On December 17, 2015, Ontario’s Ministry of Health and Long-Term Care released its discussion paper Patients First: A Proposal to Strengthen Patient-Centred Health Care in Ontario. On its release, AFHTO issued the statement below from Dr. Sean Blaine, AFHTO President and Clinical Lead, STAR Family Health Team in Stratford ON. This was published in various newspapers including The Kingston Whig-Standard, Woodstock Sentinel Review and Beacon Herald in January.
AFHTO will be working with its members in each region of the province to develop a more detailed response to the questions posed in the discussion paper. Particular attention will be paid to those areas where great care must be taken to gain the most benefit for patients and communities, and avoid unintended negative consequences.
Comparative studies tell us our health system is not performing as well as it could. How can we make it better?
We need to have the right people in the right place at the right time to deliver the most appropriate care. This requires effective planning, strong relationships, meaningful measurement and engaged leadership from health professionals. Across the world, cost-effective and high-performing health systems are built on a strong foundation of comprehensive primary care.
Over the past decade, Ontario has taken steps to strengthen primary care. Family health teams and nurse practitioner-led clinics emerged as innovative models for bringing together health professionals – doctors, nurses, pharmacists, dietitians, for example – to deliver such care. Unfortunately, only 25% of Ontarians receive their care from such team-based models.
Ontario also aimed to improve planning, relationships and performance by setting up Local Health Integration Networks (LHINs). But two parts most critical to keeping people healthy – primary care and public health – were left off the LHINs’ mandate.
More needs to be done to ensure people can get the appropriate care and support they need when they need it.
With the Patients First proposal, the Ontario government launches the next phase of health system evolution. The proposal would bring all parts of the health system under a single jurisdiction for planning and performance reporting, and focus attention on how best to meet the needs of people living in each community. It pays particular attention to strengthening primary care. These are absolutely critical steps toward ensuring more comprehensive and equitable health care services for all Ontarians.
Public health departments must be connected to LHINs. These organizations are focused on understanding whole communities to prevent sickness and the spread of communicable diseases. Public health professionals analyze communities to identify and monitor health risks, and target public education and other programs to promote health wellness and illness prevention within a population.
Equally important is the ongoing care individuals and their families receive over their lifetimes. This is primary care – your “medical home” – delivered by family doctors, nurse practitioners and primary care teams who know you, care for you, and coordinate specialized health services when you need them.
The proposal also merges community care access centres (CCACs) into the LHINs enabling greater local coordination of care, and more efficient use of health resources. If LHINs then deploy care coordination expertise into primary care settings, it will help patients and families identify a single point of contact to navigate and access programs and services.
As a family doctor working in a family health team, I can see the potential in this proposal, as well as some cautions:
Every region of this province empowered to bring together all local health system players to focus on every community’s true health needs. Primary care strengthened and supported to wrap the most appropriate care around each person. If well implemented, Patients First is an important next step to improve our health system for better health for all Ontarians.
Sean Blaine MD
Family Physician, Stratford, Ontario
Clinical Lead, STAR Family Health Team
President, Association of Family Health Teams of Ontario (AFHTO)
Note: This statement was published in various newspapers including The Kingston Whig-Standard, Woodstock Sentinel Review and Beacon Herald in January.