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The Lindsay Advocate article published October 18, 2019

By The Lindsay Advocate

The results are in from the City of Kawartha Lakes Family Health Team’s most recent survey of patients across the local area. The data revealed some interesting findings on how local residents feel about their local care, the family health team approach, the health care system in general and the main challenges to be addressed.

While the vast majority of respondents indicated they found their health care provider to be caring, friendly and easy-to-talk-to and reported overwhelmingly that their providers are caring, good listeners and thorough, the broader answers were also encouraging.

A clear majority of patients survey ranked the fact that they feel their care is “patient-centred” as the best part of the care they receive.

“We are very pleased with this positive feedback about the team from our patients”, said Dr. Eric Ready, Chair of the City of Kawartha Lakes Family Health Team’s Board of Directors. “We are always working to provide the highest quality care,” he added. “Reducing wait times is an ongoing effort and priority for the Board of Directors.”

Of particular note, 87% of patients responded that family health teams have been a positive change to the health care system. More than 90% stated they were very concerned or somewhat concerned about possible cuts to health care funding.

Interesting, while shorter wait times and more doctors were identified by the most patients as the keys to “what the perfect health care system would look like”, the close 4th place response was that the system is perfect as is.

Also, more than half of patients who replied to the survey noted that they felt at least one of their visits to the family health team has prevented a visit to the emergency room (ER), thereby getting immediate care, saving the system money and reducing wait times at the ER.

The team is also aware that patients identified office hours and appointment wait times as the main challenges of care local. This correlated within the survey where patients said that appointment availability and wait times were the top areas when asked what the health team could do better. Access to transportation was ranked third by patients when asked about the challenges they experience in obtaining care.

“Our team’s health care professionals get all the credit,” noted Executive Director Mike Perry. “We continue to take steps to reduce time patients have to wait both for an appointment and once in the waiting room. We do have some same or next day appointment, certainly for urgent cases.” The family health team recently implemented a system of automated reminders for patients in order to help increase timely access by reducing the number of patients who do not show up for their appointment. Knowing in advance of patients who cannot attend helps open more appointments sooner.

Julia Skinner of Bobcaygeon, a member of the team’s Patient Advisory Group, has also reviewed the results. “In addition to the survey, it is wonderful have a voice in local health care,” said explained. “I am very pleased, as a patient, to serve on the team’s Advisory group an provide input from a patient perspective.”

The survey was replied to by 241 patients which was a response rate of almost 25%; a very high response rate for surveys generally. The survey applied to health care providers of the family health team (e.g. nurse practitioners, pharmacist, registered dietitian, mental health team), not including local physicians. Responses skewed female.

The City of Kawartha Lakes Family Health team provides primary care to some 36,000 patients at 13 locations across the City. To obtain a family doctor, please contact Danielle at 705.328.9853 Ext. 243.

To view the full The Lindsay Advocate article, click here.

The Blackburn News article published November 5, 2019

By Allanah Wills, Blackburn News

The Municipality of Chatham-Kent is moving forward with a new Physician Recruitment and Retention Task Force aimed at bringing more doctors to the area.

On Monday night, council unanimously approved a report that detailed the task force and its initiatives. The program will look at various ways to attract physicians to Chatham-Kent and keep them here including attending family doctor job fairs, enhancing advertising practices and providing financial incentives to new physicians to cover their moving expenses and setup costs.

In December 2018, Councillor Trevor Thompson brought forward a motion requesting that administrative staff prepare the report looking at a primary care practitioner recruitment and retention program for Chatham-Kent. Almost a year later, Thompson said it feels good to see all the hard work come to fruition.

“It was a lot of work,” he said. “It took a little bit longer than I was actually hoping for, I would have liked to have seen it back about six months ago. But at the same time, staff did a lot of work to get us to this point and I think really found a good balance.”

A total of $100,000 towards the Physician Recruitment and Retention Task Force was approved in the 2019 budget and the project will start in 2020. The Chatham-Kent Family Health Team (CK FHT) will look after and distribute the funds on behalf of the other medical groups (Chatham-Kent Family Health Team, Thamesview Family Health Team, Tilbury District Family Health Team, CK Community Health Centres, and the Chatham-Kent Health Alliance) with resource support from the Erie St. Clair LHIN, HealthForce Ontario and the municipality.

“As soon as we approved the $100,000 there were questions about where does it go to, who does it help? What I wanted to make sure of is that we weren’t just offsetting somebody else’s budget,” Thompson explained. “But, this was new money for a new initiative. [I’m] really happy to see this campaign promise come through, really happy to be addressing a crisis in our community.”

When Thompson brought forward his original motion in 2018, Chatham-Kent’s rate of family doctors was 76.9 per 100,000 population against the provincial average of 109.4 per 100,000. The report approved by council on Monday recommended that only running the task force for 2020 was not enough to address the chronic doctor shortage and suggested that ongoing funding for the program be referred to the 2021 budget process as well. Thompson said he was pleased to see this option approved.

“At the time it was one-time funding — $100,000 and from there, who knows what happens. One time isn’t going to bring it, it has to be an ongoing funding request. I’m glad to see that come back again,” he said.

Now that it’s been given the green light to move forward, the task force will provide council with bi-annual updates on what’s been accomplished and any future initiative plans. Thompson said overall, he believes this is an important step in the right direction.

“The health of our residents is the economic and the demographic lifeblood of our community,” he exclaimed. “Making this a happier healthier place to live is one of the most important things we can do as Chatham-Kent councillors.”

To view the full The Blackburn news article, click here.

CTV News article published October 26, 2019

By Avis Favaro, CTV National News and Elizabeth St. Philip, CTV News

TORONTO — Amid doctor shortages across the country, nurse practitioners have been filling in the health-care gap in many communities, helping to diagnose and treat patients who don’t have access to a family physician.

But despite growing demand, many clinics can’t get adequate funding to employ enough nurse practitioners (NPs). The issue is evident in communities such as Ingersoll, a rural southwestern Ontario town where many residents often experience long waits for primary care.

Among the approximately 110,000 people who live in Oxford County, which includes Ingersoll, Elizabeth Wilson considers herself fortunate. Unlike many people in the region who don’t have a family physician, she gets regular and timely care thanks to nurse practitioner Adrienne Bienot.

Sue Tobin, a nurse practitioner and clinical director in Ingersoll, Ont., meets with physician consultant Dr. Rob Hiemstra.

NPs are registered nurses with advanced education and training that allows them to diagnose and treat minor illnesses and injuries, screen for the presence of chronic disease and monitor patients with stable conditions.

“It’s just like going to the doctor…it’s the same to me,” Wilson told CTV News. Even better, she said, is that the nurse practitioner has the time to listen and discuss her problems.

There are four nurse practitioners at the Ingersoll Nurse Practitioner-Led Clinic, handling more than 2,100 patients. The clinic, which also houses support services such as social workers and mental health counsellors, looks just like a doctor’s office. On the desk in the front office, there are hundreds of applications from people who want to join the clinic as registered patients.

Like many rural communities across Canada, Ingersoll has seen a number of its doctors retire or die. And while some new ones have been recruited, there aren’t enough physicians to meet the demand.

Almost a quarter of the doctors in Ingersoll are over the age of 60, and there is only one walk-in clinic. But while other provinces are expanding NP services, Ontario — which has the largest number of nurse practitioner-led clinics in the country — is not funding new NP positions.

The Nurse Practitioners Association of Ontario said it spoke with 10 NP-led clinics across the province, and found that funding for all of them has been reduced by between three and 10 per cent, with no new funding on the horizon. Only three of the clinics are accepting new patients and five clinics stated that their general practitioners are retiring, but they are not aware of any replacements.

“We are really hopeful that the ministry is going to see that we have a situation here, that we would like to provide services for these patients,” Ingersoll nurse practitioner Sue Tobin told CTV News. “We have 3,000 that already don’t have a primary care provider, and expect to have about another 3,000 or possibly more who will lose their primary care provider in the next few months.”

“We could easily hire four to five nurse practitioners and help take care of the situation here,” Tobin added.

About a quarter of the patients who walk through the ER doors at the Alexandra Hospital in Ingersoll — just down the road form the Nurse Practitioner-Led Clinic — are people who don’t have access to a family doctor or an NP, often referred to as “orphaned” patients.

“They’re coming in with a rash, an ingrown toenail, sore throat….We will see anyone, but I think if those people have a different avenue to pursue then maybe we will see less of those visits,” said Dr. Max Rachinsky, a physician at the hospital who said that for such patients, ER visits are a last resort.

“Any solution that would help patients that are orphaned, or patients that don’t have access to primary care, should inevitably reduce some of the volume and maybe some of the pressure and strain that we’re facing in emergency,” he said.

However, the growing role of nurse practitioners hasn’t always been well-received in Ontario, with some physicians suggesting that NPs don’t provide the same level of care.

“I don’t think that opinion is well-founded, however, because the nurse practitioners do an excellent job,” said Dr. Rob Hiemstra, a physician consultant at the NP-led clinic in Ingersoll.

Hiemstra is more than happy to work with NPs at the local hospital and he consults at the clinic once a week on more complex cases. His view is that NP-led clinics are a win for the patients.

“They get extra attention with longer visits and more spectrum of care, whereas many family doctors are tight for time,” he said. “I think there is a role for more nurse practitioners in clinics such as this one.”

The Nurse Practitioners Association of Ontario said research shows that NP-led care can be more cost effective, with the average annual cost per patient between $500 and $700. Doctor-led care costs can be as low as $200 or as high as $12,000 per patient, per year, the association said.

The Ingersoll NP-led clinic also offers a wider range of hours and makes room for same-day or next-day appointments, ready to help more patients who don’t have a family doctor.

To view the full CTV News article, click here.

The Orangeville Citizen article published October 21, 2019

By Mike Baker, Orangeville Citizen

Eight months on from the Ford government’s announcement of plans to overhaul Ontario’s health care system, service providers in Dufferin-Caledon feel our community is “well placed” to become one of the provincial leaders in the new movement. 

In this first instalment of a three-part series, the Citizen is taking an in-depth look into how the government’s plans to dissolve more than a dozen specialized provincial health care agencies, while establishing between 30 and 50 localized Ontario Health Teams, will impact services in Dufferin-Caledon.

“As far as we are concerned, this is a good thing. It’s a positive move,” said Stacey Daub, who, until last Wednesday (Oct. 9) was the President and CEO at Headwaters Health Care Centre, and co-chair of the Hills of Headwaters Collaborative (HOHC). She has vacated her position at the local hospital to take on a new challenge at a health care facility closer to her Toronto-area home. 

The reason for this story dates back to Feb. 26, when Health Minister Christine Elliott announced plans to develop a new super-agency called Ontario Health, which would effectively consolidate the 14 Local Health Integration Networks (LHINs) operating across the province, as well as other provincial agencies such as Cancer Care Ontario, eHealth Ontario and Trillium Gift of Life Network. While Ms. Elliott stressed at the time that this move “is not a financial exercise”, it is expected to save approximately $200 million annually by 2021. 

As a part of this reconstruction, the provincial government wants to build as many as 50 Ontario Health Teams – local organizations that will encourage hospitals, long-term care facilities, home-care agencies and other health service providers to form integrated care entities. 

Back in July, it was revealed that the Hills of Headwaters Collaborative was one of 31 teams selected by the provincial government to proceed through the application process to potentially become one of the first Ontario Health Teams. 

So, what exactly is the Hills of Headwaters Collaborative?  It’s a group made up of 36 different health care-related agencies and organizations. Their goal? To create one community working together to improve the health and wellbeing of everyone who lives in and provides care across Dufferin-Caledon. 

“For years and years, communities like Dufferin County and Caledon have felt that the way the provincial government, being more centralized, has organized health care doesn’t make sense locally,” Ms. Daub told the Citizen. 

She added, “Right now, the government separately funds a multitude of different organizations to deliver care in communities all across the province. They have different agreements with all those organizations and different funding arrangements too.”

She added, “Their idea moving forward, and one of the ways to change organizations who focus only on their own service, is to make a major change. They want to essentially create a single funding envelope and single accountability agreement for communities. So, instead of having 20 organizations accountable only to themselves, the Province is saying they want to see these organizations be accountable together for the overall health and wellness of your population.”

Locally, organizations such as Headwaters Health Care Centre, Dufferin Area Family Health Team, Wellington-Duffer-Guelph Public Health, Caledon Community Services, Dufferin Child and Family Services, Bethell Hospice and the Canadian Mental Health Association of Peel Dufferin have been involved in the HOHC. The group meets bi-weekly to run ideas, issues and stories by one another.

Through those discussions, the HOHC has identified three key priorities to improve health care services in Dufferin Caledon. Those include improving integration of mental health and addictions services to expand access across our community and improve care, creating an integrated palliative care team, and enhancing services and programs for individuals with complex health care needs, who are currently seeing and dealing with multiple organizations and agencies.

Lianne Barbour, Executive Director of the Dufferin Area Family Health Team, has served alongside Ms. Daub as co-chair of the HOHC. Speaking to the Citizen last week, she shared her belief that this pending transition was a positive one, both for those involved in the health care sector and residents all across Ontario. 

“What I try to say to residents is we want this to be so that health care is wrapped around patients. That there are fewer seams, fewer issues. That patients are at the core of everything the primary care provider does, and that they are involved in their decisions and abreast of who is involved in their care and supporting them,” Ms. Barbour said. 

She also opined that any move from the Province to hand over the ability to make key decisions regarding funding of programming and services to local entities was a positive one.

“I think what’s most exciting from my perspective is that, for once, we can have funds flow locally to make decisions that matter locally. That’s the biggest thing really,” Ms. Barbour said. “Right now, we all report to various branches of various ministries, either in Ottawa, Kingston or Toronto. For them to understand what happens in Dufferin-Caledon, it’s challenging. If we can make the decisions and put money where it needs to be to help people here, that would be huge.”

The HOHC submitted a new application to the Province on Oct. 8. While there has been no official timeline discussed regarding when a final decision may be made, Ms. Barbour noted she’s hoping to hear something before the end of 2019. Next steps should the application be approved is for provincial officials to carry out a comprehensive site visit to ensure the community is suitable OHT option. 

While Ms. Daub is no longer officially involved in the Hills of Headwaters Collaborative, she provided clarity on a number of questions posed by the Citizen prior to vacating her position. When asked  who would essentially lead and make the decisions on behalf of local health care service providers, should HOHC be successful in its application, Ms. Daub noted that would be decided at a later date.

“Looking at the leadership component and who would make important decisions, you can’t really do that or decide that until you’ve developed trust and relationships. You can’t go from zero to 60 mph overnight. It’s a reasonable question, and I’m sure everyone wants to know the answer, but right now all I can say is we have to co-create that format together as a team,” Ms. Daub said. 

She did note that the most likely scenario would be the formation of a community board, made up of individuals from different service providers and members of the public.

As far as relationships go, Ms. Daub is convinced the reason Dufferin-Caledon is even being considered by the Province at this point is due to the collaboration that already exists amongst various service providers in the region. Now, she hopes to see those relationships blossom to further improve health care services in the region.

“We recently held a symposium for frontline staff from all of the local agencies in our region, and it was magic. I remember the facilitator asked the room who had met somebody new they didn’t know before, and the entire room put up their hand. Then the facilitator asked who had learned about another program or service that would benefit a patient they currently serve and, again, everybody put up their hand,” Ms. Daub said. “So there are all sorts of benefits accruing as we go through this process, but the key is creating a sense of community and having a commitment towards a shared purpose.”

When asked to explain, in a simple way, what the formation of a OHT here in Dufferin-Caledon would do to improve services for patients and residents, Ms. Daub noted the creation of one entity that can communicate with all health care providers would be a huge step towards accomplishing that goal.

“For me, a big positive for local residents, something they’d be able to see right away, is the communication between service providers. Having one team, patients would no longer need to share their story 100 times when they go to different places. They won’t feel like they need to tell their primary care (physician) that they went to the hospital – they would have one integrated team who shares information and serves the community together, versus feeling served by various organizations and having to carry their story to many different people and entities,” Ms. Daub stated.

Building on that notion, Ms. Barbour noted a strong aspect of the HOHC submission centred around an enhanced digital support system.

“I think it’s key that, eventually, we have the digital tools to support one system where everyone talks to each other. One digital health record,” Ms. Barbour said. “I think there are opportunities on the horizon. There are a lot of tools out there, but there are a lot of dollars and cents involved.”

In closing, Ms. Daub addressed concerns echoing around the province that this transition could be viewed as a reduction in services.

“This is absolutely not intended to be a reduction. The goal is to find different ways to release time and energy, so instead of having a physician following up on a million different things, they have a team in place and information at their fingertip ready to use. That way, the physician can spend more time with their patient,” Ms. Daub said. “I don’t see this as a centralization, I see it as creating one team to serve the community and to serve individual patients, to break down those barriers and silos that have existed for far too long.”

Check in next week for part two of the series, where we will discuss the pending changes with various service providers in the community, and the potential impacts, both positive and negative they may have. Also, we will have comments from Kim Delahunt, the new interim President and CEO of Headwaters Health Care Centre, and new co-chair of the Hills of Headwaters Collaborative.

To view The Orangeville Citizen article, click here.