Tag: reports and relevant news

December 7, 2015 – Today the Association of Family Health Teams of Ontario released two new statements as part of members’ ongoing work to improve access and integration of care in a sustainable health system. These two statements respond to and build on recent reports:

• AFHTO response to the Expert Advisory Committee’s recommendations on population-based primary health care for Ontario – primary care teams have the leadership and willingness to step up
• Transitioning care coordination resources to primary care – bringing greater system efficiency and patient-centredness by transferring this function from CCACs

Related statements include:

• Optimizing the value of and access to team-based primary care – an evidence-informed statement released last June
• The Starfield Principles – aimed at optimizing performance by measuring quality, capacity and total health system cost of care

Family Health Teams (FHTs) and Nurse Practitioner-Led Clinics (NPLCs) have the leadership, dedication and willingness to step up to play their part in building a primary care system that understands and meets the needs of our patients and communities. Throughout the transformation process, they want to be heard, valued, and supported to succeed – above all else, with sufficient funding to stabilize the workforce and ensure sufficient capacity to deliver quality care. Furthermore, AFHTO members call upon the Ministry to begin the process of transitioning care coordination resources from CCACs to primary care teams.  The Ministry must work with primary care teams, LHINs, hospitals and other stakeholders to transfer all functions currently carried out by CCACs to the most appropriate bodies, to achieve greater efficiency and integration in care delivery. Population-based primary care and integrated care coordination are predicated on the availability of and access to primary care teams – currently limited to about one in four Ontarians. To spread access, AFHTO recommends the Ministry continue and strengthen its support for the field to:

• Develop common understanding and measurement of population needs and team capacity.
• Harness the will and expertise of local champions to spread team capacity in their communities, recognizing that different strategies and solutions will emerge to meet unique local realities.
• Expand access where:
  • Capacity is sufficiently developed to manage additional demand without decreasing quality of care, and
  • Physicians are ready to commit to minimum requirements for meaningful collaboration and communication with the team.

Advances by AFHTO members to measure results, through the Starfield Principles, are guiding the way to understand and assure progress toward government’s priorities of access, quality, and system sustainability. AFHTO policy positions can be accessed here. We look forward to working with the Ministry, LHINs, patients, communities, and health system colleagues to improve health and health care.

On November 25, Dietitians of Canada released the Dietitian Workforce in Ontario Primary Health Care Survey Report. Over four hundred dietitians working in FHTs, NPLCs, CHCs and FHOs were surveyed in spring 2015 to describe the current workforce and roles of the dietitian, and to identify factors supporting the integration of their roles into the healthcare system. Patient access to nutrition care, challenges working to full potential and high turnover all arose as key issues. Highlights from the report include:

• 87% of respondents are not satisfied with compensation.
• 35% intend to leave their current position within the next two years, and another 49% are undecided. Only 22% plan to stay in their current position beyond the next two years.
• Poor integration with other sectors (acute care, LTC, homecare, public health) is perceived.
• Due to lack of resources (time and FTEs), RDs are not practicing to their full scope which includes prevention and promotion activity.

These findings are in line with AFHTO’s 2014 report, Toward a Primary Care Recruitment and Retention Strategy for Ontario. As outlined by AFHTO and our colleagues, the inability to offer competitive compensation to interprofessional healthcare providers is a huge barrier to attracting and keeping skilled providers in primary care teams. Staff turnover, and the challenge of finding replacements, create gaps in care. Underfunding holds back the value of primary care teams. While they continue to deliver more value to patients and the health system, this sector remains woefully undervalued. AFHTO and our colleagues continue to advocate on behalf of primary care teams to strengthen recruitment and retention across the sector. For further information, please click on the links below:

• AFHTO policy position and report: Toward a Primary Care Recruitment & Retention Strategy for Ontario
• News release – Dietitians of Canada
• Report: The Dietitian Workforce in Ontario Primary Health Care Survey Report, November 25, 2015, Dietitians of Canada [PDF]
• “Dietitians in Primary Health Care Factsheet”, November 25, 2015, Dietitians of Canada
• “Undervalued: The revolving door of dietitians”, NorthernLife.ca, November 30, 2015

On November 24, 2015, The Globe and Mail published an article Ontario plans to target home care in overhaul of health care system. In response, AFHTO together with the Association of Ontario Health Centres (AOHC) sent a joint letter to the editor:

Letter to the Globe and Mail Editor, sent November 24, 2015: Research from around the world shows that cost-effective and high-performing health systems are based on a strong foundation of comprehensive primary care.

We have the building blocks. One-quarter of Ontarians now receive care from primary care teams – family health teams, nurse practitioner-led clinics, community health centres and aboriginal health access centres. Teams wrap care around each person throughout their lifetime.

We need to take the next step — expand primary care teams for all, and give teams the tools to fully coordinate care for their patients so we can reduce the duplication and role conflict that currently exists.

Net result? Better care, healthier people, best value.

The article states, “The Ontario government is preparing to overhaul health care in the province, including scrapping its troubled system for delivering home care and reforming primary care with the aim of improving patient access.” Improving access to and quality of care for patients requires effective care coordination led by a person’s primary care team throughout his or her lifetime. This reduces duplication, facilitates access and ensures continuity of care regardless of setting, be it care in the home, community, hospital or long-term care facility. As we work together to improve our health system, AFHTO joins with its colleagues on the Ontario Primary Care Council to call on government and others in Ontario’s health system to ensure primary care is supported to fulfill this central role in coordinating care. Click to read the Ontario Primary Care Council’s Position Statement on Care Coordination in Primary Care.

In a speech at the close of the OHA’s Health Achieve conference today, Ontario Health Minister Dr. Eric Hoskins, spoke about why he believes “we must undertake structural change to our health care system.” Key points include: • The need for government to improve equity of access to health services and outcomes for patients • Embracing a population-based approach to delivering care • To do this, the need for a system that is “deeply integrated at the local level” and “starts with strong local governance” • A much greater role for LHINs, including a role with primary care, and the possibility of merging LHINs and CCACs • Announcement of the first “Rural Health Hubs” in the coming weeks. Minister Hoskins committed – “Over the coming months, my ministry will be actively engaging with stakeholders and the public as I develop my plan for the next steps of system transformation.” Meanwhile, AFHTO is well-positioned to advocate and respond on behalf of members. Staff are reviewing the rich input received from members from last week’s Leadership Session and Conference on strengthening team-based primary care as the foundation of the health system. We’ll report back to members by end of next week and continue to work with members, the Ministry and LHINs, to shape the direction of the functional and structural changes ahead.

We are pleased to share our latest Annual Report – Collective Impact: The Power to Shape Our Future. This report highlights the progress AFHTO members have made, and the emerging research evidence on the added value of primary care teams.

           Leadership + governance             =     Growing VALUE for Ontario’s + measurement + improvement              patients and communities

This formula is driving the collective work of AFHTO members – family health teams and nurse practitioner-led clinics – and the results are showing. We are making visible progress toward the vision that all Ontarians will have timely access to high-quality and comprehensive primary care – care that is informed by the social determinants of health, delivered by collaborative teams, and anchored in an integrated, equitable and sustainable health system. Around the world, cost-effective and high-performing health systems share a common characteristic – they are based on a solid foundation of comprehensive primary care. We hope you enjoy reading what AFHTO members are doing to strengthen that foundation, and we look forward to continuing to work with members and stakeholders toward this vision.

In a news release announcing a Special Report on CCACs, the Auditor General of Ontario stated, “The Ontario government needs to take a hard look at how the province’s Community Care Access Centres (CCACs), along with their third-party service providers, deliver home- and community-based health care and related support services to patients outside hospital settings.” Effective care coordination is best led by a person’s primary care team throughout his or her lifetime. It reduces duplication, facilitates access and ensures continuity of care regardless of setting, be it care in the home, community, hospital or long-term care facility. As we work together to improve our health system, AFHTO joins with its colleagues on the Ontario Primary Care Council to call on government and others in Ontario’s health system to ensure primary care is supported to fulfill this central role in coordinating care. This Special Report on CCACs (Auditor’s Report) and the Report of the Expert Group on Home and Community Care (Donner Report) provide sound analysis to guide the way forward. Click here to read the Ontario Primary Care Council’s Position Statement on Care Coordination in Primary Care.

“When you can’t pay for the drugs you need to treat or manage your health conditions, you get sicker and develop more serious complications. Families, employers and communities are hurt as well. Primary care teams see this every day. We wholeheartedly support this campaign to move toward a national system of pharmacare.”- Angie Heydon, Executive Director The call to create a national drug coverage plan is gaining ground, and with the possibility of a federal election in a few short months, it can now make even greater strides with your support. Canada is the only industrialized country with universal health insurance that does not offer universal prescription drug coverage but we can change that. Health policy researchers and health organizations have started a Campaign for a National Drug Coverage. A national drug coverage plan which is public, affordable and safe, would mean that everyone in Canada would have access to the medicines they need. This campaign is aiming to build on the momentum following the recent Round Table Discussion on Pharmacare between Ontario’s Ministry of Health and Long-Term Care and other provinces. We’ve given our support and invite our members and all those interested in improving access to healthcare to do so as well. Find out more by visiting http://campaign4nationaldrugcoverage.ca/.