Tag: advocacy

The first report of the Premier’s Council on Improving Health Care and Ending Hallway Medicine was released on January 31, 2019. The Council, chaired by Dr. Rueben Devlin, provides an assessment of Ontario’s health care system and lays the groundwork for future reports that will speak to recommendations for health system restructuring.

The first report describes three key challenges facing Ontario’s health care system:

1. Patients and families are having difficulty navigating the health care system and are waiting too long for care. This has a negative impact on their own health and on provider and caregiver well-being.
2. The system is facing capacity pressures today, and it doesn’t have the appropriate mix of services, beds, or digital tools to be ready for the projected increase in complex care needs and capacity pressures in the short and long-term.
3. There needs to be more effective coordination at both the system level, and at the point-of-care. This could achieve better value (i.e. improved health outcomes) for taxpayer money spent throughout the system. As currently designed, the health care system does not always work efficiently.

While there is very little mention about primary care, it should be noted that the report references that patients are going to the hospital when they could be treated in primary care, with a recognition that there should be additional focus on preventative measures and effective engagement with primary care providers.

The essential role of primary care in providing mental health and addictions supports was acknowledged, with the report noting that about 1 in 3 adults who reported to an ED for mental health and addictions care hadn’t previously accessed physician-based care for their illness. And challenges in home and community care was highlighted, noting that the health care system is overly complex which makes it more difficult for patients and families to navigate.

The report concluded with three opportunities for improvement: digital and modern health care, integrated care delivery and efficiency in the system.

AFHTO was pleased to see that many of the findings in the report are consistent with AFHTO priorities and aligned with our most recent Pre-Budget Submission submitted to the Standing Committee on Finance and Economic Affairs:

1. We need a health system that is truly integrated, one where patients don’t have to move from one part of the system to another part to get their care, especially care for mental health and addictions – primary care and mental health care providers need to work together to ensure that mental health and addictions investments are integrated in primary care.
2. The relationship between primary care and home and community care can be strengthened by transitioning the function and associated resources of care coordination to primary care. This will bring greater efficiency and patient-centredness to care. Care will be integrated, allowing for seamless transitions of care for patients.
3. Support expansion of interprofessional team-based care across Ontario. This can start with communities that don’t have a team at all and then expand to all Ontarians who wish for it. Allow for local-level innovation but ensure that primary care providers are involved in the co-design on what would work best for them in their communities and for their patients.
4. Look at existing models of performance measurement in primary care and facilitate and fund a strategy that spreads it across the system. This strategy must measure outcomes that matter to patients and providers while assisting in lower system costs. To support this, there needs to be further investments in quality improvement practice facilitators to help support front line providers.

AFHTO members are already taking leadership in many of the areas that are highlighted as challenges in the report and we look forward to sharing your innovations, ideas and patient stories with the government so we can continually highlight that an investment in creating a robust primary care system will lead to a high performing health system with better outcomes and patient experience.

Documents of Interest:

• Hallway Health Care: A System Under Strain
• A synopsis of the Interim Report by H&K Strategies
• AFHTO’s 2019 Pre-Budget Submission
• AFHTO’s recommendations to the Premier’s Council – May 2019

A draft bill from the Ministry of Health and Long-Term Care was leaked to the media at the end of January. The Health System Efficiency Act, 2019 appears to be in early stages, but the draft provides a high-level overview of what may be a major structural overhaul of health services in the province.

A summary of the draft legislation, as it read on January 31 when leaked, can be seen here. The draft legislation itself can be seen through online media.

Additional documents that show major changes to the health care system were leaked on February 4. These provide more information on a policy that is being formed, including information about MyCare Groups, the “Super Agency,” and how the ministry may be restructured. Information about the February 4 leaked documents can be read here.

While there is now more clarity about the government’s plans, much is still up in the air and will be seen in the weeks and months ahead. As we get more information, we’ll let our members know. In the meantime, we continue to encourage teams to reach out to their MPP to speak about the value of team-based care in their communities. Tools and resources are here. 

If you have any questions, please contact Beth MacKinnon (Program Associate, Policy, Leadership and Strategic Communications) at beth.mackinnon@afhto.ca or 647-234-8605 x206.