing an AFHTO-led guide or work shop with suggestions on how to improve relations and bring groups together may be beneficial going forward.
• Strong governance will be paramount for FHTs to navigate the changes ahead and to lead this next stage of primary care evolution. Including basic governance expectations within the FHT contract may help to promote consistent, effective governance practices across the province.
• FHTs should be encouraged to play a strong leadership role in the sub-LHIN organizational approach, but before FHT governors can take on accountability for sub-LHIN populations, capacity and equity of resourcing must be addressed.

Given that the tPSA included a commitment to review/re-negotiate terms of family physician contracts (FHO, FHG, etc.) by Nov. 1, PLC identified topics that AFHTO should seek to influence in these Ministry-OMA discussions. With the OMA membership’s rejection of the tPSA, it’s not clear when or how that will proceed; however, AFHTO will look for opportunities to advocate with MOHLTC and OMA for such things as support for physician work in non-clinical tasks such as Health Link development, Quality Improvement Plans, data collection, etc., and sustainable models for funding EMR infrastructure. Next Steps: Over the next few months we will be listening to our membership as we try to reach consensus on a number of important MOHTLC-FHT contractual elements. Based on the input received from PLC, the discussion guide will be updated and brought forward to a joint meeting of ED Advisory Council (EDAC) & PLC. Steps in the process include:

• Mid-Aug to mid-Sep – AFHTO staff to meet with other key stakeholders (OMA, AOHC, OCFP) to exchange issues/perspectives/emerging positions
• 16 – joint in-person meeting of the ED Advisory Council (EDAC) and Physician Leadership Council (PLC)
• 20 – AFHTO board meeting to review input to date and provide further direction on consultation content and process.
• Late Sep – option to test some ideas with broader membership via survey/web meeting
• Oct. 17 – Leadership Triad Session before AFHTO conference – opportunity to build consensus and/or ratify positions on key issues with roughly 250 leaders of AFHTO-member organizations in attendance.