This is an update on government’s implementation of Patients First and development of new FHT contract templates. Senior representatives of the Ministry of Health and Long-Term Care met with the AFHTO board on Wednesday. This is a report on what the board learned and direction provided on behalf of the membership. Further below is current info on preparation for the new compensation funding.
Patients First
Discussion with the ministry centered on four themes:
- LHIN accountability, consistency, capacity and willingness to take on a constructive role with primary care
- Measurement & quality improvement – opportunity to leverage AFHTO members’ work on Data to Decisions
- Need for physician-team relationships to be supported and strengthened
- Potential for expansion of interprofessional care across the province
The board welcomed the openness and willingness to listen of the ministry representatives – Associate Deputy Minister Nancy Naylor, PHC Branch Director Phil Graham, and Interprofessional Programs Manager Nadia Surani. The AFHTO board remains fully committed to the direction of Patients First. While there are many unknowns and much potential for “devils in the details”, this is the case in any major change. And it is particularly challenging at a time when the biggest segment of the primary care workforce – family physicians – remain without a contract. Together with our members, AFHTO is prepared to lead – FHTs and NPLCs have the experience and innovative, collaborative approach needed to show the way. Links to further information on Patients First
- MOHLTC – Patients First Presentation to AFHTO Board (June 21 2016)
- AFHTO’s analysis (for members only)
- Opinion piece by Dr. Sean Blaine, Clinical Lead, STAR FHT and AFHTO President
- Video presentation by Dr. Bob Bell, Deputy Minister and Mr. Tim Hadwen, Assistant Deputy Minister
Developing new FHT contract templates
The AFHTO board and ministry reps also discussed the ministry’s approach to consultation leading to implementation of new FHT contracts in early 2017. The Ministry is also required to consult with the Ontario Medical Association. While these contracts will be held by the ministry, it will work closely with the LHINs – passage of the Patients First Act would enable these contracts to be transferred to LHINs at some point when they are ready to take them on. Meanwhile, AFHTO will be working with members to identify specific needs and positions to take in these consultation discussions. Members laid a foundation 18 months ago, articulated in Toward the next ministry contract: Principles and guidance for moving forward. Since then discussions with AFHTO’s board, ED Advisory Council and Physician Leadership Council has identified the following topics for deeper probing with members:
- Relationship between FHT and physicians – both those who are within the team and those outside the team who may want to collaborate in the care of high-needs patients
- Board governance requirements
- Accountability and reporting requirements
- Dispute resolution between FHT and ministry and/or LHIN
AFHTO’s member consultation will culminate with deliberations at the annual Leadership Triad Session, Oct. 17, just before the start of the AFHTO 2016 Conference. Board chairs, EDs and Lead MDs/NPs of AFHTO member organizations are welcome to register. Legal and consulting help through the consultation and implementation process will be supported by a special fund of $104,700. A huge thank you as well, to the 48 AFHTO member organizations of all sizes, waves and LHIN regions who made voluntary contributions toward this fund.
Preparation for implementing new compensation funding
We understand the letters approving increased compensation funding for each FHT, NPLC, AHAC (and through LHINs for the CHCs) are in the final stages of ministry sign-off. We don’t know how long this will take, but hopefully will be “soon”. Each primary care organization will be required to develop its own compensation plan to allocate these funds, and report back to the ministry on how the funds were used. Ministry direction is clear that this funding can only be used for compensation for approved staff positions and cannot be used for any other purposes. Meanwhile AFHTO:
- is developing support materials to help EDs and boards to develop and implement their compensation plans. These materials are generic at the moment – we won’t have any more specific details until the ministry letters have final sign-off.
- will schedule webinars soon after the ministry letters are signed.
- may enable members to get better value from their benefits dollars. On June 22 the AFHTO board approved a group benefits partnership with the Association of Ontario Health Centres and Addictions and Mental Health Ontario. More information will follow in the coming weeks.
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