To: Physician Leaders in all AFHTO member organizations AFHTO is pleased to announce the inaugural meeting of the Physician Leadership Council (PLC) took place on January 28^th. This email provides an overview and highlights key items discussed:

• Physician Leadership Council: Creating Collective Impact
• The Provincial Primary Care Environment
• The FHT Context
• PLC Priority Areas of Focus

Physician Leadership Council: Creating Collective Impact

The newly created PLC plays a significant role in enabling Physician leaders from across the FHTs to provide a sounding board on FHT related matters and give advice to the AFHTO board and staff as needed. For the first time, Physician leaders now have a platform to advance best practice knowledge transfer, enhance collaborations and to work together to surface operational, governance and other FHT issues. A draft Terms of Reference has been developed to guide the work of PLC and to clearly identify its purpose, roles and responsibilities, and structure. The TOR may be amended as the Council evolves and work progresses. The PLC is an opportunity for lead Physicians to create a collective impact that can optimize FHT value, function and operations. Members of the Council will communicate, engage and consult with their physician colleagues to create strong communication mechanisms and a better understanding of current challenges and/or opportunities within FHT practices. The Council will provide leadership to harmonize working relationships to ensure optimal interprofessional comprehensive primary care delivery.

The Provincial Primary Care Environment

There are a number of current provincial factors that are shaping and influencing the primary health care change agenda. Members discussed the potential role the PLC may play in responding and advising on the following items:

• OMA-MOHLTC Negotiations

On January 15^th 2015, the Ontario Medical Association held a press conference announcing that they will not accept the government’s offer reached through the current negotiation and conciliation process. The parties have reached the point where government is now in a position to impose a contract. The Ministry announced a Ten-Point Plan, but we are awaiting details with respect to implementation. One of the points — Only areas with a high need for physician services will get new Family Health Organisations and Family Health Teams — caused a number of concerns to be raised by PLC.  AFHTO will continue to keep all members informed as further details are released and will work with PLC to determine the impact the changes may have on FHTs and the delivery of interprofessional primary care.

• MOHLTC’s Expert Advisory Committee on Strengthening Primary Health Care in Ontario

It is expected that the Advisory Committee will define a future strategic vision, goals and objectives to advance Ontario’s primary health care sector and make recommendations around the design of the PHC system. When these findings are released, PLC and AFHTO will work to identify the potential impacts and opportunities for FHTs.

• Evolution of Primary Care & Access to Team Based Care

Recent addresses by the Minister and Deputy Minister focus on person-centredness, system integration, accountability, increasing health and wellness, and ensuring sustainability and quality. The Deputy has also referenced the need to improve access to interprofessional care. PLC members also spoke about the evolution of Health Links and how this may influence the direction of primary care.

The FHT Context

The FHT approach involves considerable changes in the provision of care for family physicians; working in an interprofessional care delivery system requires members to explicitly reflect upon and address how to work as a team and introduces the concept of shared responsibility. Members reviewed the clear evidence of the solid relationship between governance, leadership and performance:

• Soon-to-be published research by the Ontario College of Family Physicians on characteristics of high-performing FHTs identifies strong leadership, governance and team collaboration to be highly correlated with quality outcomes.
• The recently released FHT Evaluation Report found that governance, leadership, use of patient data and quality improvement as critically important contributors to stronger performance.

Based on the results of the Leadership survey provided to board chairs, lead MD/NP’s and executive director of each AFHTO member organization, members also reviewed the following statement of adopted principles:

• Governance Principles
• Accountability and Reporting Principles
• Principles for Determining Accountability Measures

Click here to see the principles.

PLC Priority Areas of Focus

Based on the provincial and current FHT environment, members agreed on a number of priority areas of focus for the PLC:

• Ministry-FHT Contract Renewal in 2016 & Focus on Manageable, Meaningful Measurement

Contracts between MOHLTC and FHTs expire on March 31, 2016. The contract defines the terms and conditions and the legal framework under which funding is provided to the FHTs. The Ministry has been clear that ongoing FHT funding will be tied to accountability measures as set out in the next contract agreement. The renewal of the contracts will provide an opportunity for the PLC to advocate for changes that can influence the next stage of evolution for interprofessional primary care. The PLC will also have a role to play in shaping and influencing the measures selected to reflect the value FHTs deliver. There is significant work being done by the QSC and Indicators Working Group that will benefit from continued physician engagement.

• Harmonizing FHT Relations and Practices

The September 2014 AFHTO leadership survey found that 80% of respondents agreed that “greater harmony between the physician-funded groups and the FHT-funded groups is essential to the FHTs moving forward to ensure optimal interprofessional comprehensive primary care.” PLC members agreed on the opportunity to assists FHTs in harmonizing working relationships and practices for effective and efficient teamwork.

• Access to Interprofessional Health Providers (IHP)

The OMA is in the process of consulting with its members on access to IHP services to address priority populations. The OMA provided a draft paper to PLC members, and a collective response will be generated.  In the next 2-3 weeks, AFHTO will send you the draft paper and PLC’s response. OMA welcomes any of its members to provide individual or group feedback by Feb. 23 to Peter.Brown@oma.org.

• Governance and Leadership

Physician leadership, strong governance and effective working relations are the building blocks to achieving high-performing primary healthcare teams. The PLC will reinforce excellence in team performance by acting as a vehicle for communication, collaboration and problem solving.  The formation of regional networks for FHT physicians will be explored. The PLC also provides the opportunity for FHT physician leaders to give voice, not only to AFHTO but to external bodies as well. The next meeting of the Physician Leadership Council will be held in late March/early April. Click here for the list of members. For further information, please contact: