A GP for Me -A GPSC Initiative 2015 Quality Forum

Dr. Brenda Hefford- Executive Director, Practice Support and Quality, Doctors of BC Shana Ooms, Director, Primary Health Care,

Ministry of Health

Benefits of a continuous doctor – patient relationship

• Improved Patient Heath

• Patients who have access to a regular primary care provider or family doctor are healthier – they don’t get sick, go to emergency rooms or end up in hospital as often

• Improved Health System

• Family doctors are able to oversee and coordinate a patient’s care across the health system and can help to reduce overall costs

• Positive Economic Impact

• Research in BC shows it costs less to look after patients who have regular access to primary care

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Problem/Issue: There are many people in BC who do not have a family doctor

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Number of People in BC Without a Family Doctor

Number of People in BC Looking for a Family Doctor

2010 (Pop approx. 4,456,900)

13.8 per cent (approximately 615,000)

3.96 per cent (approx. 176,000)

2013

(Pop approx.

4,582,000)

15.5 percent (approx. 710,000)

4.57 per cent (approx. 209,000)

The number of people without a family doctor is rising

14.1% 14.3%

15.1% 15.6%

15.1% 15.2% 15.3% 14.9%

15.5%

10.6% 10.9%

11.9%

13.2% 13.2%

14.3% 13.9% 14.0%

15.5%

10.0%

12.0%

14.0%

16.0%

18.0%

2003 2005 2007 2008 2009 2010 2011 2012 2013

Percentage of Population without a Regular Medical Doctor

Canada British Columbia

Data Source: Statistics Canada, CANSIM Table 105-0501

Data is only available up to 2013 when A GP for Me started so do not have data to see any impact.

Similar issues exist across Canada

Percentage of Population without a Regular Medical

Doctor

Attachment Initiative: Three prototype communities

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A province-wide initiative funded jointly by Doctors of BC and the Government of BC to strengthen the primary care system

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Goals of A GP for Me

• Enable patients who want a family physician

to find one

• Strengthen and support the family doctor -

patient continuous relationship, including

better support for vulnerable patients

• Increase capacity of the primary health care

system

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Multi-pronged approach

1. Physician practice level incentive fees

2. Community patient attachment strategies

through Divisions of Family Practice

3. Integration, alignment, and leveraging of

existing health authority, ministry, joint clinical

committees, and partner initiatives, programs and

policies

4. Patient and public engagement and education

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Practice Level - attachment incentives

Four new family physician fees. The fees are for:

• Attaching unattached patients with complex health needs;

• Managing the care of frail patients;

• Providing patient care over the telephone for all patients;

• Conducting conferences with other health care providers for all patients.

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Community supports: Local divisions of family practice

$40 million over three years to: • Engage and assess: community and patient needs,

local family doctor needs, strengths and gaps in local primary care resources

• Develop and implement community plans for improving local primary care capacity, including finding doctors for patients who want one

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Practice level results to date*

3,101 family physicians have ‘signed-up’ to participate in A GP for Me locally via their Division of Family Practice.

• 75% of full service family physicians.

More than 415,000 patients have received attachment related services

$31.0 million has been paid for these services

*Based on services from April 1, 2013 to

December 31, 2014, paid to December 31, 2014

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Practice level incentives have enabled family physicians to:

Attach 54,600 unattached patients with complex health needs (to over 1,900 family physicians)

Provide telephone care to 326,000 patients (by 3,300 family physicians)

Provide enhanced care to 17,600 frail patients (by more than 1,640 family physicians)

Hold conferences with other health care providers about the shared care of 64,000 patients (by over 2,550 family physicians)

*Based on services from April 1, 2013 to Dec 31, 2014, paid to Dec 31, 2014

Practice level results to date*

Community level results to date

1

10

20

3

0

5

10

15

20

25

Not Interested Assessment and PlanningPhase

Implementation Phase Sustainability Phase

Divisions' Participation in Attachment - Jan 2015

Planning and

Assessment Implementation Total

Expenditure as of

December 2014 $10,746,231 $7,832,000 $18,578,231

Divisions Progress from Assessment & Planning to Implementing

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1

6

9

12

17 18 18 18

19 20 20

21 22

21 21

16 15

14

12

10

1 1 1

3 3

7 7 12 13 15

18 20

0

5

10

15

20

25

30

35

Divisions in Assessment & Planning Divisions Implementing Local Solutions

Key Community Strategies

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• Physician retention and recruitment

• Practice Efficiency and Clinical Improvement

Supports

• Inter-professional team based care

• Public Education and Health Promotion

• Attachment mechanism

Challenges and lessons

•Importance of relationships and collaboration

•Balancing improving access to care with providing improved quality of care •Complexity: multiple factors influencing primary care capacity and access •Strength of community engagement and planning •Challenge of provincial expectations and timelines

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Challenges and lessons

• Benefits of assessment and planning in building relationships, increasing understanding of local issues, and being more targeted and customized in solutions

• Existing payment models in supporting team based care models

• Challenge of evaluation

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Section Title goes here Section 3

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An initiative of the GPSC, funded by Doctors of BC and the Government of BC

Thank you!