March 19, 2018

March 8 marked a key milestone in the evolution of primary care in BC and the collective efforts of the Ministry of Health, Doctors of BC, divisions of family practice, and health authorities to support patients in a more meaningful way.

Division and health authority representatives from 10 geographic areas, along with Ministry of Health leaders and GPSC support teams, came together in Vancouver to discuss detail around a 90-day planning process for primary care networks (PCNs) that will begin in April. Creating PCNs in 10 regions will be the next step toward building an integrated system of care in BC.

The event provided an opportunity for participants to learn more about the vision and context for PCNs and a system of primary and community care. The provincial leadership team reviewed research and supports available to participating communities, discussed challenges and concerns, and sought feedback into a draft PCN service planning template.

PCNs will create a partnership between patient medical homes (PMHs) and health authorities’ primary and community care services, and other providers and community agencies in a geographic area. Allied health and other professionals work with physicians; and together they support and rely on each other, share joint resources, and work to their strengths in order to give patients the best possible care.

A PMH – which describes an ideal family practice that provides patient-centred care – gives patients access to continuous, comprehensive, and coordinated care through their GP, who is supported by the teams and networks.

“In order for the PMH to be fully functional, it needs a broader, supportive system and relationships around it,” said Dr Brenda Hefford, Executive Director for Community, Practice, Quality & Integration for Doctors of BC. “That’s where the PCN comes in.”

“One supports the other. Without operating within a broader system of care, patients are not going to get the full range of care they need,” she said. “Doctors cannot do it on their own. Providers are struggling.”

PCNs further link to Specialized Community Services Programs (SCSPs) delivered by health authorities. Those services, which are being redesigned, focus on supporting vulnerable patients, such as those with moderate to severe mental health and substance use issues, adults with complex medical problems, and the frail elderly.

Through their CSCs, health authority and division partners will work together to identify key needs in their communities to ensure development of PCNs that accommodate local circumstances, including differences in urban and rural settings. During the initial 90-day planning process, the first five regions will develop a service plan and determine funding needs.

Creating PCNs involves collaborative discussions at all levels to re-imagine and re-design services, and link siloed parts of the system together. Rather than starting from scratch, the process draws on rich experiences and a foundation of partnerships established through more than a decade of primary care reform in BC.

While partners still need to determine aspects of the PCN model, including precise funding options, there was general agreement that it is better to take action sooner, rather than to wait for every detail to fall into place. The approach moving forward is rooted in learning, monitoring, talking and sharing.

Creating PCNs and redesigning foundational elements will not happen overnight. But the journey has started, and is on the way to fundamentally shifting the health care system in positive directions for patients for the future.

“We are excited about the opportunity to carry on the path we have been going – to sustain the work we started and the push the boundaries of what we are already doing to support patient health,” said Dr Garry Knoll, Physician Lead for the Prince George Division of Family Practice.