A Larger Role in Primary Care

A discussion paper released in December by the Ontario Ministry of Health and Long-Term Care proposes a significant overhaul of the primary care model to deliver “more effective integration of services and greater equity… timely access to primary care, and seamless links between primary care and other services.” The report proposes that each of the province’s 14 Local Health Integration Networks “bring the planning and monitoring of primary care closer to the communities where services are delivered.”

This is an important community conversation that is overdue. The Guelph Family Health Team (FHT) supports an improved model for providing primary care that better serves the health and lifestyle of patients while promoting efficiencies and savings across the system.

We should be looking to the organizations that are already successful at doing more or less what the Ministry has proposed. Our peers at the Guelph Community Health Centre are a solid example – they have been working on collaborative approaches to community healthcare for many years. Guelph FHT is another example. We are a non-profit corporation that brings family doctors and registered nurses together with other healthcare specialists such as nurse practitioners, pharmacists, dietitians, mental health counsellors and community agencies for a ‘wraparound’ care team approach to patient wellness. Serving Guelph for 10 years, our work has included leading collaborative, community-led and team-based healthcare solutions. The Guelph FHT is already attracting provincial attention as a best-practice model for collaborative and proactive primary care. Currently, the majority of family physicians and about 85 per cent of patients in Guelph participate in the Guelph FHT model.

Guelph FHT is a logical choice to assume greater responsibility for coordinating primary care in our community. Family Health Teams are well established in Canada, and especially in Guelph, where we are seen as a best practice with a proven track record of meeting community objectives. We are in a strong position to continue a leadership role in delivering the best healthcare to everyone in Guelph.

The traditional approach of going to the doctor or emergency department when you need medical attention is evolving to that of a care team that offers patients medical and wellness support for every need in every stage of life, with the goal of keeping patients healthy so they are sick less often. In the Family Health Team model, doctors are the quarterbacks of a full team they regularly interact with, rather than a sole practitioner providing medical care or referrals to external medical specialists or community supports.”

Guelph FHT patients can also access after-hours clinics and specialized programs such as Diabetes Care Guelph and Health Link, a program run in collaboration with more than a dozen community agencies to identify high-risk patients and create a care plan to address their specific needs in a proactive, personalized manner. The Guelph Health Link initiative, recently recognized as best-in-class with a provincial award from the Association of Family Health Teams of Ontario, is designed to improve complex and vulnerable patients’ wellbeing while reducing their impact on the healthcare system.

The effort is leading to faster response time for patients, who may not need to visit their doctor but can be helped by a Nurse Practitioner or other specialists such as a mental health counsellor. In need of advice from a Registered Dietitian? There’s someone down the hall. Looking to ensure your Pharmacist has a full understanding of your medical situation? No problem – they’re part of the team, too. Interested in some free workshops to learn how to improve your wellbeing? The Guelph FHT runs several. In addition to faster and more comprehensive access, the FHT model is demonstrating improved efficiencies across the system, and a proactive approach to patient care that is resulting in healthier people who are getting the right care at the right time, visiting the Emergency Department less, and overall are an reduced a strain on a burdened health-care system.

Careful and thoughtful planning, and significant stakeholder engagement, will be necessary before moving forward, it would be relatively easy to leverage the same person-centred approach to delivering a wider array of healthcare services to the entire community.

We look forward to participating, to delivering on a strong community imperative to do this right, and to the best possible primary care in Guelph.

Traditional Primary Care Model and Family Health Team Model

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