patient engagement learning series: primary care...
TRANSCRIPT
Patient Engagement Learning Series: Primary
Care Networks
Hosted by
Jacquelyne Foidart | Engagement Leader
Patient & Public Engagement
7. First Nations (province-wide)
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✓Understand the Primary Care Strategy
✓Understand what and who is the Primary Care Network
✓Recognize the relationship between Primary Care Networks and models of care
✓Understand collaborative local partnerships moving this work forward
We heard a desire to:
Primary Care Strategy
Presented by Joanna Richards, A/Executive Director
Primary Care Division
DRAFT for discussion
A story of two neighbours
Primary Care Networks 6
PCNs will be designed to meet the needs of individuals and
ensure the comprehensive suite of primary care services are
accessible by the community population they serve.
- PCN Policy Direction 2017
“”
Who is the PCN?
Primary Care Networks 7
PCN
Health
Authority
Division
members
Other
Groups
First
Nations
Primary Care Networks (PCN)
Primary Care Networks 8
CHCs
UCCs
Primary Care Networks (PCN) (2/2)
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Primary Care Network Core Attributes
1. Process for ensuring all people in a community have access to quality primary care, and are
attached within a PCN.
2. Provision of extended hours of care including early mornings, evenings and weekends.
3. Provision of same day access for urgently needed care through the PCN or an Urgent Primary
Care Centre.
4. Access to advice and information virtually (e.g. online, text, e-mail) and face to face.
5. Provision of comprehensive primary care services through networking of PMHs with other
primary care providers and teams, to include maternity, inpatient, residential, mild/moderate
mental health and substance use, and preventative care.
6. Coordination of care with diagnostic services, hospital care, specialty care and specialized
community services for all patients and with particular emphasis on those with mental health and
substance use conditions, those with complex medical conditions and/or frailty and surgical
services provided in community.
7. Clear communication within the network of providers and to the public to create awareness
about and appropriate use of services.
8. Care is culturally safe and appropriate.
PCN Wave 1 CSCs
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Wave 1a: Wave 1b:
Comox South Island
Richmond Vancouver
Burnaby Fraser North West
South Okanagan Similkameen Kootenay Boundary
Prince George Ridge Meadows
Pacific Northwest (Bulkley Valley-Witset)
Wave 2 in planning
Primary Care Networks
Stakeholder Map – Who’s Who
Primary Care Networks 11
Roles and Responsibilities of Key Stakeholders (1/2)
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Stakeholder Roles and Responsibilities
Collaborative Services
Committees (CSC)
• Community based and co-led by Health Authority Primary and Community Care leadership and Division of Family Practice
leadership.
• Governs local Primary Care Networks facilitating broad engagement of providers and key community partnerships.
• Provide PCN strategic leadership with respect to establishment of local PCN Steering Committee(s), PCN design and
implementation, and analysis of data to help identify community care needs and outcomes.
Primary Care Network
Steering Committee
• Has primary responsibility and oversight to operationalize the PCN clinical services.
• The PCN SC will be co-chaired by a practicing physician member of the local division, and a Health Authority
representative.
• Decisions in regards to the operations of the local PCN will be made by consensus, consistent with existing primary care
governance committees.
Regional Health Authorities
• Provide integrated and effectively linked primary and community care services to the Primary Care Network and PMHs.
• HAs act as a co-chair of local Collaborative Services Committees (CSC), and participate in the PCN Steering Committee
(PCN SC), which is formed by the CSC to coordinate the operations and implementation of the PCN.
• Provide fund administration and contract management for team-based clinical providers (RNs and Allied Health
Providers)as well as new GP and NP service contracts.
Divisions of Family Practice
• Community-based networks of family physicians (and NPs in some cases) organized into not for profit societies with
funding and support from GPSC through the Physician Master Agreement.
• Provide support to their members in the delivery of primary care, and implement GPSC funded initiatives.
• Support clinical network development and work in partnership with their local HA and other community partners to
examine gaps in health care in their community and to address these gaps.
• The division advises GP and NP members on local, regional and provincial direction and issues related to implementation of
PCNs and patient medical homes, UPCCs, and CHCs in local communities and SCSP developments.
First Nations Health Authority
(FNHA)
• Works collaboratively to provide strategic advice, resources and supports to other provincial bodies and local PCNs on
relevant issues and programs for indigenous populations; in order to enhance and enable cultural safety and humility at the
local level; and to support information sharing across all local PCN and Specialized Community Service Programs.
Doctors of BC (DoBC)
• Provides strategic advice and influence to the primary care policy direction. Employs staff for the collaborative committees
and provides administrative and practice support services on behalf of GPSC.
• In its advocacy role for physicians and its commitment to helping achieve the highest standard of health care, DoBC
participates in the development of physician payment models and reviews physician contracts and agreements.
Primary Care Networks
Roles and Responsibilities of Key Stakeholders (2/2)
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Work Stream Details & Risks
General Practice Services
Committee (GPSC)
• Collaborative committee between the Doctors of BC and the Ministry which includes HA and Division participation.
• Advises the Ministry of Health on key issues regarding primary and community care policy framework and implementation
• Supports PCN development and delivery through support of the PMH as the foundation of PCN, physician incentives,
funding to divisions, communication tools and resources, and support of physician leadership, engagement and
partnerships.
Interdivisional Strategic
Councils (ISC)
• Regional forum including representatives of all Division and HA Primary Care leads within a region.
• Provide an opportunity for information sharing and problem solving and help to ensure strategic alignment of PCNs and
primary care services within a HA region.
• Advise the PCC Advisory Forum and GPSC on issues related to PCN implementation and SCSP alignment, and GPSC on
issues related primarily to PMH implementation. The ISC advises CSC on regional issues related to PMH/PCN
implementation and SCSP alignment.
Nurse Practitioner Council of
Nurse and Nurse Practitioners
of BC (NPC)
• Communicates collaboratively and provides strategic advice to other provincial bodies and with local PCNs as needed on
nursing issues relevant to the PCN program
Primary and Community
Advisory Forum
• Advises Ministry decision making on BC’s health system transformation agenda through collaboration and consensus.
Specifically, it will allow partners to:
o Share information and provide advice regarding the implementation of PCN policy (including UPCC and CHC) and
SCSP policy for Mental Health and Substance Use & Adults with Complex Medical Conditions and/or Frailty;
o Provide updates on progress, challenges, and issues;
o Seek advice on how best to continue to move work forward and how to resolve issues.
Provincial Health Services
Authority (PHSA)
• Communicates collaboratively with other provincial bodies and with local PCNs as needed on issues relevant to the PCN
program and with effective linkages to SCSPs
• Support information sharing across all local PCN and SCSPs.
Ministry of Health
• Holds the overall accountability and funding for the health care system.
• Through the GPSC it holds joint accountability for the support and establishment of the PMH as the ideal primary care
practice and the foundation for the PCN and for community engagement and local implementation of the PCN.
• Responsible for the PCN, Team Based Care and Specialized Community Service Program (SCSP) policy development,
oversight, funding and accountability.
• Provides data for regional and local planning and evaluation, and oversees ongoing monitoring and evaluation and policy
revisions.
Primary Care Networks
Models of Care (1/2)
Primary Care Networks 14
Primary care will be built around team based care provided through a mix of patient medical homes, urgent
primary care centres (primarily in larger urban communities), community health centres (to better address the
social determinants of health), and health authority based primary care services, linked together in primary care
networks.
Primary Care
Network (PCN)
Urgent Primary
Care Centres
Patient Medical
Homes
Community
Health Centres
Health Authority
Based Primary
Care Services
Models of Care (2/2)
Primary Care Networks 15
New Models of Care Description
Patient Medical Homes
The foundation and corner stone as the practice model for delivering
key services associated with a full service primary care practice
delivered by Family Physicians (FPs) and Nurse Practitioners (NPs)
working to full scope as part of a broader team gradually replacing the
traditional solo GP practice.
Urgent Primary Care CentresWill both provide primary care to patients who currently do not have a
family doctor or nurse practitioner, and weekend and after-hours care.
Community Health Centres
Will bring together health and broader social services to improve
access to health promotion, preventive care and ongoing services. Each
of these centres will be designed and developed uniquely in line with
the needs of their communities and fully integrated into local primary
care.
Primary Care Networks: Backbone of the team-based approach, allowing patients access to a full range of health-
care options from maternity to end of life, streamlining referrals from one provider to another, and providing better
support to family physicians, nurse practitioners, and other primary health-care providers.
In addition to the above models of care, Technology Solutions will help bring health care even closer to home
for people, particularly those in rural and remote areas of the province (telehealth, digital home health
monitoring etc.)
Collaborative Local Partnerships
Primary Care Networks 16
The local PCN Steering Committee will be minimally comprised of:
• Local patient representatives
• Local First Nations representatives
• Physician representatives from local primary care practices
• Nurse practitioner representatives
• The Division
• The Health Authority
Other local partners may be invited to participate as members of the PCN Steering
Committee at the discretion of the CSC.
Questions?
Information & General Inquirieswww.patientvoicesbc.ca