About the pilot

Updated September 6, 2023

Table of contents: 

For an overview, you can download a PDF one-pager about the after hours care service.

A solution for after hours care requirements

FPSC's pilot program provides family physicians and nurse practitioners with a solution from HealthLink BC that meets the College of Physicians and Surgeons of BC Practice Standard for Care Coverage Outside Regular Office Hours. During the pilot, care will be provided to attached patients only; unattached patients calling the service will be transferred to 811. If the service expands, we will explore providing services to unattached patients. Learnings from the pilot will inform the future development and implementation of a provincial solution for after hours care that could also be scaled to include unattached patients. The program aims to address pain points raised by family doctors during Doctors of BC's summer 2022 engagement: The Future of Primary Care: Doctors of BC 2022 Member Engagement Report. 

Over the past year, FPSC and HealthLink BC worked closely together to create a service that enhances patient access to care outside regular office hours. In September 2022, FPSC formally adopted this work as the After Hours Care Program. The pilot will include an evaluation framework to capture measurable aspects of the quadruple aim (i.e., improved health outcomes, improved patient experience, cost sustainability, and improved provider experience).

The program isn't meant to replace a patient's MRP (most responsible provider); rather, it’s meant to act as an extension of the care they already provide to encompass after hours access to longitudinal care for urgent issues. The program isn't a new call group. It's a consolidated after hours service that can be available to your practice. In time, it will make it unnecessary to have a separate call group. Administrative and true emergencies will be triaged away from the service, which means that only after hours issues requiring the advice of a longitudinal physician will be addressed. During the pilot, prescription refills, sick notes, forms, lab requisitions, medical imaging requisitions, etc. are outside the scope of the service, although they may be offered at the discretion of the individual who manages the patient’s issue. Anything the service orders, the service will follow-up on; the MRP/PMH will be copied.

This program also isn't meant to replace a patient's existing family physician or nurse practitioner. It is intended to support patients in gaining consistent and increased access to longitudinal care after hours--for appropriate reasons. It is intended to reduce the burden faced by family doctors in meeting the College of Physicians and Surgeons of BC requirements for providing after hours care. 

If the pilot is successful, then it will provide participating practices with an easy way to demonstrate compliance with the College of Physicians and Surgeons of BC standards for providing after hours care, lessening a considerable source of stress for many family physicians. It will also create a consistent, province-wide means for patients to get access to appropriate care outside regular office hours. It will significantly reduce the burden for family doctors and nurse practitioners to organize, schedule, and maintain their own call groups. It will likely reduce the number of family physicians and nurse practitioners who are occupied providing after hours care each night, meaning that other services such as extended hours clinics might be possible.

Who can participate

  • Longitudinal family physicians who are members of the following divisions of family practice and longitudinal nurse practitioners who are within the geographic boundaries of the following divisions of family practice can sign up to use the after hours service with their patients:

    • Langley Division of Family Practice

    • South Okanagan Similkameen Division of Family Practice

    • South Island Division of Family Practice

    • Thompson Region Division of Family Practice

    • Victoria Division of Family Practice

  • Family physicians who are members of one of these divisions of family practice can also sign up to staff the service.

  • You may register to use the service with your patients without committing to working any shifts. This is possible because we anticipate sufficient numbers of family physicians will be interested in staffing the service.

Hours of service

During the pilot, the After Hours Care Program service is available:

  • Monday to Friday from 5:00 p.m. – 9:00 a.m.

  • 24-hours on weekends and statutory holidays (also includes Easter Sunday, Easter Monday and Boxing Day).

Timelines

  • Sign up – June, July & August 2023: Service sign up is now available. There are  options for family physicians to use and/or staff the service, and for nurse practitioners to use the service with their patients.

  • Launch of the pilot – September 19, 2023: The pilot service will launch Tuesday, September 19, 2023. It will run for six months.

  • Evaluation: Evaluation of the service will take place after three months (i.e., by the end of January). If the evaluation shows that the pilot is successful, then the service will simply continue beyond the pilot end date and we will begin provincial expansion through a community expression of interest process.

  • Notice: If the evaluation shows that the pilot is unsuccessful, then we will notify users and staff at least two months prior to ending the service. This will allow users and staff time to identify a replacement for their longitudinal after hours care needs.

Governance & contributors

As the After Hours Care Program pilot is an FPSC project, FPSC has decision-making authority over it. During the pilot, an advisory group of participating pilot communities is providing ongoing guidance. FPSC and HealthLink BC are responsible for day-to-day planning and implementation of the after hours care service. HealthLink BC is handling the operations.

Our thanks and gratitude to the individuals and groups who've worked tirelessly over the past year to build this new program for family doctors:

  • HealthLinkBC
  • BC Ministry of Health
  • Langley, South Okanagan Similkameen, South Island, Thompson Region, and Victoria divisions of family practice
  • University of British Columbia Digital Emergency Medicine
  • Nurses and Nurse Practitioners of British Columbia

While most of the working groups who contributed to the development of the After Hours Care Program have now concluded their work, the Advisory Group will continue providing guidance to the pilot. We appreciate the tremendous efforts of all of the working group contributors in readying the pilot for implementation:

Advisory Group

  • Dr Jaron Easterbrook (physician lead), Dr Kendall Ho (physician lead), Sandra Sundhu (executive director, HealthLinkBC), Brandon Wong (A/director, HealthLinkBC), Jillian Wong (FPSC manager), Dr Sarah Critchley (physician, Victoria/South Island divisions), Leslie Keenan (executive director, Victoria/South Island divisions), Ellen Peterson (executive director, Langley division), Taunya Cossentine (project manager, South Okanagan Similkameen division), Dr Kevin Hill (physician, South Okanagan Similkameen division)

Clinical Working Group

  • Dr Graham Dodd (physician lead, Thompson Region), Dr Jaron Easterbrook (physician lead), Dr David Chapman (physician, Langley division), Dr Kristen Iverson (physician, Victoria/South Island division), Dr Kendall Ho (physician lead), Danielle Daigle (nurse practitioner), Sue Lissel (project manager, Thompson Region division), Nikki Ebdon (nurse services manager, HealthLinkBC), Drew Binette (HealthLinkBC), Kimberley Melnyk (HealthLinkBC), Sebastian Delmas (PHSA), Dr Talveen Gill (physician, Victoria division), Dr Mari LaCock (Victoria division), Myla Yeomans Rutledge (project manager, Victoria division)

Technology Working Group

  • Dr Paul Mackey (physician lead, Thompson Region), Sue Lissel (project manager, Thompson Region), Dr Andrew Du Toit (physician, Victoria/South Island divisions), HealthLinkBC digital enablement team, Brandon Wong (A/director, HealthLinkBC), Taunya Cossentine (project manager, South Okanagan Similkameen division), Dr Kevin Hill (physician, South Okanagan Similkameen division), Kimberly Melnyk (HealthLinkBC), Dr Stuart Bax (physician, Victoria division), Dr Jaron Easterbrook (physician lead)

HR & Admin Working Group

  • Dr Jaron Easterbrook, Brandon Wong (A/director, HealthLinkBC), Thea Blakely (project and change manager, HealthLinkBC), Myla Yeomans Routledge (project manager, Victoria division), Simone Sharma (project manager, Langley division), Aara Johnson (HealthLinkBC HEiDi), Sue Lissel (project manager, Thompson Region), Jillian Wong (FPSC manager), Julie Young (project manager, South Okanagan Similkameen division), Monica McLean (FPSC project coordinator), Dr Anna Rounis (physician, Victoria division)

Evaluation Working Group

  • Dr Kendall Ho (physician lead), Nathan Patten (analytics, Doctors of BC), Brandon Wong (A/director, HealthLinkBC), Myla Yeomans Routledge (project manager, Victoria division), Sonya Cressman (UBC digital emergency medicine), Julie Young (project manager, South Okanagan Similkameen division), Joan Assali (UBC), Dr Jennifer Begin (physician, South Okanagan Similkameen division), Dr Melissa Duff (physician, Victoria division), Dr Jaron Easterbrook (physician lead), Dr George Smith (physician, Victoria division)

How the After Hours Care Program differs from HEiDi ER

While the After Hours Care Program is similar to HEiDi ER (HealthLink BC Emergency iDoctor-in-assistance), the two services are not the same:

  1. The structure is different.

    • HEiDi ER takes 811 calls from all patients triaged by nurses at HealthLink BC and provides 811 support from 9:00 a.m. - 11:00 p.m. daily.  

    • During the pilot, FPSC's After Hours Care Program is limited to calls only from attached patients. The service operates from 5:00 p.m. - 9:00 a.m. weekdays, and 24-hours on weekends and statutory holidays.

    • Family physicians and nurse practitioners who sign up to use FPSC's After Hours Care Program with their patients also agree to quickly see their patients who call the service and are deemed to need semi-urgent follow up.

  2. The breadth of services is different.

    • Consistent with the requirements of the College of Physicians and Surgeons of BC, FPSC's After Hours Care Program will manage critical labs, etc., for physicians and nurse practitioners using the service with their patients. 

    • In addition to providing advice to patients, FPSC's After Hours Care Service can also (if appropriate) prescribe, refer, order medical images, etc., and follow up on these.

  3. Longitudinal focus is different. 

    • FPSC's After Hours Care Program serves as a comprehensive extension of the patient's longitudinal family physician or nurse practitioner. For some issues, this nuance might not be evident, but for others, understanding longitudinal practice and/or community services allows more effective advice and follow up recommendations. Regardless, the community physician or nurse practitioner receives a timely encounter note for each call to FPSC's After Hours Coverage Program.

How the After Hours Care Program differs from virtual care clinics

  • The service is not a virtual care provider. As physicians staffing the service will have access to CareConnect and PharmaNet, they will have some insight into the longitudinal record. However, they won’t have access to the comprehensive patient record in your EMR (electronic medical record).

  • The After Hours Care Program will reconnect patients to their longitudinal family physician or nurse practitioner for any necessary follow up in order to close the loop to longitudinal care.

  • When urgent, telephone handoff will take place between the service and the community family physician or nurse practitioner.